Credit Card

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Electronic Check

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Employment

We are required to use our best efforts to collect and report your occupation and employer.

Please do not leave blank or enter 'N/A'.

If self-employed, enter 'self'; if unemployed enter 'none' or 'retired'.

Please complete even if self-employed; enter 'none' or 'retired' if unemployed.

Your total one-time contribution will be

Contributions to political candidates and committees are not deductible for federal income tax purposes.

Authorized by Committee to Elect Chasity L. Wells Armstrong. A copy of our report is filed with the State Board of Elections and is available on the Board’s official website or for purchase from the Board in Springfield, IL. All contributions are reported. The names, occupation and employers of donors are required to be reported. Political donations are not tax deductible.