PC to Politics

Donation Page

Contributor

First Name

Last Name

Street Address

City

State

Zip

Country

Phone

Employment

Federal law requires us to use our best efforts to collect and report name, mailing address, occupation and name of employer for individuals whose contributions exceed $200 in a calendar year and in the case of candidates, election cycle.

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

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

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

Legal Compliance

I confirm that the following statements are true and accurate:

I am a United States citizen or a permanent resident alien.
This contribution is made from my own funds, and funds are not being provided to me by another person or entity for the purpose of making this contribution.
I am making this contribution with my own personal credit card and not with a corporate or business credit card or a card issued to another person.
I am not a federal contractor, nor am I a foreign national who lacks permanent resident status in the United States.
I have read and accept the Democracy Engine Terms of Service, Privacy Policy, and Refund Policy.
I am at least eighteen years old.

Recipients & Amounts

PC to PoliticsFederal PAC
$
TOTAL
$

Make this a recurring donation …

That repeats

Until

donations have been made

Stopping after

Payment Method

Credit CardElectronic Check

Select a payment method to continue …

Credit Card

Card Number Four_cards

Expiration Date

Security Code (CVV)

Electronic Check

Account Type

CheckingSavings

Routing (Bank) NumberOmit any dashes or spaces

Retype Routing Number

Account NumberOmit any dashes or spaces

Retype Account Number

By clicking the donate button below, I acknowledge that my payment is being made to Democracy Engine, who accepts the responsibility of distributing the funds to my designated recipient(s) in accordance with applicable campaign finance laws. My card or bank statement will show a payment to “Democracy Engine” or “DEMENG” and if there are any issues or discrepancies with the payment or I wish to revoke the payment, I can contact Democracy Engine at support@democracyengine.com. Democracy Engine will charge each recipient an applicable service fee.