Donations

All donations made to Citizens for Ken Punter will be used to support Ken’s campaign for the 91st District. Thank you for your contribution.

THIS DONATION FORM IS PROVIDED FOR INDIVIDUAL CONTRIBUTIONS. POLITICAL ACTION COMMITTEES, PARTNERSHIPS, AND LIMITED LIABILITY COMPANIES SHOULD CONTACT CITIZENS FOR KEN PUNTER BY MAIL, EMAIL OR PHONE TO CONTRIBUTE.

You may also download this form to submit by mail. Download Donation Form Here

Personal Information

First Name: *

Last Name: *

Street Address: *

City: *

State: *

Zip: *

Phone:

email:

Work Information

Occupation: *

Employer: *

Address of Employment: *

City: *

State: *

Zip: *

Donation

I would like to donate the following amount to Ken Punter's campaign: * $

Confirmation

I AM A UNITED STATES CITIZEN OR A LAWFULLY ADMITTED PERMANENT RESIDENT OF THE UNITED STATES. I AM AT LEAST 18 YEARS OLD. THIS CONTRIBUTION IS FROM MY OWN PERSONAL FUNDS AND WILL NOT BE PAID FOR BY A THIRD PARTY, CORPORATION, LABOR UNION, OR NATIONAL BANK. I AM NOT A FEDERAL GOVERNMENT CONTRACTOR. I WILL NOT CLAIM THIS DONATION AS A CHARITABLE CONTRIBUTION ON MY INCOME TAX FORMS.

Confirmation: *

BY CHECKING THIS BOX, I CONFIRM THAT THE STATEMENT ABOVE IS TRUE AND ACCURATE