Mailing In Your Donation

Thank you for making a contribution to the Conyers For Congress Campaign Committee. Please mail your contribution to:

Conyers For Congress
1831 Bay Street, SE
Washington, DC   20003

Federal election law requires political committees to use best efforts to report the name, mailing address, occupation, and name of employer of individuals whose contributions exceed $200 in an election cycle. An individual may contribute a total of $2100 to the Conyers For Congress Committee for the primary election and a total of $2100 for the general election. Federal law prohibits contributions to the committee from the general treasury funds of a corporation or labor organization, from any person contributing another`s funds, from a Federal government contractor, or from a foreign national who lacks permanent resident status. Contributions and gifts are not deductible for Federal income tax purposes. Your contribution will be used in connection with Federal elections and is subject to the limits and prohibitions of the Federal Election Campaign Act.

First Name ___________________________________ Middle Initial _____
Last Name ____________________________________ Suffix ________

Spouse's Name ________________________________ Middle Initial _____
Last Name ____________________________________ Suffix ________

Your Mailing Address____________________________________________
City_______________________ State________ Zip Code___________

Home OR Work Phone required:
Home Phone ________________ Work Phone _________________
Fax _______________________

E-mail ________________________________

Your Employer _____________________ Your Occupation _____________________

Amount of Donation$_________________________________________