Vote Tyler Byrd - Online Contributions by eFundraising Connections

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The Public Disclosure Commission requires donations over $250.00 to included your Occupation and Employers Name, City and State. (being and checking retired fulfills this requirement)

$75.00
$100.00
$500.00
$750.00
$1,200.00

Per Election
$2,400.00

Per Couple
$ Other

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Iterations

This recurring donation will process on the 6th of every month.

This recurring donation will process every three months.

Phone

First Contributor

First Name

Last Name

Company Name

I agree to the following statements:

Certification that Contribution is Not From a Foreign National
I certify that the entity making this contribution is not organized under the laws of, and does not have its principle place of business in, a foreign country. This contribution is not financed in any party by a foreign national, and foreign nationals were not involved in making decisions regarding the contribution in any way.

I, the Authorized Agent listed above, certify that the entity is making this contribution. This contribution is being made, and this certification is being submitted, as of today.

Second Contributor

First Name

Last Name

Joint Address

Address

City

State

Zip

First Contributor

I am retired

Employer

Occupation

If you have no occupation or employer, do not leave blank. For occupation use general terms such as 'manager', 'homemaker', or 'none.' If not employed by a company, use terms such as 'self', 'retired', or 'unemployed.'

Employer City

Employer State

Second Contributor

I am retired

Employer

Occupation

Employer City

Employer State

Comment

The maximum contribution amount is $2400.00. Please lower your contribution amount.

Credit Card Number

MM/YY

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Please input a value between $25.00 and $2400.00

Please input a value between $25.00 and $2400.00 or select "I want to donate as a couple" to double the contribution limit.

Iterations may not exceed 32000

Total recurring amount plus merchadise may not exceed $2400.00. Please reduce the number of iterations, or reduce the payment amount.

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