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RE-ELECT LENNY MIRRA

http://www.lennymirra.com

Contribute now to support the Lenny Mirra campaign for State Representative.

The maximum annual individual contribution amount is $500 per calendar year. Please note that the law requires us to collect your name, address, current employer and occupation. Corporate contributions are prohibited. Campaign donations are not tax deductible.

Contribution Amount

$25
$50
$100
$250

$500
$

Payment Information

Debit/Credit Card

Billing Information

Same as home address.
Billing Address
Billing Address (line 2)
City
State
Zip/Postal

Legal Compliance

I affirm that the following statements are true and accurate:

1.) I am at least eighteen years old.

2.) I am a United States citizen or a permanent resident alien.

3.) This contribution is made from my own funds, these funds are not being provided to me by another person or entity for the purpose of making this contribution.

4.) 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.

5.) I am not a Federal Contractor

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