Thank you for your interest in making a contribution.
To contribute by mail with either a check or a credit card, please print out
this page, fill in the form below, and include this page in your envelope
addressed to the Utah Democratic Legislature Fund (or D PAC):
Utah Democratic Legislature Fund (or D PAC)
89 East 4050 South
Bountiful, Utah 84010
Name*:_______________________________________________
Home Address*:________________________________________
City*:__________________________ State*:____________ Zip*:_______________
Home Phone:____________________________
Work Phone:____________________________
Mobile Phone:___________________________
E-mail Address:________________________________________________
Occupation*:___________________________________________________
Employer:_____________________________________________________
G Check this box to confirm that the following statements are true and accurate: 1) I am a United States citizen or a permanent resident alien. 2) This contribution is not made from the general treasury funds of a corporation, labor organization or national bank. 3) This contribution is not made from the treasury of an entity or person who is a federal contractor. 4) The funds I am donating are not being provided to me by another person or entity for the purpose of making this contribution. 5) I am 18 years of age or older.
If paying by check, please make your check payable to:
The Utah Democratic Legislature Fund (or D PAC).
If paying by credit card:
Card Type:_______________________________________
Card Number:_____________________________________
Expires:__________________________________________
Contribution Amount:________________________________
Signature:________________________________________
* required information. Utah law requires political action committees to report the name, mailing address and occupation for each individual whose contributions aggregate in excess of $50 in a calendar year. Your contribution will be used in connection with elections for the Utah State Legislature and is subject to the limits and prohibitions of the Utah Election Code.
Political contributions are not tax deductible.