NAIFA-Texas PAC Contribution Request
NAIFA-Texas PAC Contribution Request
If you are a current NAIFA-Texas member and would like to request a PAC check for your Representative or Senator, please complete the form below. A NAIFA-Texas staff member will reach out to you once the form is reviewed by the Texas IFAPAC Executive Committee. PAC Contribution Requests take approximately three (3) to six (6) weeks to complete.
Member Name
*
First Name
Last Name
Member Email
*
example@example.com
Member Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Are you an Insurance and Financial Advisors Political Action Committee (PAC) contributor?
*
Yes
No
Elected Official or Candidate Name
*
Please enter the name of the intended check recipient.
Office and District Number
*
Please enter the office and district number of the intended check recipient.
Do you have a relationship with the Elected Official or Candidate listed above? If yes, please describe below
*
Requested Contribution Amount
*
Amount listed should be in United States Dollar (USD) format
Why should the Elected Official or Candidate listed above receive a contribution?
*
When and where would the contribution be delivered to the intended recipient?
*
Mailing Address for PAC Check
*
Please list the preferred mailing address where you would like the check to be sent. NAIFA-Texas highly encourages members to hand deliver PAC checks to legislators.
Please provide any additional information you would like the NAIFA Texas PAC Executive Committee to consider when reviewing your contribution request.
*
A NAIFA-Texas staff member will reach out to you once the form is reviewed by the Texas PAC Executive Committee. PAC Contribution Requests take approximately three (3) to six (6) weeks to complete. Expedited requests are NOT guaranteed.
Submit
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