NARPM PAC Investment Card

NARPM® PAC Investment Card
This form is for those making a one-time investment in NARPM PAC.

If you would like to set up a monthly NARPM PAC investment, please click here.

If you are looking for the NARPM Advocacy Fund, please click here.
Is this one-time or monthly investment?

One-timeMonthly
Investor Information
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Occupation/Employer
Email
example@example.com
Phone Number
Payment Information

NARPM PAC One-Time Investment*

USDDescription

Sign Date

MonthDayYear
Date
Signature

Clear
With my signature, I authorize the above transaction. NARPM® PAC cannot accept contributions from or in the name of a corporation. Only personal contributions received from individual donors can be used to support candidates. Any contributions received for NARPM PAC from a corporation will be returned. With my signature, I certify that I am a U.S. Citizen or Permanent Resident and that my NARPM PAC contribution is being made with personal funds.
Contributions to NARPM® PAC are not tax-deductible as charitable contributions for federal income tax purposes. Contributions from non-permanent resident foreign nationals are prohibited by federal law. All contributions to NARPM® PAC are voluntary. You may refuse to contribute without reprisal. Contributions to NARPM® PAC are used for federal election purposes, and may be used in connection with state elections, as well. *A contribution in the amount of $5,000 per person is the maximum allowed per year. If this solicitation suggests a contribution in a certain amount, it is only a suggestion, and you may give more, less or not at all, and the amount given or refusal to give will not benefit or disadvantage you.
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NARPM® PAC Investment Card