Sherman for Congress
Credit Card Donation Form

  1. Print this page.
  2. Fill out all items on the form.
  3. Fax to (818) 817-3633
    or mail to 4570 Van Nuys Boulevard, #270, Sherman Oaks, CA 91403.
  4. Personal checks can be made payable to Sherman for Congress and mailed to the address above. Please send the completed form with your contribution.
  5. Need help?  Call (818) 817-9555 for assistance.
Name on card:
Individuals may contribute a maximum of $2300 per election.  Please circle the amount of your donation:
 
$2300 $1000 $500 $250 Other: $               

Card Number: Expiration Date:
Signature: Today's Date:
Circle the type of card:
 
VISA MASTERCARD AMERICAN EXPRESS
 
Please fill out all of the following information.   If you are unemployed, write "none" in the space for employer.
Name:
Address:
City: State: Zipcode:
Phone Number:
Fax Number:
E-mail Address:
Occupation:
Employer:
Federal law requires political committees to report the name, mailing address, occupation, and employer for each individual whose contributions aggregate to $200 or more per calendar year.
Corporate contributions cannot be accepted.   Contributions are not tax deductible.

Paid for by THE SHERMAN FOR CONGRESS COMMITTEE-- FEC# C00308742