• YES! I want to support the Randolph County Democratic Party as it works for economic opportunity, quality education, affordable health care, safe communities, and a clean environment for all of our residents. Please accept my donation in the amount of:
  • I understand that my donation is not tax deductible.  And that the information I am providing below meets federal relegations regarding political donations.  

 
___ $25 ___$50 ___ $75 ___ $100* ___ Other: _____

FIRST AND LAST NAME: ___________________________________________________

MAILING ADDRESS: _______________________________________________________

________________________________________________________________________
E-MAIL ADDRESS:

________________________________________________________________________

HOME PHONE: __________________________________________________________

WORK PHONE:____________________________________________________________

OCCUPATION:____________________________________________________________

EMPLOYER:______________________________________________________________

Federal law requires political committees to use their best efforts to collect and report the name, mailing address, occupation and name of employer of individuals whose contributions exceed $200 in a calendar year.

Federal law prohibits contributions to a political committee from:

  • the general treasury funds of corporations, labor organizations or national banks (including corporate credit cards);
  • any person contributing another person's funds;
  • foreign nationals who lack permanent resident status; and
  • government contractors.

A political committee may accept contributions from minor children (i.e., persons under 18 years of age) if the minor makes the decision to contribute knowingly and voluntarily, and the child contributes his or her own funds, and the contribution is not controlled by another individual or made from the proceeds of a gift given to provide funds to be contributed.

Donations to the Democratic Party are not tax-deductible for federal income tax purposes.

 


Please send this form with a check or money order made out to
“Randolph County Democratic Party” to:
Randolph County Democratic Party, P. O. Box4814,  Asheboro, NC 27204