Dear fellow patriot,

Please consider helping my re-election campaign by making a financial contribution today. Thank you so much for your continued support. I enjoy representing your best interests in Harrisburg, but I can't continue to do it without your help.

Amount:	$250.00 $500.00 $1000.00
Occupation:
OR check here if not employed.
Employer Name:
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Employer Address:	AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWYGUPRVI
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This form accepts all major credit cards and PayPal payments. You may be asked for your address. This information is needed for compliance with Pennsylvania's Campaign Finance regulations. Thank you.

Click here for a PDF form you'll need to print, fill out and submit with your contribution. Filling out this form completely will make it possible for us to comply with government regulations for reporting campaign activities.

Cash contributions can be accepted, but there are a few legal stipulations:

• anonymous contributions are prohibited, and must be turned over to the state
• cash contributions over $100.00 are prohibited
• cash contributions over $50.00 must be accompanied by a completed copy of this form. Filling out this form completely will make it possible for us to comply with government regulations for reporting campaign activities.
  
  

Sending cash via US mail is not recommended.

Candidates and their committees are required to report the name, mailing address, occupation and employer information for each individual whose contributions aggregate in excess of $200.00 in a calendar year. We choose to collect this information for all contributions in order to ease compliance.

The IRS requires us to print "contributions are not tax-deductible" on all fundraising appeals. The Pennsylvania Election Code prohibits contributions to a candidate or a candidate's committee from:

• the general treasury funds of any national or state bank or any corporation or unincorporated association, with the specific exception of political committees
• any person contributing another person's funds or on behalf of any third party

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