Contribution Form

Make a Contribution

To make a contribution today by credit card, please fill in your information below. Florida law requires us to collect complete contact information, as well as the occupation and employers of contributors.

If you prefer, you can also mail your contribution to the Alan Williams for Supervisor of Elections Campaign to P.O. Box 10169, Tallahassee, Florida 32302.

Contribution Limit Per Contributor: $250.

Contribution Information

$25.00$50.00$100.00$200.00$250.00 $

Contact Information

First Name

Last Name

Phone/Mobile Number

Address 1

Address 2

City

Country

State

Zip

Employer Information

Employed Not Employed Retired

Employer

Occupation

Payment Method

Credit/Debit Card eCheck Transfer

Card Type

Card Number

Expiration

Security Code

Bank Name

Account Type

Name on Account

Routing Number

Account Number

Legal Compliance

*ECMSProcessing.com will appear on your statement*

Type the code Shown

I affirm that the following statements are true and accurate:

(1) I am a United States citizen or an individual lawfully admitted with permanent residence status;

(2) This contribution is made from my own personal funds and not those of another; and

(3) Contributions are not tax deductible as charitable contributions for federal income tax purposes.

Political advertisement paid for and approved by Alan Williams for Leon County Supervisor of Elections.