WE TRUST THE RESULTS....WE JUST NEED TO VERIFY THEM!

We appreciate your help in verifying. Your contribution is greatly appreciated.

Remember, contributions are not tax-deductible and Michigan Campaign Finance Law requires us to report the name, mailing address, occupation and employer for individual contributions so will ask for that information below.

FIRST NAME LAST NAME
ADDRESS
CITY STATE ZIP
EMAIL ADDRESS
PHONE NUMBER
REQUIRED EMPLOYMENT INFORMATION (EVEN IF RETIRED)
Michigan law requires that we obtain name, mailing address, occupation and name of the employer of individuals. This is required even if retired.
EMPLOYER'S NAME
EMPLOYER ADDRESS
CITY STATE ZIP
YOUR OCCUPATION OR RETIRED

If Making Your Recount Donation By Credit Card or Debit Card

Credit Card Information 

Name On Card
Card Type (Visa etc)
Card Number
Card Expiration Date
Three Digit Code on Back

 

If Making Your Recount Donation By Check

BANK'S NAME
BANK'S CITY & STATE
 
NAME AS SHOWN ON CHECK
ROUTING NUMBER (9 Digits)
ACCOUNT NUMBER

Select Donation Amount


Other
Legal Compliance 
Check to confirm that the following statements are true and accurate:
  1. The donation is not being provided to me by another person or entity.
  2. This contribution is not made by from the general treasury funds of a corporation.
If by check, be sure to enter this check on your register and subtract it from your balances. The amount may be deducted from you bank balance as early as the next business day.
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