Hofheinz for Congress: Make a Contribution

How to contribute to the Hofheinz for Congress 2002 Campaign

Thank you for supporting the Hofheinz for Congress 2002 Campaign.

Please complete, print, and mail the form below with your check to:

Walter Wm. Hofheinz for Congress Committee
2401 Turtle Creek Blvd. Dallas, Texas 75219

If you have any questions, please contact us at info@hofheinz2002.org or by phone at 214.363.2400.

Contribution Amount:

Email:

First Name:
Middle Name:	(optional)
Last Name:
Preferred Name:	(optional)
Organization:	(optional)
Home Street Address:
City:
State:
Zip:

Home Telephone:	(111-222-3333)
Business Telephone:	(111-222-3333) (optional)
Fax:	(111-222-3333) (optional)

Employer:
Occupation:

(Please print before continuing)

Federal law requires political committees to employ best efforts to collect and report the name, mailing address, occupation and name of employer for each individual whose contributions aggregate in excess of $200 in a calendar year.

By making a contribution, you affirm that each of the following is true:

This contribution is made from my own funds, and not those of another.
This contribution is not made from the general treasury funds of a corporation, labor organization, or a national bank.
I am not a Federal government contractor.
I am not a foreign national who lacks permanent resident status in the United States.

Paid for by the Walter Wm. Hofheinz for Congress Committee. ©2002 Walter Wm. Hofheinz.
Last modified April 4, 2005 6:37 pm