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1. Amount

$77.55

Includes the processing fee

2. Your information

Law requires we ask for your employer and occupation. If you don't have an employer or are retired, put N/A, and if you are self-employed put "self-employed" in employer and describe your occupation.
Contributions are not tax deductible.

3. Payment information

- I am a U.S. citizen or lawfully admitted permanent resident (i.e., green card holder). - This contribution is made from my own funds, and funds are not being provided to me by another person or entity for the purpose of making this contribution. - I am making this contribution with my own personal credit card and not with a corporate or business credit card or a card issued to another person. - I am at least eighteen years old. I am not, nor am I making this contribution on behalf of, a corporation, labor organization, national bank, foreign national without a green card, a federal contractor, or any other federally impermissible source.
$77.55