2. Your information
NB: Election law requires that we ask for your employer and occupation. If you don't have an employer or are retired, PLEASE PUT N/A in the "Employer" box. If you are self-employed put "self-employed" in employer box and describe your occupation. Also, if unemployed or self-employed, please put N/A in BOTH the "Employer City" AND "State" boxes.
Contributions are not tax deductible.
3. Payment information