Automatic Bank Deduction Contribution

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Monthly Donations Really Add UP!

The Bonneville Democrats need your financial help on an on-going, sustanining basis to help provide the resources our candidates need when they run for office, and to provide a headquarters during the campaign season. The most efficienct method both for us and for many of our supporters is to set up a automatic checking account monthly donation. That way you can count on a small amount being withdrawn each month and we can budget and make longer term plans. If you can donate $5, $10 or more each month it will really help.

Print this page, fill out the form, attach a voided check, and give to our Treasurer, Neil Williams, and we will do the rest. Send your form to:

Neil Williams, Treasurer Bonneville County Democratic Central Committee
P.O. Box 50821
Idaho Falls, ID 83405

Bonneville Democrat's Monthly 'Direct-Deposit' Contribution Authorization Form

Bank Name: __________________________________ Branch Routing #: _____________________________________________

Account #: _______________________________________________________________ (Attach a voided check.)

For the purpose of the Idaho Democratic Party and the Bonneville Democrats I,

_______________________________________________________________________________________________________________,
(first and last name)
authorize the bank named above to honor drafts drawn by the Bonneville Democrats in the amount of

$ _________________________________________________ per _____________________ effective _______/_______/_________

Signature: __________________________________________________________________________Date: ____________________

Address: ________________________________________________________________ City ________________________________

Zip: _____________________________ Phone (______)_________________ eMail: _______________________________________

Occupation: _____________________________________ Employer: __________________________________________________

Paid for by the Bonneville Democrats, Neil Williams, Treasurer. Your contributions may be used in connections with federal elections and are subject to the limitations and prohibitions of the Federal Elections Campaign Act. Federal law requires us to request and report the name, address, occupation, and name of employer whose contributions exceed $200 per calendar year. Contributions more than $50 in a calendar year will be reported the the Idaho Secretary of State.

Not authorized by any candidate or candidate committee.