HJTA Donations | Howard Jarvis Taxpayers Association

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If contributing as a BUSINESS or other entity, please click here.

Donor Information (INDIVIDUAL): *required fields

First Name:*

Last Name:*

Address 1:* Unfortunately, we cannot accept a P.O. Box address. Please provide
a street address. You may also enter an alternative mailing address
in Address 2.

Address 2:

City:*

State:*

ZIP Code:*

Email Address:*

Phone Number:

Occupation:*

Employer:* If self-employed, please put name of business. If retired, please put "none".
Occupation and employer information is required by state law for donations to campaign committees. Thank you.

INTERMEDIARY: If you are making this contribution on behalf of someone else, either because you are the person's agent in control of disbursing funds at their direction held in an account under your name or because you are being reimbursed, you are an intermediary. State laws require the following information:

Name of Intermediary:

Intermediary's Street
Address (No P.O. Box): (P.O. Box addresses are not permitted.)

City:

State:

ZIP Code:

Please indicate if intermediary is an individual or a business:

Intermediary is an individual

Occupation:

Employer:

Intermediary is a business

My Billing Information: *required fields

Payment Type:*

Name on Card:*

Billing Address (if different from "Donor Information" Address): *required fields

Street Address or P.O. Box:

City:

State:

ZIP Code:

Card Number:* Do not use dashes or spaces between numbers.

Exp. Date:*

CVV Code:* cvv

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If contributing as an INDIVIDUAL, please complete the following fields.
If contributing as a BUSINESS or other entity, please click here.

Donor Information (INDIVIDUAL): *required fields

My Billing Information: *required fields

Billing Address (if different from "Donor Information" Address): *required fields

I confirm that the following statements are true and accurate: *required fields

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If contributing as an INDIVIDUAL, please complete the following fields.If contributing as a BUSINESS or other entity, please click here.

Donor Information (INDIVIDUAL): *required fields

My Billing Information: *required fields

Billing Address (if different from "Donor Information" Address): *required fields

I confirm that the following statements are true and accurate: *required fields

Your card will be charged the following:

If contributing as an INDIVIDUAL, please complete the following fields.
If contributing as a BUSINESS or other entity, please click here.