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RECLAIM the REPUBLIC RESTORE the CONSTITUTION If you would prefer to donate by mail, make checks payable to Campaign For Liberty and mail to: Campaign For Liberty, PO Box 104, Lake Jackson, TX 77566. Personal Information Federal Law requires us to use our best efforts to collect the following information for each donor. Please verify that all fields marked with the red color contain correct information and address the following errors: Title First Name Middle Name Last Name Suffix Mr. Ms. Mrs. Dr. Other Address 1 Address 2 City State Zip Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island Puerto Rico South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming AA AE AP Email Address Phone Number Company Title Contribution Information Please select amount you would like to contribute. $10.00 $25.00 $50.00 $100.00 $250.00 $500.00 $1,000.00 $1,500.00 $2,500.00 Other .00 Want to make this a monthly recurring donation? Click here to sign up as a Patriot Club monthly contributor! Payment Information Credit Card PayPal Bitcoin Card Type Card Number Expiration Date Security Code Visa MasterCard Amex Discover 01 02 03 04 05 06 07 08 09 10 11 12 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 My billing address is the same as my mailing address Address 1 Address 2 City State Zip Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming AA AE AP After clicking 'Make Donation' button you will be redirected to CoinBase website to complete transaction. After clicking 'Make Donation' button you will be redirected to PayPal website to complete transaction. Because of Campaign for Liberty's tax-exempt status under IRC Sec. 501 (C) (4) and its state and federal legislative activities, contributions are not tax deductible as charitable contributions (IRC § 170) or as a business deduction (IRC § 162(e)(1)). Processing... Please wait while your donation is being processed. x Close x Verify address Please check if the following address is your mailing address. Yes, this is correct No, I need to change it x Verify address We are still not able to verify your mailing address. Are you sure it is correct? Yes, it is correct No, I need to change it Campaign for Liberty RECLAIM the REPUBLIC. RESTORE the CONSTITUTION. © Copyright 2014 Campaign for Liberty...