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Employer

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Business Street Address

Apt / Suite / Floor (optional)

City

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ZIP

Are you an owner, principal officer or senior manager of an organization that does or is proposing to do business with the City?

Yes

No

If a contributor has business dealings with the City as defined in the Campaign Finance Act, such contributor may give only up to $250 for city council member, $320 for borough president, and $400 for mayor, public advocate or comptroller.

Find out the rules on contributions from people doing business with the City of New York

Please enter the following personal information:

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First Name

Last Name

Residential Street Address

Apt / Suite / Floor (optional)

City

State

ZIP

Email Address

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Is your billing address the same as your residential address?

Yes

No

My credit card billing address differs because:

My card is billed to my work address.

I recently moved.

My card is billed to a P.O. Box or mail drop.

Other.

Although my billing address is different than my home address, the card is paid from my personal funds.

Please enter the following billing information:

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Billing Street Address

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City

State

ZIP

Please review contributor information below. Click “Back” to change any details.

Contribution Amount:
Name:
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Employer:
Occupation:
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Doing business with NYC:

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Angela Aquino