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Campaign/Fund Information
Campaign/Fund * NYSAPLS LS PAC
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Donation Information
Donation Amount *

OTHER: $ 
Payment Method *
Donation Type *

Contributor Type *
LLC or PLLC Ownership Information (if applicable)
The NYS Board of Elections requires any donation by an LLC or PLLC to include ownership information. PLEAST LIST ALL OWNER NAMES AND PERCENT SHARE IN COMPANY ABOVE.
Donor Comments
Donor Information
First Name *
Middle Name
Last Name *
Suffix
Organization
Email *
Address *
Address Cont.
City/Town *
Country *
State
Postal Code*
Phone *
     
Billing Information
[ Click here if billing address is the same as donor address ]
 *  
Organization 
Address *
Address Cont.
City/Town *
Country *
State
Postal Code*
Billing Phone *

NYSAPLS, Inc.
146 Washington Avenue
Land Surveyors Building
Albany, NY 12210
518-432-4046 -- (f) 518-432-4055
info@nysapls.org

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