A non-partisan effort to reform state government in Pennsylvania

PACleanSweep PAC Contribution

Thank you for supporting us with your generous contribution. Simply print this form, fill it out completely and mail it to the address listed below with your contribution. We are required by the Pennsylvania Election Code to report this information to the Department of State. Anonymous contributions are prohibited.


*Your Name:

Amount:

*Address:


*City, State, Zip:


Email:


Home Phone:


*Occupation:


*Employer
Name &
Address:







* indicates required information
Government Mandated Notice
PACleanSweep is required to report the name, mailing address, occupation and employer information for each individual whose contributions aggregate in excess of $200.00 in a calendar year. We choose to collect this information for all contributions over $25.00 in order ease compliance.

The IRS requires us to print "contributions are not tax-deductible" on all fundraising appeals.

The Pennsylvania Election Code prohibits contributions to a political committee from:
  • the general treasury funds of any national or state bank or any corporation or unincorporated association, with the specific exception of political committees
  • any person contributing another person's funds or on behalf of any third party
Mail to PACleanSweep PAC, 109 West Main Street, Annville PA 17003

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