$4 for 4 years Donate $4 to stop Obamacare! Step 1 of 2 50% Amount*$5.00$10.00$25.00$50.00$100.00$250.00$500.00Make this a monthly recurring donationYesNoFederal law limits individual contributions to a candidate to $2,600 per individual donor per election. Contact InformationName*FirstLastEmail*Phone*Address*Street AddressAddress Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificStateZIP CodeEmployment InformationEmployer*Occupation*Payment InformationDonation Amount*Price: $0.00Credit Card*American ExpressDiscoverMasterCardVisaCard NumberMonth010203040506070809101112Year20142015201620172018201920202021202220232024202520262027202820292030203120322033Expiration Date Security CodeCardholder Name ComplianceFederal Law requires that you verify the following statements are true and accurate. I am a United States citizen or an individual lawfully admitted with permanent resident status (e.g., “green card holder”). This contribution is made from my own personal funds with a personal credit card, and not with a corporate credit card or funds provided to me by another person or entity. I am not a federal government contractor. I am at least 18 years old. Contributions to Lee Terry for Congress Committee are not tax deductible for federal income tax purposes. Contributions to Lee Terry for Congress Committee will be used in connection with federal elections and are subject to the limitations and prohibitions of federal law.