Contribution Form

Lorena Gonzalez for Assembly 2014 || 642 Palomar Street, Suite 406-337, Chula Vista, CA 91911 || 619.302.1907 || FPPC ID# 1358017


Line 2:

Home Phone:
( ) -
Work Phone:
( ) -
Mobile Phone:
( ) -
( ) -



Credit Card #:
Card Type:

I have read the following contribution rules and certify that I comply with them: (1) I am a United States citizen or a permanent resident alien; (2) This contribution is made from my own funds, and funds are not being provided to me by another person or entity for the purpose of making this contribution; (3) I am making this contribution with my own personal credit card and not with a corporate or business credit card or a card issued to another person; and, (4) I am not a federal contractor.

The CA Political Reform Act (Prop. 34) places limits on contributions to candidates for state office and imposes certain prohibitions. This request does not seek a contribution of excess of applicable limits or from prohibited sources. An individual, corporation, union, PAC, and other entities may contribute a maximum of $4,100 to the committee per election, primary and genreal. A registered Small Contributor Committee may contribute a maximun of $8,200 per election. Contributions are not deductible for tax purposes. All contributions will be publicly disclosed, including those under $100.

Contact information provided will be transmitted to the committee. assumes no responsibility or obligation for the protection of the privacy of this information by the committee. Credit Card information will be used for processing only and will not be shared with the committee or any third party except for the express purposes of processing or as required by law.

This site utilizes full 128-bit encryption and fulfills the security requirements of our credit card processor to protect your privacy.