National Cotton Council's
Committee for the Advancement of Cotton
(CAC)
PO Box 2995
Cordova, TN
(901) 274-9030

Credit Card Contribution Form

CAC is the political action committee for the National Cotton Council. CAC was established to support candidates for federal office who support the NCC's policies and positions.

Contributions to CAC are not deductible as charitable contributions for federal income tax purposes. Contributions to CAC are strictly voluntary and the contribution guidelines given are only suggestions. You are free to contribute more or less than the guidelines stated; NCC will not favor or disadvantage anyone by reason of the amount of their contribution or their decision not to contribute. You also have a right to refuse to contribute without reprisal.

Federal law requires the PAC to use best efforts to collect and report the name, mailing address, occupation, and employer name of each individual whose contributions exceed $200 in a calendar year. CAC cannot accept corporate contributions. Contributions from partnerships require the name of the partners and their percentage of participation in the partnership.

As this is a communication intended for members of the NCC's "restricted class" only, please do not forward.

The minimum contribution by credit card is $100. To contribute by credit card, please complete the forms below.

PAYMENT INFORMATION

American Express, Mastercard, Discover, or Visa ONLY - All fields are required

Contribution Amount: *

- minimum contribution is $100

Credit Card Number: *

- numbers only, no hyphens

Security Code: *

- For American Express, this is a 4-digit number on the front of your card.
- For Mastercard or Visa, this is a 3-digit number on the back of your card.

Expiration Date: *

- enter as MMYY, for example, 0317 for March 2017

Billing Information for this Credit Card

Prefix:

First Name: *

Middle Name:

Last Name: *

Suffix:

Address: *

City: *

State: *

ZIP Code: *

**Please verify you are not a robot by entering the text in the box below:**

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To complete your contribution, please click the below button. It may take a few seconds to process your credit card information, so DO NOT click your back button or re-click the button once it has started.