Mail this completed form (or *click* here to download a PDF form) and your check, payable to: "Tom Truex, Campaign Account"

Mail to:

              Mayor Tom Truex
              P.O. Box 291671
              Davie, FL 33329

Phone: 954-797-9168
Email: truex@davie.org
Web Page: www.davie.ORG

Contribution of $__________________ is enclosed (State Law limits all contributions to $500 for any single individual or corporation)

Information: Please provide the following information. Your name and address are necessary for the Campaign Reports required by State law. Your phone number and email address are helpful, but not required.

Print Name: (Required)

Address: (Required)

Phone:

Email:

Occupation or Nature of Business:

(IMPORTANT: State Law requires disclosure of an occupation for contributions totalling more than $100 from any individual or corporation)