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Legal name of recipient: *

This is the legal recipient of funds.  For a candidate, this will the registered candidate committee.  For an organization, this is the legal name of the corporation (or LLC or Partnership) receiving the funds.  If there is anything complicated (such as a fiscal sponsor for a charitable project), please let us know in the notes.
Recipient (if different from the legal name):

Name of Bank *

Type of Account *

Bank Routing Number *

Must be 9 digits.
Account Number *

This will rarely be less than 5 digits.
Name and affiliation of person filing out this form: *

Recipient Terms of Service *

I agree (and am empowered to agree), on behalf of this Recipient, to the Democracy Engine LLC Recipient Terms of Service located at
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