VOTE PAC Contribution Form

Contribute to VOTE (Veterinarians Organized to Elect) PAC and receive a tax credit against your Oregon income taxes on the amount you contribute—up to $100 per couple who file jointly and $50 for an individual return.

This tax credit (not a deduction) is exclusive to Oregon and is taken on Form 40-Long Form, Oregon Individual Income Tax Return (line 37). Credit applies to only one PAC donation and does not apply to federal taxes.

Contribution Level

Other Contribution Amount

$1.00

Total Amount

Contact Information

Your First Name *

Your Last Name *

Clinic *

Start to type the first few letters of your clinic and then select it from the list. Be patient as the system is queried. If you cannot find your clinic, please contact the OVMA at membership@oregonvma.org for assistance in completing this form. If you don't work at a clinic at this time, please choose None.

Phone *

Email Address *

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *