CrossState PAC Participation Agreement Form

By submitting this participation agreement, this credit union hereby authorizes CrossState Credit Union Association (CrossState) to solicit this credit union’s members and executive or administrative personnel for contributions to CrossState PAC, the federal PAC of CrossState, and/or America’s Credit Union PAC, the federal PAC of America’s Credit Unions.

The credit union may only grant such prior approval to one trade association per calendar year. The credit union grants its permission to CrossState and America’s Credit Unions for each of the years indicated below. The credit union has not approved a solicitation from any other trade association for these years.

Name(Required)

Please re-enter your full name for each year during which you would like the permission agreement to be active.
This field is hidden when viewing the form
(Required)
This field is hidden when viewing the form
(Required)

CROSSSTATE PAC IS THE REGISTERED SEPARATE SEGREGATED FUND OF CROSSSTATE CREDIT UNION ASSOCIATION. ITS FEDERAL ELECTION COMMISSION ID # IS C00109397
Consent
I Would Like a Confirmation Email(Required)