Mail-In Support for
Silveira v. Lockyer lawsuit
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Print and Mail this form to:

Keep and Bear Arms

12500 N.E. Tenth Place

Bellevue, WA 98005

I appreciate the hard work going into the Silveira lawsuit and am committed to doing my part. Enclosed is my contribution to help restore and preserve my right to Keep And Bear Arms. Please use my contribution to prepare the best possible legal case, and keep up the great work!

Method of Donation(s)

Frequency of Donation: One-time: ____  Monthly: ____  Quarterly: ____  Annual: ____
For Interval Donations: Please bill my credit/bank account on or near the _______ of the month.
Type of Donation: Check: ____  Money Order: ____  Credit Card: ____  Bank Draft: ____
NOTE: Please make check payable to
Bank draft note: Please include voided check with this form.

Type of bank account:  checking: _____  savings: _____
Enclosed is: $10 __  $25 __  $50 __  $100 __  $250 __  $500 __  Other $_________
Credit Card Info: Card # ________-________-________-________  Exp. Date: _________

Personal Info:

Mr. Mrs. Ms. Name (print) ___________________________________________________

Address: _________________________________________________________________

City/State/Zip: _________________________________________________________

Telephone Number: __________________________________

E-mail address: ___________________________________________________

Signature: __________________________________________

Please contact at any time to alter your arrangement for supporting our efforts. Please allow 5-10 business days to be notified by email or postal mail that your donation has been received and processed. Please make check payable to Thank you for helping us prepare the best possible lawsuit we can.