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Name
Address
City
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Home Phone
Office Phone
Fax
Email
Occupation
Employer
I would send my gift for better representation:
$25
 $50
 $100
 $250		 $500
 $1000
 $3300
 Other
I would also like to support the campaign by (check all that apply)

Fundraising for the campaign
Use my name as an endorsement
Distributing campaign literature in my neighborhood
Telephoning voters to spread the word.
Hosting a "Coffee" at my house.
Working to "Get-Out-The-Vote" on Election Day.
Place a yardsign on my lawn or business.

Contributions are not deductible as charitable contributions for federal income tax purposes. The maximum an individual may contribute is $3300 and $6600 per couple. Corporate and union contributions are permitted except for contributions from national banks and national coporations or corporations established by an Act of Congress. Contributions from foreign nationals and foreign corporations are generally prohibited. However, contributions from foreign individuals with permanent residence status (green cards) and corporation subsidiary funds not directed or controlled or transferred by a foreign corporation may be legal. If questions contact campaign committee (626) 480-8086 or Federal Election Committee at (800) 424-9530 or Fair Political Practices Commission (FPPC) before contributing. Federal law requires us to report the name, address, occupation and name of employer for each individual whose contributions aggregate in excess of $200 in an election cycle. Small contributor committees, other committees and political parties may contribute higher amounts. Please make your check payable to "Committee to Elect Rolando Valera For Water Board" Campaign ID#1279438

Campaign ID#1279438