| Donate
by Mail |
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Please print this page, fill in ALL fields and mail with your check
to:
Moore for Senate Committee, PO Box 496, Uxbridge, MA
01569 |
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| 1.
Your
Information: (All
fields are required unless otherwise noted) |
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| Name:* |
______________________________________________________________________________ |
| Address:* |
______________________________________________________________________________ |
| City:* |
___________________
State:* ______ Zip:* ___________ |
| Telephone: |
______________________________
(optional) |
| Email
Address |
______________________________
(optional) |
| Occupation:* |
______________________________________________________________________________ |
| Employer:* |
______________________________________________________________________________ |
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2. Please
confirm and sign below:
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Enclosed
is my check in the amount of $_________ made
payable to the Moore for Senate Committee. I confirm
that the following
statements are true and
accurate:
- I
am a United States
citizen or a permanent
resident alien.
- I
am making this
contribution from my own
funds, and not those of
another.
- I
am at least 18 years of
age.
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| Your
signature:
__________________________________________________________________ |
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|
Massachusetts
Campaign Finance Regulations
- Massachusetts law requires that we request the
name and address of each donor.
- For
contributions of $200 and above, we are
required to report your occupation and
employer
- Contributions
are limited to $500 per candidate per
calendar year ($200 for registered
lobbyists)
- Corporate checks
cannot be accepted under state law.
- Campaign
contributions are not tax deductible.
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