Kelli contribution form for website (PDF)
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Title: Microsoft Word - contribution form for website.docx
Author: kelli butler
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!
!
As!your!State!Representative!from!District!28,!I!will!work!tirelessly!to!
create!responsible!solutions!to!Arizona’s!most!critical!issues.!!We!must!
prioritize!funding!for!child!safety!and!education,!create!opportunities!
and!jobs!for!hardworking!families,!restore!our!reputation!as!a!state!that!
values!diversity!and!inclusion.!!
!
I!need!your!help!to!WIN!!!Any!contribution!will!help!me!share!my!message!with!voters.!!
Thank!you!so!much!for!your!support!!
!
!
!
Kelli!Butler,!Candidate,!State!House!of!Representatives,!District!28!
KelliButlerAZ@gmail.com!
(602)!509T2790!
www.kellibutleraz.com!
!
Please!make!checks!payable!to:!Kelli!Butler!for!Arizona!!
Mail!to:!Kelli!Butler!for!Arizona,!8316!E.!Cypress!Street,!Scottsdale,!AZ!85257!
!
The!following!information!is!required!for!campaign!reporting!purposes:!
!
Full!name:_____________________________________________________________________________________________!
!
Email:!_____________________________________________! Phone:________________________________________!
!
Address:_______________________________________________________________________________________________!
!
City,!State,!ZIP:________________________________________________________________________________________!
!
I!would!like!to!contribute:!
!
!_____$1,000!!!_____$500!!____$250!!!!!____$100!!!!!____$50!!!!_____$25!!!OTHER!$____________________!
!
Employer:__________________________________________! Occupation:__________________________________!
!
Signature:_____________________________________________________________________________________________!
!
Spouse!Name:________________________________________________________________________________________!
!!!!!
Employer:__________________________________________! Occupation:__________________________________!
!
Spouse!Signature!(if!joint!contribution):___________________________________________________________!
!
Contributions!are!not!tax!deductible!for!federal!income!tax!purposes.!The!maximum!contribution!is!
$5,000!per!person,!per!election!cycle.!Contributions!from!corporate!and!foreign!nationals!are!not!
permitted.!Law!requires!us!to!obtain!and!report!the!above!requested!personal!information.!
!
Paid!for!by!Kelli!Butler!for!Arizona!
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