Contributions

Name: ___________________________________________________________

Street: ___________________________________________________________

City: ______________________________ Zip Code: ______________________

Phone: __________________________________________________________

Profession/Trade: __________________________________________________

Employer: ________________________________________________________

I know campaigns are expensive and Mike does not accept money from businesses. Enclosed is my check for:

$25
$50
$75
$100
$200
$500
Other: $______________

Election regulations require that contributions of $100 or more be accompanied by the above information.

Print this page and send it along with your contribution. The campaign ID # is 1289674.

Checks should be made payable to Committee to Elect Mike Katz and mailed to:

46 Estabrook St.
San Leandro, CA 94577-5908

Web design donated by Y.Day Designs