US Congressman Elton Gallegly
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Elton Gallegly for Congress

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[ ] Enclosed is my contribution by personal check (payable to Elton Gallegly for Congress) in the

amount of:

 

     [ ] $4,800 per couple (maximum primary donation) [ ] $2,400 per person (maximum primary donation)

     [ ] $1,000 per person [ ] $500 per person [ ] $250 per person [ ] Other $_____________

 

Please mail completed form with your donation (or address inquiries) to:

Elton Gallegly for Congress

PO Box 940001

Simi Valley CA 93094-0001

Phone: (805) 522-4487

 

ALL CONTRIBUTORS MUST COMPLETE THE FOLLOWING INFORMATION. WE ARE REQUIRED TO REPORT THE NAME, ADDRESS, OCCUPATION AND EMPLOYER OF ALL CONTRIBUTORS*.

 

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Full Name                           & nbsp;                                           ;               Your Spouse’s Name & Signature (Required if Joint Contribution)

 

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Occupation                           & nbsp;                                           ;                       Employer

 

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Spouse’s Occupation (Required if Joint Contribution)                  ;   Spouse’s Employer (Required if Joint Contribution)

 

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Your Address

 

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Contributions are not deductible as charitable contributions for federal income tax purposes. *

 

Federal Election Law requires us to report the name, address, occupation, and employer for contributions aggregating in excess of $200 in an election cycle. The maximum an individual may contribute is $2,400 for the primary election and an additional $2,400 for the general election. Couples may contribute $4,800 for the primary and general elections, respectively. Federal PACs may contribute $5,000 for each election. Contributions from corporations, labor unions, federal government contractors, national banks, and foreign nationals without permanent residency status are prohibited.

Paid for by Elton Gallegly for Congress — FEC# C00194803
Paid for and authorized by Gallegly for Congress. Not paid for at government expense.
PO Box 940001 | Simi Valley CA 93094-0001 | (805) 522-4487 | (805) 522-1287 fax
E-mail: elton@gallegly.com (Please include a U.S. Postal Service address if you wish a response.)

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