for State Rep LD23
Seed Money Form
Please make out your check of up to $140 per individual to
"Committee To Elect Barbara McGuire 2010"
First Name: __________________ Last Name: ________________________
City: ________________________ State: _______ Zip: ___________
Preferred Phone: ________________________________
Employer: _______________________ Occupation: _______________________
State law requires us to use our best efforts to collect and report the name, mailing address, occupation, and name of
employer of contributing individuals. Candidates are prohibited from accepting contributions from corporations and foreign
nationals. Persons are prohibited from making contributions in the name of another person. Contributions are not tax deductable
for state or federal income tax purposes. An individual may contribute a maximum of $140. Couples may contribute $280 from
a joint bank account.
Content paid for by the committee to elect Barbara McGuire 2010