Contribution Form

Shlikas for Senate Contribution Form

To contribute to the Shlikas for Senate Campaign, please make check payable to Shlikas for Senate mail this form to:

Shlikas for Senate

10308F Sunnylake Place

Baltimore, Maryland 21030

The maximum contribution an individual may make to Shlikas for Senate is $2,700 for the general election.  A couple may contribute up to $5,400 from a joint account as long as both individuals sign the check or sign above.  A multicandidate federal PAC may contribute up to $5,000 for the general election.

Contributions to Shlikas for Senate are not deductible for federal income tax purposes. Contributions from corporations, foreign nationals and federal government contractors are prohibited.

Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation and name of employer for each individual whose contributions exceed $200 per election.

Name:______________________________________________________

Address:____________________________________________________

City:_________________________________________________

State:__________________________________________

Zip:_________________________________________

Email:_____________________________________________________

Employer:_____________________________________________________

Occupation:____________________________________________________

Spouse’s Email (if applicable):_____________________________________________________

Spouse’s Employer (if applicable):_________________________________________________

Spouse’s Occupation (if applicable):________________________________________________

 

Paid for by Shlikas for Senate

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