State law requires us to report donations to our campaign.
Please print this page and fill out this form with the appropriate information in the space provided.
Contributions to Estelle Fennell for Supervisor are not tax-deductible for federal income tax purposes.

Please make checks payable to EFFS or Estelle Fennell for Supervisor Committee.
Mail to:
EFFS
P.O. Box 501
Redway, CA 95560

The Fair Political Practices Commission requires the following information:

For All Donations $25 or Over.

(Please Print clearly)

Name______________________________________________________

Address____________________________________________________

City___________________________________ST_______ Zip_________

Home Phone___________________Business Phone__________________

For Donations of $100 and Over:

Occupation ____________________ Employer ____________________

If self-employed, business name_________________________________

Are you willing to volunteer?

Email is the most economical, energy efficient, and resource-friendly way for us to communicate with you.

Email Address:__________________________________________

Can we use your name as a supporter?

Thank You!

This form is for you convenience. You may print it out and send it in with your check.

Paid for by Estelle Fennell for Supervisor Committee

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