YES! TED LIEU CAN COUNT ON MY SUPPORT!

(Please make check payable to Ted Lieu for State Senate 2014 ID# 1333752)
[__]

$8,200*
[__] $500

[__] Please bill my:

$4,100
$250 [__] $100
[__]

[__]

[__] Visa

[__]
[__]

[__] Master Card

$2000
[__] $1000
Other $_________
[__] American Express

Card #____________________________________________
Expiration Date____________
In the amount of $_____________________
Signature_________________________________________ __________________________________
Name, as it appears on credit card
You may use my name as an endorser:________________________________________
Please sign here
*The following information is required by law for each contribution:
*Donor Name: _______________________________________________________________________
*Street Address: _____________________________________________________________________
*City/State/Zip: ______________________________________________________________________
*Occupation: ________________________________________________________________________
*Employer: _________________________________________________________________________
(If Self-Employed, Name of Company)
Home Phone: _________________________ Business Phone: ________________________________
E-mail : ___________________________________________________________________________
FOR MORE INFORMATION, PLEASE CALL (562) 981-2111
MAILING ADDRESS: TED LIEU STATE SENATE 2014 FPPC ID# 1333752
4320 Atlantic Avenue #125, Long Beach, CA 90807
Contributions are not tax deductible as charitable contributions for income tax purposes
Lobbyists registered to the agency of the officeholder may not contribute. The California Political Reform Act (Prop. 34) places limits on contributions (including loans) to
candidates for state office and imposes certain prohibitions.
This request does not seek a contribution in excess of applicable limits or from prohibited sources.
An individual, political action committee, association, committee, partnership, business or corporation may contribute a maximum of $4,100 to Ted Lieu for State Senate per
election. *A Small Contributor Committee may contribute a maximum of $8,200 to the committee per election.