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TEN
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Declarations: The Contribution listed is for a campaign in the State of
Oklahoma, and the contribution was freely and voluntarily given by me
 $50  $100  $200  $300  $400  $500  $600
from my personal property, or the above named committee or person from
the committee’s or the person’s personal property. I (or the committee or
 $700  $800  $900  $1,000  $___________
person) have not directly nor indirectly, been compensated or reimbursed
for the contribution listed by persons other than those from whom contribu-  Visa  Mastercard  American Express  Discover
tor statements have been received and of whom disclosure has or will be
made, or, if from a person exempt from the definition of political action
committee, by other persons. Required by single contributions exceeding
$50 or multiple contributions from a single source exceeding $50 in the Credit Card Number Exp. Date Security Code
aggregate. [74 O.S. Supp. 2007. Ch. 62 App. § 257:10-1-2(c)]

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TEN PAC TEN PAC is a political action committee that supports candidates who
Checks payable to TEN PAC stand for fairness, equal rights, and opportunity for all Oklahomans.  Your
3701-A S. Harvard Ave., #183 contribution is not tax-deductible as a charitable contribution for Federal
Tulsa, OK 74135 income tax purposes.