Contributions from corporations are not permitted. Contributions are not deductible as charitable contributions for federal income tax purposes. NC law requires political committees to report the name, address, occupation and employer for each individual. All contributions over fifty dollars shall be in a check. Please left click your mouse, highlight this form, right click again and select copy, go to your document typing system, right click, select paste then print, fill out form and mail to address below.

Name_____________________________________________________

Street Address______________________________________________

City______________________________________________________

Occupation_________________________________________________

Amount  $4000_____  $1000_____  $500_____ $100_____ Other $____

Checks made to:

The Committee to Elect Starling,

Mail to:

P.O. Box 11387, Goldsboro, NC 27532, Attn: Cheryl Alleman, Treasurer.

Please indicate in an email message below if you can assist other than contributing by:

Making calls in support of Willie Ray,

Posting signs,

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