POLITICAL CAMTAIGN CONTRIBUTION REQUEST 6/99/48 Stale: Local: Date: RECIPIENT LNFORMATON WlcqyKv Name Kles divedual Candud:ic Fun-duLiSn ? Address aKuale_ Rl 3049 Ocisb Mo l?O28 District Current Office And Aspired Office and District At CALnil Iod Party Leadership Position Committees Mat- Chalmunshinal CONTRIBUTION INFORMATION 4275 Amount 401-7710 MO 01 Account Code Check Payable to LpniLle Ll A keax / Address (Only if different from addrcss abovc) (aq8 Notes: 08 Ye (Date needed; fundraiser date; Other info. Approved by: (Rcgional Vixe President' signalure ) 1nAYL Senior Vice President' signature) Revised 295 TI1712-0190
POLITICAL CAMTAIGN CONTRIBUTION REQUEST Date: 6/99/48 Stale: Local: RECIPIENT LNFORMATON Kles WlcqyKv Name divedual Candud:ic Fun-duLiSn ? Address 3049 aKuale_ Rl Ocisb Mo l?O28 Current Office And District Aspired Office and District CALnil At Iod Party Leadership Position Committees Mat- Chalmunshinal CONTRIBUTION INFORMATION 4275 401-7710 MO 01 A keax / LpniLle Ll Amount Account Code Check Payable to Address (Only if different from addrcss abovc) Ye 08 (aq8 Notes: (Date needed; fundraiser date; Other info. Approved by: (Rcgional Vixe President' signalure ) 1nAYL Senior Vice President' signature) Revised 295 TI1712-0190