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To make a contribution, print this page and mail it to: Committee to Elect Ted Hess-Mahan Please make checks payable to the Committee To Elect Ted Hess-Mahan Individuals may contribute up to $500 to a candidate during a calendar year by law. If you contribute $200 or more, please also provide your occupation and the name of your employer. Enclosed is my contribution of: [ ] $200 [ ] $100 [ ] $50 [ ] $25 [ ] Other $____________ Name: _________________________________ Address:
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