Aborn For Da Contribution Form

Yes! I would like to make a contribution to Richard Aborn for District Attorney! ___ $100

___$250

___$500

___$1,000

___$5,000

___ Other

To contribute by PERSONAL/CORPORATE check, please make your contribution payable to: “Richard Aborn for District Attorney” To contribute by credit card, please provide the information below:

Please charge $

to my PERSONAL/CORPORATE credit card:

Visa / MasterCard / AMEX

Name of Cardholder: Credit Card #:

Exp. Date:

Please sign below: I designate my contribution(s) to Richard Aborn for District Attorney as follows, the first $34,748 for the 2009 Democratic primary, and any additional amount that I contribute up to $50,000 for the 2009 general election. I am making this contribution with my own personal funds and not with funds provided by any other person. 2ndSignature (Joint Accounts):

Signature required:

New York State Contribution Limits: Individuals may contribute up to $34,748 for the Primary Election and up to an additional $50,000 for the General Election, provided that s/he does not contribute in excess of $150,000 in a calendar year to all candidates for public office in New York State. During 2009, a corporation may contribute up to $5,000, in the aggregate, to candidates seeking election to non-federal office in New York. A partnership may also contribute up to $34,748 and the contribution will be attributed to its partners for the purpose of an individual’s campaign and annual limit. Campaign contributions must be from the individual or entity’s own funds and are not tax-deductible.

Please complete this form and send it to us with your check or credit card contribution: Mail:

Richard Aborn for District Attorney P.O. Box 3250, New York, New York 10163

Fax:

(646) 478-9765

Questions?:

Please contact the campaign at (212) 916-3197

Contributor #1: Name:

E-Mail:

Occupation:

Employer:

Address: City:

State:

Home Phone:

Work Phone:

Mobile Phone:

Fax:

Zip:

 Referred by: Contributor #2 (for joint accounts): Name:

E-Mail:

Occupation:

Employer:

Address: City:

State:

Home Phone:

Work Phone:

Mobile Phone:

Fax:

Zip:

Contributions to Richard Aborn for Manhattan District Attorney are not deductible for federal income tax purposes. Printed in house.