Mailing In Your Donation

To mail in your contribution, print the form and send it with your check payable to:

Friends of Charles Samuels
203 N MULBERRY ST
RICHMOND VA 23220-4014

Is there a limit?
There are no contribution limits for local and state offices in Virginia, unlike in federal elections.

Why do you collect certain information?
Virginia law requires us to report the name, mailing address, job title or profession and name of employer or employer`s specific field for each individual whose cumulative contributions aggregate in excess of $100 in an election cycle.

Can companies and organizations contribute?

Yes. In Virginia, individuals, partnerships, committees, corporations and labor organizations may contribute in support of or in opposition to candidates for nomination or election to public office.

First Name ___________________________________ Middle Initial _____

Last Name ____________________________________ Suffix ________

Spouse's Name ________________________________ Middle Initial _____

Last Name ____________________________________ Suffix ________

Your Mailing Address____________________________________________

City_______________________ State________ Zip Code___________

Home OR Work Phone required:

Home Phone ________________ Work Phone _________________

Fax _______________________

E-mail ________________________________

Your Employer _____________________

Your Occupation _____________________

Amount of Donation$_________________________________________

 

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Paid for by the Friends of Charles Samuels • Authorized by Charles Samuels