The $5.00 Donations have been completed.  I would like to say thank you to all those who contributed!-

Don Jorgensen

 

ELECT DON JORGENSEN

to the ARIZONA HOUSE of REPRESENTATIVES

 

I am choosing to run for the Arizona House of Representatives as a “Clean Elections candidate”  This means that I will not accept any corporate donations or special interest monies,  and I will adhere to the Citizens Clean Elections Act and Commission Rules in return for receiving funding from the Citizens Clean Elections Fund.  In order to receive funding, I must collect a minimum of 220 $5 Qualifying Contributions from registered voters within Legislative District 26.

 

The Citizens Clean Elections Act is a campaign finance reform measure that was initiated by Arizona citizens and passed by voters in 1998.

Please help Don Jorgensen qualify as a participating candidate by completing this form and returning it with your $5.00

To meet the strict qualifications of state election officials:

• Contributions may be in the form of check or cash and must be exactly $5.00
• Checks must be payable to: DON JORGENSEN 2008
• One contribution form per registered voter only
• A $10.00 (ten dollar) check is acceptable from a couple, provided both names appear on the account and both husband and wife sign the check.  Each person must fill out a separate contribution form.
• This form must remain whole.  It may be photocopied, but CANNOT be altered.
• Any voter registered in Legislative District 26 can contribute regardless of party affiliation or lack of affiliation.

THIS CONTRIBUTION FORM SHOULD BE SENT BY MAIL TO:

DON JORGENSEN 2008   6460 N CAMINO ABBEY  TUCSON, AZ 85718

Candidate's Name: DON JORGENSEN          Office Sought: STATE REPRESENTATIVE  LD-26

Contributor's Name: (please print)_________________________________________________

Voter Registration Address:______________________________________________________

County::__________________________  Date of Contribution:_________________________

Signature of Contributor:_________________________________________________________

I, the undersigned, upon my oath and under penalty, verify that I received a $5.00 contribution from the above contributor, who is, to the best of my information and knowledge, a qualified elector of LD26.

SIGNATURE OF SOLICITOR:______________________________________________________

PRINTED NAME OF SOLICITOR:___________________________________________________

SOLICITOR'S ADDRESS:_________________________________________________________

Paid for by Don Jorgensen 2008