Contribution Form
Skylar Fynboh for Senate District 5
Please print clearly. Make checks payable to Skylar Fynboh for Senate District 5.
| Amount: $ | Check no. Cash |
| Date: | |
| First name: | Last name: |
| Street address: | |
| City: | State: ZIP: |
| Email: | Phone: |
| Employer, or occupation if self-employed or not employed: Required if your contributions to this campaign exceed $200 in a calendar year. |
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I am a Minnesota resident (required to claim the state refund).
Please send me an official Form EP-3 receipt (refund up to $75).
This contribution is from my personal funds, not a corporation, union, business, or another person.
I am a US citizen or lawfully admitted permanent resident.
I understand Minnesota limits individual contributions to $1000 per two-year election segment.
Signature:
Date:
Prepared and paid for by Skylar Fynboh for Senate District 5, PO Box 6, Akeley, MN 56433. Contributions are not tax-deductible for federal income tax purposes. Contributions from corporations, LLCs, partnerships, and foreign nationals are prohibited. Anonymous cash contributions over $20 must be forwarded to the Minnesota Campaign Finance Board.