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California law requires we ask for your employer and occupation. If you don't have an employer or are retired, indicate it in employer and put N/A for occupation. If you are self-employed put "self-employed" in employer and describe your occupation.

Contributions are not tax deductible.


$25   $50   $99   $200   $300   $400   $500   $999   $2,000   Other $





1. I am a United States citizen or a permanent resident.
2. I am making this contribution with my own personal funds, and will not be reimbursed.
3. Contributions are not tax deductible for income tax purposes.