Leon Stavrinakis for SC State House District 119

Financial contributions are crucial to our campaign. We gladly accept check contributions that can be mailed to our campaign address or made online. The South Carolina Ethics Commission requires us to collect information from all of our contributors.

Please help to elect Leon Stavrinakis by contributing as generously as possible.

First Name Middle initial __ Last Name

Address _______________________________________________________

Apartment _______________________

City ________________ State ________________ Zip _______________

Daytime phone number ____________________________________

Employer _______________________________________________

Occupation _____________________________________________

Credit card type ___________________

Credit card number ____________________________ Expiration _________

Check enclosed ___

I hereby certify that the following five statements are true: *

This contribution is made from my own funds.
I am a U.S. Citizen or I have permanent legal residence in the United States.
I am not a federal contractor.
This contribution is not made from the treasury funds of a corporation, labor organization or national bank.
This contribution is made on a personal credit card or debit card for which I have the legal obligation to pay, and is not made on the card, or from the account, of a corporate or business entity or of another person.

Please make your check payable to Leon For House, 1101 Lining Lane, Charleston, SC 29407 Note: Leon For House Campaign.