UNITED CALIFORNIANS FOR TAX REFORM

CALIFORNIA SIMPLE TAX INITIATIVE

MANDATORY ENDORSEMENT AND/OR CONTRIBUTION FORM


INDIVIDUAL ENDORSEMENT

Name________________________________________ Signature ______________________

Name________________________________________ Signature ______________________

Street ________________________________ City _________________ State ____ Zip ________

Occupation (required) ______________ Employer (required) _____________________________

(If self-employed, provide name of business)

Email (optional) _________________________

Comment for possible use on our website (optional) __________________________________

_____________________________________________________________________________________

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BUSINESS / ORGANIZATION ENDORSEMENT

Name of Business or Organization_________________________________________________

Signature & Title of Authorizing Officer _____________________________________________

Street ________________________________ City _________________ State ____ Zip ________

(optional) Email ______________________ Phone ________________ FAX _____________

Comment for possible use on our website (optional) __________________________________

_____________________________________________________________________________________

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CONTRIBUTIONS (optional)

AMOUNT c $10 c $20 c $50 c $100 c $250 c $500 c other _______

Individual Contribution c Corporate Contribution c

Please make checks payable to "UNITED CALIFORNIANS FOR TAX REFORM" and write "CAL SIMPLE TAX: State ID # 942030" on the check.

 

Mail this form, plus check or money order, to:

CAL SIMPLE TAX, 14252 Culver Drive # 728, Irvine CA 92604 Thank you!!

 CAL SIMPLE TAX and the UNITED CALIFORNIANS FOR TAX REFORM operate within the regulations of the Fair Political Practices Commission of the State of California (registered with the California Secretary of State, ID No. 942030). Contributions can be accepted from individuals, corporations, and most other domestic entities. Foreign contributions cannot be accepted at this time.

Contributions to CAL SIMPLE TAX are not tax deductible.