Committee to Elect Timur Edib

Name________________________________ Phone_______________________________

Address___________________________________________________________________

E-mail__________________________________________

Occupation/Employer _______________________________________________________

I confirm by signing the attached check that I am an American (or Lawful Permanent Resident), and that this is my own contribution.

Please make checks payable to: Committee to Elect Timur Edib

Mail to: 200A Monroe St, Ste 115, Rockville, MD 20850

______$20 _____ $50 _____ $100 ­_____ $250 _____ $500 _____ $1000

______ Other Monetary Amount $_________ (The Maximum per campaign cycle is $6,000)

______ Other In-Kind Donation of Services or Supplies $__________ (Fair Market Value)

Yes, I want to help with Timur’s incr-EDIB-le campaign!

_____ Host a Fundraiser _____ Be a Volunteer _____ Host a Yard Sign

_____ Use my name as an endorsement

By Authority: Committee to Elect Timur Edib, Raj Singh, Treasurer

By Clicking "Donate" I agree that I am: over 18 years old and a U.S. citizen or lawfully admitted permanent resident (i.e., green card holder), my contribution is made from my own funds, and funds are not being provided to me by another person or entity for the purpose of making this contribution.

THANK YOU!!