SUPPORT THE CAUSE PROSPERITY & OPPORTUNITY THROUGH ECONOMIC FREEDOM 1 SELECT YOUR LEVEL(S) OF CONTRIBUTION CLUB FOR GROWTH PAC ENDORSED CANDIDATES YOUR SUPPORT MAKES THE DIFFERENCE YOUR DONATION TO SENATE CANDIDATES We are truly grateful for each donation we receive, regardless of size and $_____________ Marsha Blackburn (TN-SEN) “Marsha for Senate” $5,400 maximum frequency. Thank you for your support. $_____________ Ted Cruz (TX-SEN) “Ted Cruz for Senate” $2,700 maximum $_____________ Josh Hawley (MO-SEN) “Josh Hawley for Senate” $5,400 maximum YOUR DONATION TO $_____________ Kevin Nicholson (WI-SEN) “Nicholson for Senate” CLUB FOR GROWTH $5,400 maximum $_____________ Matt Rosendale (MT-SEN) “Matt Rosendale for Montana” $ $2,700 maximum (amount not limited) YOUR DONATION TO HOUSE CANDIDATES Monthly recurring contribution Corporate contribution Ted Budd (NC-13) $_____________ “Ted Budd for Congress” $2,700 maximum $_____________ Michael Cloud (TX-27) “Cloud for Congress” $2,700 maximum $_____________ Andy Coleman (OK-01) “Friends of Andy Coleman” YOUR DONATION TO $8,100 maximum CLUB FOR GROWTH ACTION $_____________ Russ Fulcher (ID-01) “Russ Fulcher for Idaho” $ $2,700 maximum $_____________ Mark Green (TN-07) “Mark Green for Congress” (amount not limited) $5,400 maximum Monthly recurring contribution $_____________ Mark Harris (NC-09) “Mark Harris for Congress” Corporate contribution $2,700 maximum $_____________ Scott Perry (PA-10) “Patriots for Perry” $2,700 maximum $_____________ Denver Riggleman (VA-05) “Friends of Denver Riggleman” $2,700 maximum YOUR DONATION TO $_____________ Dino Rossi (WA-08) “Dino for Congress” CLUB FOR GROWTH PAC $5,400 maximum $_____________ Chip Roy (TX-21) “Chip Roy for Congress” $ $2,700 maximum Greg Steube (FL-17) ($5,000 maximum per calendar year) $_____________ “Greg Steube Congressional Committee” $5,400 maximum $_____________ Van Taylor (TX-03) “Van Taylor Campaign” $2,700 maximum $_____________ Ron Wright (TX-06) “Ron Wright for Congress” $2,700 maximum ON REVERSE 2 YOUR INFORMATION 3 COMPLETE PAYMENT INFORMATION 4 INSTRUCTIONS FOR RETURN GOVERNMENT MANDATED LEGAL DISCLAIMERS ALSO ON REVERSE SUPPORT THE CAUSE PROSPERITY & OPPORTUNITY THROUGH ECONOMIC FREEDOM 2 YOUR INFORMATION Name/Company ___________________________________________________________________________________ Mailing Address ___________________________________________________________________________________ City, State Zip ____________________________________________________________________________________ Phone ____________________________________ Email __________________________________________________ * Occupation ______________________________ * Employer _____________________________________________ 3 COMPLETE PAYMENT INFORMATION CREDIT CARD VISA MASTERCARD AMEX DISCOVER Credit Card Number Expiration Date Name on Card CVV/Sec. code Signature Amount(s) Indicated on front: CHECK(S) - Enclosed Amount(s) Indicated on front: Please make your check(s) payable to the campaign committee name listed for each candidate or entity on front of this form. For questions, call a Club for Growth team member at 202-955-5500 or email at [email protected] 4 INSTRUCTIONS FOR RETURN MAIL THIS FORM TO: FAX THIS FORM TO: 2001 L St. NW, Suite 600 Washington, DC 20036 202-955-9466 FOR QUESTIONS OR MORE INFORMATION, PLEASE CALL US AT 202-955-5500 LEGAL DISCLAIMERS Donations to Club for Growth are not deductible as charitable contributions for Federal income tax purposes and may be used for political purposes such as supporting or opposing candidates. No funds will be earmarked or reserved for any political purpose. Contributions from foreign nationals (non-Green Card holders), government contractors and national banks are prohibited. Donations to Club for Growth PAC and Club for Growth Action or to Federal candidate campaign committees are not deductible as charitable contributions for Federal income tax purposes and contributions from corporations, foreign nationals (non-Green Card holders), government contractors and national banks are prohibited. Contributions made to the Club for Growth PAC directly will be spent for Club PAC activities and programs as the PAC determines within its sole discretion. Contributions made directly to the PAC will not be earmarked for any candidate. All contributions are voluntary and you may refuse to contribute without reprisal. Club for Growth Action is an independent expenditure committee established by the Club for Growth. Your contribution to Club for Growth Action affirms your membership in the Club for Growth. *Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and employer of individuals whose contributions to candidates or the Club for Growth PAC, Club for Growth Action or to an individual candidate campaign committee exceeds $200 in a calendar year. Paid for by Club for Growth PAC and not authorized by any candidate or candidate’s committee. 202-955-5500.