Federal law requires us to make our best efforts to collect employer and occupation information from contributors.

By making this contribution, you affirm that the following statements are true and accurate:

• I am a United States citizen or permanent resident (e.g. greencard holder) or I am a representative of a corporation that is chartered and operating in the U.S., the funds are derived from U.S. revenues, and no foreign national has participated in the decision to make this contribution

• This contribution is made from the funds of the above-listed contributor, will not be reimbursed by another, and, if this contribution is made via credit card, it is being made with a card for which the contributor has a legal obligation to pay and will not be made on the card of another

Contributions to Conservative Action Fund are not tax deductible for federal income tax purposes.

Contributions from foreign nationals are prohibited.

Federal government contractors should consult counsel prior to making a contribution to Conservative Action Fund.

Conservative Action Fund is registered with the Federal Election Commission as an independent expenditure-only committee and may accept unlimited contributions from individuals, corporations, and other organizations. Your contribution is not subject to FEC contribution limits. Conservative Action Fund’s spending is independent, and it does not make contributions to, or coordinate its spending with, any candidates or political parties.

Mail: To contribute by mail, please send a check made payable to “Conservative Action Fund” to:

Conservative Action Fund

138 Conant Street

Beverly, MA 01915

Please include your full name, address, email address, occupation and employer in the envelope.