Full Name: Address:
City: State: Zip Code:
Occupation: Employer:

Send donations of check or money order to:
Stahlberg for Sheriff
c/o Steven Stahlberg, Treasurer
100 Cooperative Way, Suite 100
Kalispell, MT 59901

Contributions are not tax deductible. An individual may contribute a maximum of $170 per person.

Federal law requires us to use our best efforts to collect and report the name, address, occupation, and employer of each individual that contributes during an election cycle.

By donating I am affirming that:

1. I am a United States citizen or “green card” holder at least 18 years of age.

2. I am making this contribution with my own personal funds, and I am not using funds provided by any another person or from any corporation, labor union, or national bank to make this contribution.

3. I am not a federal contractor.