Contribution Form
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Important News: During the recently concluded legislative session, the legislature passed a public financing bill which applies to the 2008 campaign for state insurance commissioner. This bill has now been signed into law. If John Odom is to compete on a level playing field in 2008 election, it is imperative that he qualify for and participate in this public financing program. In order to qualify, John Odom must collect contributions of between $10 and $200 from at least 750 registered voters in North Carolina. Please help John take his message to the voters of North Carolina by sending your donation today.

___ John Odom, I support your campaign for election. Enclosed is my donation to help you qualify for the public financing program that now applies to your election campaign:

Amount enclosed: ___ $10 ___ $25 ___ $50 ___ $75 ___ $100 ___ $125 ___ $150 ___ $200

___ Other $______________ (must be between $10 and $200)

Important instructions: Contributions must be between $10 and $200 and must come from voters registered in North Carolina. All donations must be made by personal check or money order (no cash, business checks, campaign checks, credit cards or PAC checks). We cannot accept donations from registered lobbyists. Please write legibly.

Name:__________________________________________________________________________________________
(please legibly print your full name as it appears on your voter registration card; it is important that we be able to verify your voter registration)

Address:________________________________________________________________________________________

City:______________________________________________________ State:__________ Zip:___________________

Home Phone:_____________________________________ Work Phone:____________________________________

E-mail:_________________________________________ Fax:____________________________________________

Occupation:_____________________________________ Employer:_______________________________________

John, I will assist with your campaign by:
_____ Distributing literature in my neighborhood
_____ Distributing literature at community events
_____ Putting up signs
_____ Sending an e-mail to my personal address book
_____ Writing a letter to the editor
_____ Other:_______________________________

Business contributions are not permitted. Please note that North Carolina law requires political committees to report the name, mailing address, job title or profession and employer for all aggregate contributions over $50 in any election. Contributions are not deductible as charitable contributions for federal income tax purposes.

Please mail your contribution to:
John Odom Election Committee
4441 Six Forks Road
Suite 106-181
Raleigh, North Carolina 27609

Thank you!

John Odom,
candidate for insurance commissioner
Paid for by John Odom Election Committee, 4441 Six Forks Road, Suite 106-181, Raleigh, North Carolina 27609 | © 2008 John Odom