___ Yes, I would like to help Thom Carter end the wasteful spending that has lead to large

amounts of debt for our great community. I believe that with the principled leadership of Thom
Carter Montgomery can achieve its potential.

I will contribute:

___ $2400 ___ $1000 ___$500 ___$250 ___ Other $_______

Please make checks payable to: The Montgomery Township Republican Organization
Please mail to: Thom Carter
35 DeHart Drive
Belle Mead, NJ 08502

Name: ________________________________________________________________________

Address: ______________________________________________________________________

City: _____________________________________ State: ___________ Zip: _______________

Telephone: ___________________________ Email: ___________________________________

Occupation (Required): __________________________________________________________

Employer (Required): ___________________________________________________________

Employer’s Address (Required): ___________________________________________________

Contributor Signature (Required): __________________________________________________

Election law requires political committees to use best efforts to report the name, mailing address, occupation, and name of employer of
individuals whose contributions exceed $200 during an election cycle. An individual may not contribute more than a total of $2400 per election
to the committee. Law prohibits contributions to the committee from the general treasury funds of a corporation, labor organizations or national
banks (including corporate or other business entity credit cards), from any person contributing another's funds, from a Federal government
contractor, or from a foreign national who lacks permanent resident status. Contributions are not deductible for Federal income tax purposes.