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Dear Jim,

YES, I am sending a small donation to assist with your campaign to reduce taxes and government bureaucracy of ____ $10 ____ $20 ____ $50 ____ $100 ____ $200
____ other ($________) to Friends of Jim Huber

Your name: _____________________________________

Address: ________________________________________________

Phone: _________________________

E-mail: _____________________________________

Occupation: _____________________________________

Employer: _____________________________________

Principal place of employment (city, state): ___________________________________________

PRINT OUT AND MAIL TO:

Friends of Jim Huber
P.O. Box 1222
Leesburg, VA 20177

Paid for and authorized by Jim Huber

	Yes, Jim! I am sending a small donation to assist with your campaign to reduce taxes and government bureaucracy
Employer
Occupation
Principal place of employment (city, state)
Phone
Amount:	$