“I’m Running As The Conservative Working Family Candidate

For The Virginia 5th Congressional District Republican Nomination.”

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I affirm that the following statements are true and accurate:

1. This contribution is made from my own funds and not those of another.

2. This contribution is not made from the general treasury funds of a corporation, labor organization or national bank.

3. I am not a Federal government contractor.

4. I am not a foreign national who lacks permanent resident status in the United States.

5. I am at least 18 years of age.

6. This contribution is made on a personal credit or debit card for which I have the legal obligation to pay and is made neither on a corporate or business entity card nor on the card of another.

Contributions are not tax deductible for federal income tax purposes. Individuals may contribute a maximum of $4,800 - $2,400 for the Primary election and $2,400 for the General election. Multi-candidate PACs may give a maximum of $10,000 - $5,000 for the Primary election and $5,000 for the General election.

All contributions are subject to limitations and regulations set by the Federal Election Commission.

To send a contribution by U.S. Mail, please send your check payable to:

Ron Ferrin For Congress

PO Box 12037

Lynchburg, VA 24506

Paid For By Ron Ferrin For Congress

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