Please print this page, fill out the form, and include it with your contribution check. Without this information we cannot accept your contribution.

Mail to:

Cedric Hicks For Carson City Council 2016 (ID# 1386005)
P.O. Box 4541
Carson, CA 90745

Political contributions are not tax deductible.

Please make checks payable to: “Hicks Sr. For Carson City Council 2016”

Contribution Form
Please accept our support of (circle one or write in):
$100-$200-$500-$1,000-$2000-$2500-Other$______
Election law requires the following information for contribution of $100 or more:
Name________________________________________E-Mail__________________________________
Address___________________________________________
Phone_____________________________________________
Employer___________________________________________
Signature___________________________________________