Conservative Partners Contribution Options ... AWS
YES! LAST NAME
MR.
MRS.
MISS
MS.
I want to join the Conservative Party.
FIRST NAME
INITIAL/MIDDLE NAME
RESIDENTIAL ADDRESS
(IF NOT THE SAME AS ABOVE)
MAILING ADDRESS
MOBILE PHONE NUMBER
* PLEASE HELP US TO KEEP YOU INFORMED
DATE OF BIRTH
CITY/TOWN
PROVINCE
POSTAL CODE
CITY/TOWN
PROVINCE
POSTAL CODE
* EMAIL
ON EVENTS AND OTHER PARTY NEWS BY INCLUDING YOUR E-MAIL ADDRESS.
Membership in the Conservative Party of Canada 1 year - $15
2 year - $25
3 year - $35
4 year - $45
5 year - $50
Please Note: Membership fees are non-refundable and non-receiptable in accordance with Canada Revenue Agency Guidelines.
By attaching payment I certify that I meet these Conditions of Membership: I am a Canadian Citizen or Permanent Resident of Canada. I actively support the founding principles of the Conservative Party of Canada. I am at least 14 years of age. I do not hold membership in another federal political party. My membership fees are paid from my own funds and no individual or organization will reimburse me.
Applicant Signature: (mandatory)
Conservative Partners Contribution Options
YES!
I want to help build the crucial resources needed for the next campaign by becoming a Conservative Partner monthly donor: On the 15th day of every month, I would like to contribute:
10
25
$
35
$
131.25 (max)
$
$
Other $
YES! I would like to make a one-time gift of: 35
$
75
$
125
$
500
$
1200
$
1575 (max)
Other $
$
Registered political parties are unable to accept membership fees or contributions from corporations, trade unions, or associations. Please ensure you are using a personal credit card or chequing account. I authorize the Conservative Fund Canada to withdraw these monthly contributions from my bank account. My sample cheque marked “VOID” is enclosed. I have enclosed a personal cheque or money order payable to: Conservative Fund Canada. I would like to pay my contribution/membership by credit card. VISA
MasterCard
American Express
Card Number: Cardholder’s Name:
Expiry Date:
/
Cardholder’s Signature:
Conservative Fund Canada will issue you an official tax receipt.
page 1 of 2
The Conservative Party uses automated devices (ADADs) to make phone calls to inform our members of upcoming events in their area. By purchasing a membership or making a donation, you agree that we may contact you using ADADs and/or other electronic communications at the phone number given above. Conservative Fund Canada only accepts personal pre-authorized debits (PADs). Please note that contributions from corporations, labour unions or associations, and unicorporated associations are prohibited. You may cancel or change your monthly contribution at any time by calling the Conservative Party of Canada at 1-866-808-8407 or by notifying the Party in writing at Suite 1720-130 Albert St., Ottawa, ON K1P 5G4. You have certain recourse rights if any debit does not comply with this agreement. For example, you have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD Agreement. To obtain more information on your recourse rights, you may contact your financial institution or visit www.cdnpay.ca.
Political Tax Credit and Receipt Information Contributions may qualify you for a tax credit on your federal income tax return as illustrated below.
Your contribution $ 50.00 $ 100.00 $ 250.00 $ 500.00 $ 1575.00
Tax credit $ 37.50 $ 75.00 $ 187.50 $ 350.00 $ 650.00
Actual cost $ 12.50 $ 25.00 $ 62.50 $ 150.00 $ 925.00
In accordance with the Conservative Government’s Federal Accountability Act, the Conservative Fund Canada, on behalf of the Conservative Party of Canada, accepts contributions from individual Canadian citizens or permanent residents to a maximum of $1575 per calendar year. Cash contributions in excess of $20 will not be accepted. Tax receipts can only be issued in the name of the contributor and the contributor is considered to be the holder of the credit card or the signatory on the cheque. Please note that contributions from corporation, labour unions or associations, and unincorporated associations are prohibited. Canadian citizens or permanent residents may also donate a separate amount up to $1575 to a combination of Conservative riding associations, candidates and nomination contestants, in addition to contributions made to the National Party.
CONSERVATIVE PARTY OF CANADA 1720-130 Albert Street, Ottawa, Ontario K1P 5G4 • 1-866-808-8407 • www.conservative.ca Fax: 613-755-2001
page 2 of 2
MR.
MRS.
MISS
MS.
I want to join the Conservative Party.
FIRST NAME
INITIAL/MIDDLE NAME
RESIDENTIAL ADDRESS
(IF NOT THE SAME AS ABOVE)
MAILING ADDRESS
MOBILE PHONE NUMBER
* PLEASE HELP US TO KEEP YOU INFORMED
DATE OF BIRTH
CITY/TOWN
PROVINCE
POSTAL CODE
CITY/TOWN
PROVINCE
POSTAL CODE
ON EVENTS AND OTHER PARTY NEWS BY INCLUDING YOUR E-MAIL ADDRESS.
Membership in the Conservative Party of Canada 1 year - $15
2 year - $25
3 year - $35
4 year - $45
5 year - $50
Please Note: Membership fees are non-refundable and non-receiptable in accordance with Canada Revenue Agency Guidelines.
By attaching payment I certify that I meet these Conditions of Membership: I am a Canadian Citizen or Permanent Resident of Canada. I actively support the founding principles of the Conservative Party of Canada. I am at least 14 years of age. I do not hold membership in another federal political party. My membership fees are paid from my own funds and no individual or organization will reimburse me.
Applicant Signature: (mandatory)
Conservative Partners Contribution Options
YES!
I want to help build the crucial resources needed for the next campaign by becoming a Conservative Partner monthly donor: On the 15th day of every month, I would like to contribute:
10
25
$
35
$
131.25 (max)
$
$
Other $
YES! I would like to make a one-time gift of: 35
$
75
$
125
$
500
$
1200
$
1575 (max)
Other $
$
Registered political parties are unable to accept membership fees or contributions from corporations, trade unions, or associations. Please ensure you are using a personal credit card or chequing account. I authorize the Conservative Fund Canada to withdraw these monthly contributions from my bank account. My sample cheque marked “VOID” is enclosed. I have enclosed a personal cheque or money order payable to: Conservative Fund Canada. I would like to pay my contribution/membership by credit card. VISA
MasterCard
American Express
Card Number: Cardholder’s Name:
Expiry Date:
/
Cardholder’s Signature:
Conservative Fund Canada will issue you an official tax receipt.
page 1 of 2
The Conservative Party uses automated devices (ADADs) to make phone calls to inform our members of upcoming events in their area. By purchasing a membership or making a donation, you agree that we may contact you using ADADs and/or other electronic communications at the phone number given above. Conservative Fund Canada only accepts personal pre-authorized debits (PADs). Please note that contributions from corporations, labour unions or associations, and unicorporated associations are prohibited. You may cancel or change your monthly contribution at any time by calling the Conservative Party of Canada at 1-866-808-8407 or by notifying the Party in writing at Suite 1720-130 Albert St., Ottawa, ON K1P 5G4. You have certain recourse rights if any debit does not comply with this agreement. For example, you have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD Agreement. To obtain more information on your recourse rights, you may contact your financial institution or visit www.cdnpay.ca.
Political Tax Credit and Receipt Information Contributions may qualify you for a tax credit on your federal income tax return as illustrated below.
Your contribution $ 50.00 $ 100.00 $ 250.00 $ 500.00 $ 1575.00
Tax credit $ 37.50 $ 75.00 $ 187.50 $ 350.00 $ 650.00
Actual cost $ 12.50 $ 25.00 $ 62.50 $ 150.00 $ 925.00
In accordance with the Conservative Government’s Federal Accountability Act, the Conservative Fund Canada, on behalf of the Conservative Party of Canada, accepts contributions from individual Canadian citizens or permanent residents to a maximum of $1575 per calendar year. Cash contributions in excess of $20 will not be accepted. Tax receipts can only be issued in the name of the contributor and the contributor is considered to be the holder of the credit card or the signatory on the cheque. Please note that contributions from corporation, labour unions or associations, and unincorporated associations are prohibited. Canadian citizens or permanent residents may also donate a separate amount up to $1575 to a combination of Conservative riding associations, candidates and nomination contestants, in addition to contributions made to the National Party.
CONSERVATIVE PARTY OF CANADA 1720-130 Albert Street, Ottawa, Ontario K1P 5G4 • 1-866-808-8407 • www.conservative.ca Fax: 613-755-2001
page 2 of 2
