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BY CREDIT OR DEBIT CARD VISA MASTERCARD Full Monthly 10 mo. installments AMERICAN EXPRESS Quarterly Amplify charged 3/2/17 Annual charged 11/1/17 PAID IN FULL cash / check made payable to Y Annual Campaign attached BY MONTHLY BANK DRAFT signature voided check attached BY INVOICE Card number Exp. Date Annual invoiced 11/1/17 Sec. Code Signature OFFICIAL USE ONLY ONLY -- 2017 2016 Annual OFFICIAL USE ONLY - Pledge History Fund Time ID Campaigner Name Campaign Division Excel...

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