ed. Name Address City/State/Zip Employer Occupation Phone Fax Email Please make checks payable to: Friends of Max Baucus 122 C Street NW, Suite 240, Washington, DC 20001 Or you can fax a credit card contribution to (202) 347-6140 Please bill my personal credit card: K Visa K Mastercard K AMEX

ed. Name Address City/State/Zip Employer Occupation Phone Fax Email Please make checks payable to: Friends of Max Baucus 122 C Street NW, Suite 240, Washington, DC 20001 Or you can fax a credit card contribution to (202) 347-6140 Please bill my personal credit card: K Visa K Mastercard K AMEX