5 P O Box 141, Kalamazoo, MI 49004

City Michigan FairTax

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Sponsor
Date ____/____/____
______________________ mifairtax.org
Fax (360) 248-6211
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Name E-mail Address Zip (circle) Tel No's
40 Roger
Mr Ms roger.buchholtz 5620 Clato St
Street: hwc 269 345-0950
5- Buchholtz @ mifairtax.org h w c 586 530-3298
Last Kalamazoo
City+Zip: 49004
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( ) Last @ City, Zip hwc
$ I'll help Mr Ms Street: hwc
( ) Last @ City, Zip hwc
$ I'll help Mr Ms Street: hwc
( ) Last @ City, Zip hwc
$ I'll help Mr Ms Street: hwc
( ) Last @ City, Zip hwc
$ I'll help Mr Ms Street: hwc
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( ) Last @ City, Zip hwc
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( ) Last @ City, Zip hwc
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( ) Last @ City, Zip hwc
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( ) Last @ City, Zip hwc
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 5
P O Box 141, Kalamazoo, MI 49004
28 ________________________ Date ____/____/____
City Michigan FairTax Fax (360) 248-6211
Sponsor
6 ______________________ mifairtax.org
9 Use
MI FT For: ATTENDANCE + PROGRESS UPDATES
5 PLEASE PRINT CLEARLY PLEASE PRINT CLEARLY
I'll help ( )
$ Donation

3
Name E-mail Address Zip (circle) Tel No's
40 ( ) Last @ City, Zip hwc
5-
-3
02
9
58
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