I subscribe, freely and voluntarily the sum indicated on the previous page each week to DRIVE with the understanding that this voluntary contribution may be used by DRIVE for political purpose, including contributions to support candidate for local, state and federal offices. I understand my right to refuse to contribute without reprisal and that the amounts listed serve merely as suggestions. I am free to subscribe more, less, or nothing, without benefit or disadvantage.
I further hereby authorize and request my employer to deduct from my earnings the sum indicated on previous page each week to be remitted to National DRIVE.
I reserve the right in accordance with the applicable state or federal laws to revoke this voluntary authorization at any time by giving written notice of such revocation to National DRIVE in accordance with such laws or otherwise.
A copy of the DRIVE report is filed with the Federal Election Commission and is available for purchase from the Federal Election Commission, Washington, D.C. 20463. Donation not U.S. tax deductible.