Check the appropriate box or write in a whole dollar amount for each fund to which you wish to contribute. Your contribution is irrevocable.

Aids Research Education Fund

This fund assists research, education, and community service programs related to Acquired Immune Deficiency Syndrome (AIDS). The fund is administered by the Connecticut Department of Public Health. To contribute directly send to:

Department of Public Health AIDS and Chronic Diseases Division MS #11APV PO Box 340308 Hartford CT 06134-0308

Make check payable to: "Treasurer, State of Connecticut/AIDS Fund"

Organ Transplant Fund

This fund assists Connecticut residents in paying for the unmet medical and ancillary needs of organ transplant candidates and recipients. The fund is administered by the Connecticut Department of Social Services. To contribute directly send to:

Department of Social Services Accounts Receivable 25 Sigourney Street Hartford CT 06106-5003

Make check payable to: "Commissioner of Social Services/Organ Transplant Fund"

Endangered Species, Natural Area Preserves, And Watchable Wildlife Fund

This fund helps preserve, protect, and manage Connecticut's endangered plants and animals as well as wildlife and their habitats. The fund is administered by the Connecticut Department of Environmental Protection. To contribute directly send to:

Department of Environmental Protection-Bureau of Administration Financial Management 79 Elm Street Hartford CT 06106-5127

Make check payable to: "DEP-Endangered Species/ Wildlife Fund"

Breast Cancer Research And Education Fund

This fund assists research, education, and community service programs related to breast cancer. The fund is administered by the Connecticut Department of Public Health. To contribute directly send to:

Department of Public Health Breast and Cervical Cancer Early Detection Program AIDS and Chronic Diseases Division MS #11 HLS PO Box 340308 Hartford CT 06134-0308 Make check payable to: "Treasurer, State of Connecticut/Breast Cancer Fund"

Safety Net Services Fund

This fund protects the children of families who are no longer eligible for public assistance benefits. The fund is administered by the Connecticut Department of Social Services. To contribute directly send to:

Department of Social Services Accounts Receivable 25 Sigourney Street Hartford CT 06106-5003

Make check payable to: "Commissioner of Social Services/Safety Net Fund"

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