Enclosed is my contribution of:

$25      $50     $100     $200     $325

Please make checks payable to Citizens for Chris Ruggles.

NAME

ADDRESS

CITY

STATE, ZIP

EMPLOYER (REQUIRED)

OCCUPATION (REQUIRED)

Do you or does your business have a contractual relationship of more than $500 with the state of Missouri?

YES      NO

Current Missouri Election Law permits individuals, businesses and PACs to contribute up to $325 per primary election cycle and $325 per general election cycle to candidates for state representative. The law also requires that contributors disclose whether or not they have a current contractual relationship of more than $500 with the state of Missouri.

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