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Richard H. Collins
Doug Deason
Dan Donohoe
Jim Francis
Forrest Hoglund
Willie Hornberger
Gary Griffith
Michael Lunceford
Matt Malouf
Joe Taylor
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JOHN RATCLIFFE
U.S. Congressman-Elect, 4th Congressional District of Texas
Contribution Form
Yes, I would like to attend the luncheon and support John at the following level:
Chair: $10,400 Includes 4 tickets to the luncheon.
Co-Chair: $5,200 Includes 2 tickets to the luncheon.
Sponsor: $2,600 Includes 2 tickets to the luncheon.
Patron: $1,000 Includes 2 tickets to the luncheon.
Guest: $500 Includes 1 ticket to the luncheon.
Unfortunately, I cannot attend the luncheon, but I would like to support John. Enclosed is my contribution of $______________.
ALL CONTRIBUTORS PLEASE READ AND COMPLETE:
Contributions are not tax deductible for federal purposes. Federal law requires us to report the name, address, occupation, and name of employer of each
contributor whose contributions exceed $200 in an election cycle. Individuals may contribute a maximum of $10,400 ($2,600 for 2014 primary election debt,
$2,600 for 2014 general election debt, $2,600 for the primary election 2016, and $2,600 for the general election 2016) or $20,800 per couple. Multi
candidate PACs may give a maximum of $20,000 ($5,000 for 2014 primary election debt, $5,000 for 2014 general election debt, $5,000 for the primary
election 2016, and $5,000 for the general election 2016). Contributions from corporations, foreign nationals, and federal government contractors are
prohibited. Not printed at government expense.
_________________________________________________________________________________________________________
Full Name
Spouse Name (if joint contribution)
_________________________________________________________________________________________________________
Address
City
State
Zip Code
_________________________________________________________________________________________________________
Home Phone
Work Phone
Cell Phone
_________________________________________________________________________________________________________
Facsimile
E-Mail
_________________________________________________________________________________________________________
Employer, Occupation
Spouses Employer, Occupation (if joint contribution)
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