Texas Rural Water Association

PAC Contribution Remittance Form


By typing my name, I certify that all of the following are true:

* I was informed of my right to contribute without reprisal. My contribution is not made under any actual or threatened physical force, threat of job discrimination or financial reprisal, or as any condition of employment.

* I was informed of eligibility requirements to be a Texas Rural Water PAC contributor. I understand that only executive, professional and managerial employees who are either U.S. citizens or noncitizens admitted to permanent residency may contribute to the Texas Rural Water PAC. I meet these requirements.

* I was informed of the political purpose of the Texas Rural Water PAC.

* I understand that any contribution guidelines are merely suggestions.

* I understand that I am free to contribute more or less than the guidelines suggest and the association will not favor or disadvantage me by reason of the amount of the contribution or the decision not to contribute.

*I understand that corporate contributions are prohibited. We can only accept contributions from individuals. If we find that you have paid with corporate funds, your donation will instead go toward the Texas Rural Water Foundation scholarship fund.