Tina Liebling for State Representative

Yes! I want to help elect Tina Liebling for State House in District 30A! Enclosed is my contribution in the amount of:

$250 $100 $50 $25 Other _____

Name____________________________________________

Address__________________________________________

City/State/Zip______________________________________

Home Phone_______________________________________

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Election law requires Occupation and Employer information for contributors over $100.

Please make checks payable to Liebling for State House.

Please mail your contribution and this form to:

Liebling for State House

PO Box 6332

Rochester, MN 55903-6332

____Please send me a Political Campaign Refund application form. Thanks!

____I printed my own PCR form from the web. I'll save you the printing costs. Thanks!

If you would like to volunteer for Tina Liebling's campaign, please fill out the volunteer form found on the campaign web site. Thank you again for your support!

Prepared and paid for by Liebling for State House, PO Box 6332, Rochester, MN 55903 (507) 289-4664