Donation Form Name* First Last Address* Street Address City State / Province / Region ZIP / Postal Code Phone*Email* Additional Required InformationTo make campaign contributions, please include the DONOR’S OCCUPATION as well as their EMPLOYER’S NAME AND ADDRESS. This information is REQUIRED.Employer*Occupation*Employer Address* Street Address City State / Province / Region ZIP / Postal Code Donations**Michigan campaign finance laws limit political contributions to 1,000 per individual and 2,000 per couple for each election cycle. No cash or corporate checks**Donations*$25.00$50.00$100.00$250.00$500.00$1000.00Total $0.00 Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name Mike and Angela with Sheriff Clarke Paid for by Mike Mueller for State Representative 6127 Lobdell Rd. Linden, MI 48451