Choose Amount

Cover the fees

* By providing your phone number, you are consenting to receive text message updates, including automated text messages, to that number from Rivard for Council. Message & Data rates may apply, and message frequency may vary over time. Reply "STOP" to opt out of these text message updates.

This form only accepts US addresses.

Are you a Individual Contributor?*

“Individual Contributor” means a human being, a sole proprietorship, or a professional service corporation organized under chapter 594a and owned by a single human being. A sole proprietorship is a business in which one human being owns all the assets, owes all the liabilities, and operates in his or her personal capacity. Any other type of business is not permitted to make a contribution, including LLCs. See General Statutes § 9-601 (9).

If self-employed, provide Name of Business. Example: Dave’s Painting Other Examples: Retired, Unemployed, Student, Homemaker

If self-employed, provide Job Description. Example: Painter Other Examples: Retired, Unemployed, Student, Homemaker

Are you under 18 years of age?*
Are you a lobbyist?***

**The law requires disclosure for each itemized contribution made by a lobbyist, the spouse of a lobbyist or any dependent child of a lobbyist who resides in the lobbyist’s household. General Statutes § 9-608 (c) (1) (H). The term lobbyist includes anyone required by law to register as a lobbyist with the Office of State Ethics because they (a) expend or agree to expend $3,000 or more in a calendar year on lobbying; OR (b) receive or agree to receive $3,000 or more in a calendar year for lobbying. General Statutes § 1-91 (as amended by Public Act 15-15). Individual lobbyists may contribute to candidate committees and exploratory committees for municipal office up to the limits for those offices.

Are you the spouse or dependent child of a lobbyist?*
Do you or a business with which you are associated*** have a contract with the town, city or borough in which the candidate is running that is valued at more than $5,000?*

***A “business with which you are associated” refers to any business in which the contributor is a director, officer, owner, limited or general partner, or stockholder of 5% of more of the total stock of the business.

I hereby certify and state that all of the information disclosed by me and set forth above on this contributor card is true and accurate to the best of my knowledge and belief. I certify that I am either a United States citizen or a foreign national with permanent resident status in the United States. I certify that this contribution is being made from my personal funds, is not being reimbursed in any manner, is not being made as a loan, and is not an otherwise prohibited contribution.*