Hillrom Political Action Committee

YES! I want to be involved and help HR PAC meet political challenges that will affect our company and my interests.

Platinum ($2,000 or more)
Bronze ($200 - $499)
Gold ($1,000 - $1,999) Copper ($199 or less)
Silver ($500 - $999)    


Name:
Phone #:
Title:
Mailing Address:

I am contributing to the PAC as indicated below. Prior to contributing, I am aware:

  • That contributions to the PAC will be used in connection with federal elections and are subject to the prohibitions and limitations of the Federal Election Commission.
  • That contributions are voluntary and of my right to refuse to contribute without reprisal.
  • That the guidelines for contributing are merely suggestions. I may contribute more or less than the guidelines suggest or nothing at all and I will not be favored or disadvantaged by reason of the amount of my contribution or my decisions not to contribute.
  • That contributions to the PAC are not deductible for federal income tax purposes
  • That I must be a U.S. Citizen or Permanent Resident Alien (i.e. a Green Card holder residing in the U.S.) to make a contribution.
  • Federal law requires the PAC to use its best efforts to collect and report the name, mailing address and occupation of each employee/individual whose contributions exceed $200 in a calendar year.