Section R. 169.39d - Affirmative consent; formRule 39d.
(1) The affirmative consent required by section 55(6) of the act shall be given in writing and shall include, at a minimum, all of the following: (a) A notice, which shall read as follows: Affirmative Consent to Political Contributions Section 55(6) of the Michigan Campaign Finance Act provides that a corporation, a joint stock company, a domestic dependent sovereign, or a labor organization "may solicit or obtain contributions for a separate segregated fund established under this section from an individual described in subsection (2), (3), (4), or (5) on automatic basis, including but not limited to a payroll deduction plan, only if the individual who is contributing to the fund affirmatively consents to the contribution at least once in every calendar year."
(b) The contributor's first, middle, and last names.(c) The amount of money to be withheld from the contributor's wages or the percentage of the contributor's wages to be withheld.(d) The frequency with which the withholding is to be accomplished. The withholding may be per day period, per week, per month, or per year.(e) The name of the committee to which the withheld earnings are to be transferred.(f) The calendar year for which the consent is given.(2) The written affirmative consent shall be signed and dated by the contributor.Mich. Admin. Code R. 169.39d