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* 1. I am involved in the consumer finance industry in the following way:

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* 2. I have been a member of TCFA:

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* 3. I am interested in participating in the TCFA Legislative Program and agree to the following: (please check all boxes that apply)

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* 4. Please identify the State Senator in the Texas Legislature from you District.

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* 5. Please inicate below how well you know your State Senator.

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* 6. Please identify your State Representative in the Texas Legislature from you District.

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* 7. Please indicate below how well you know your State Representive.

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* 8. Please list any additionalelected State of Texas Representatives or Senators you may know.

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* 9. I am willing to personally contact my listed officials above when needed by TCFA.

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* 10. Please indicate any appointed agency or regulatory officials you may know.

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* 11. Plese provide your contact information for developin the TCFA Legislative Contact database:

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