Check Off Authorization 

This is to authorize Laclede Gas Company to deduct the sum of:

         □ $.75     □ $1.00    from my pay each week, and forward that sum to the

GAS WORKERS, LOCAL 11-6 VOLUNTARY POLITICAL ACTION COMMITTEE,

7750 Olive Boulevard, St. Louis County, Missouri 63130. I acknowledge that I am

aware that this Fund will be used for purposes of making political expenditures

and/or contributions for candidates and/or ballot issues in elections in the State of

Missouri. I further acknowledge that I am aware that this contribution is purely vol-

untary and that I have the right to refuse to contribute without reprisal. This author-

ization may be removed at any time by written notice to Laclede Gas Company.

     Print Name:  __________________________________________________

     Date:  ____________ Signature  __________________________________

     Employee#:  __________________________________________________

     Address:  _____________________________________________________

                     _____________________________________________________

Please print and fill out the above and mail to:

Gas Workers Union Local 11-6, USW

7750 Olive Boulevard

St. Louis, MO 63130-2043