I certify the following:
- This contribution is not being made under a false name, is not being made under another person’s name, has not been reimbursed, and will not be reimbursed.
- This contribution does not cause me to exceed my contribution limit of $900.00. I understand that all contributions I make to this candidate or committee must be cumulated. I understand that a contribution from another individual or entity whose contribution activity I control, such as a business that I own or control, must be aggregated with this contribution, and both contributions will be treated as a single contribution from me.
- I am a United States citizen or a lawfully admitted permanent resident (i.e., green card holder).
- I am not a lobbyist or lobbying firm that is prohibited from contributing under Los Angeles City Charter § 470(c)(11).
- I am not a bidder, sub-contractor, principal, or underwriting firm that is prohibited from contributing under Los Angeles City Charter § 470(c)(12) or 609(e).
- I am not a planning applicant, owner, or principal that is prohibited from contributing under Los Angeles Municipal Code § 49.7.37.
If you don't have an employer or are unemployed, put N/A, and if you are self-employed put "self-employed" in employer and describe your occupation.
Note: Contributions are not deductible as charitable donations for federal income tax purposes.