Protect Prop. 13 Committee Mail-in Donation FormThank you for contributing to the Protect Prop.13 Committee, a project of the Howard Jarvis Taxpayers Association. Your contribution will help to protect California taxpayers from the rampant tax increases that would become an annual occurrence if we ever lost Proposition 13. Donations to this committee may be used for radio and TV ads, campaign mail, yard signs and all the other efforts that go into a campaign related to ballot measures. California law requires that we collect the following information from all donors to the committee. Please print and complete this form and send it along with your check to the address below. Thank you!
Name:__________________________________________ Address:_______________________________________ City:_________________ State:____ Zip:_________ Phone:_______________________________(optional) E-Mail:______________________________(optional) If donor is a PAC, provide SOS ID number: If donor is a business or organization, choose one: Corporation LLC Partnership Other: _________________ Name of individual with primary responsibility If donor is an individual, complete the following: Occupation:____________________________________ Name of Employer:______________________________ INTERMEDIARY: If you are making this contribution on behalf of someone else, either because you are the person’s agent in control of disbursing funds at their direction held in an account under your name or because you are being reimbursed, you are an intermediary. State law requires the following information: Full Name of Intermediary:__________________________________________ Intermediary's Street Address (No PO Box):_______________________________________ City:_________________ State:____ Zip:_________ Intermediary is an individual Intermediary is a business Please make your checks payable to "Protect Prop. 13." Donation Amount: $_________ Thanks again for your support. Every dollar and every vote counts in the fight to protect taxpayers. Please Mail To: Protect Prop. 13 Committee
|
Paid for by Protect Prop. 13, a Project of the Howard Jarvis Taxpayers Association. |