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If you have no occupation or employer, do not leave blank. For occupation use general terms such as 'manager', 'homemaker', or 'none.' If not employed by a company, use terms such as 'self', 'retired', or 'unemployed.'
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I certify the following:
·This contribution is not being made under a false name, is not being made under another person’s name, and has not been and will not be reimbursed.
·This contribution does not cause me to exceed my contribution limit of $1,500.00. 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 certify under penalty of perjury under the laws of the City of Los Angeles and the state of California that all of the information above is true and correct.
Total donation amount may not exceed $1500.00
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