Test Donation V2 - on template / not custom

1. Amount ($800 maximum)

$

2. Your information

Law requires we ask for your employer and occupation. If you don't have an employer or are retired, put N/A, and if you are self-employed put "self-employed" in employer and describe your occupation.
Contributions are not tax deductible.

3. Payment information

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 $800.00. 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.
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