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Contribute
Please print this
page and mail it to:
Julie
Brown for City Council
610 S Boulevard
Tampa, FL 33606
PLEASE
PROVIDE THE FOLLOWING INFORMATION:
First Name:
_________________________________________
Last: ______________________________________________
Address: ___________________________________________
City ____________________ST __________ Zip___________
Home Phone:___________________________
Work/Cell ______________________________
Fax:_________________________
Email_______________________________________________
Election laws require
we report the following if you make a contribution in
excess of $100:
Occupation:
__________________________________
Employer: ____________________________________
PLEASE CHECK: ______
Yes, you may use my name for endorsements and/or
publications.
Signature:
____________________________________
I hereby grant
permission for my name to be published as an endorsement
of the Julie Brown Campaign in political advertisements.
ENCLOSED IS MY CONTRIBUTION OF:
____$5
____$25 ____$50 ____$100 ____$250 ____$500 ____OTHER
Please make checks payable to the Julie Brown for
City Council.
Please make checks payable to Julie Brown for City Council.
Contributions are not solicited nor accepted from
children under the age of 18.
Maximum cash donation is $100. Any donation greater than
$100 must be a check. Contributions to the
Julie Brown Campaign are not deductible for Federal
income tax purposes. Maximum contribution
under Florida Law is $500 per individual, business or
PAC.
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