FADC MEMBERSHIP
Membership Application for the Filipino American Democratic Caucus (FADC)
California Democratic Party (CDP)
California Democratic Party (CDP)
Account Number 2408
Membership Application/Information Form (Required by Federal Law.)
For 2011-2012, active member dues shall be $25.00, two-year membership for $40.00, $10 for seniors and students if requested.
NAME:___________________________________________
ADDRESS:_______________________________________
P.O. BOX: _______________________________________
City/State/ Zip:____________________________________
Occupation:_______________________________________
Employer:________________________________________
(If Self-Employed, please state Business Name)
Home Phone Number:_______________________________
Mobile Phone Number:______________________________
Fax Number:______________________________________
Email:___________________________________________
Note: Contributions are not tax deductible for federal income tax purposes.
1. Your contribution will be used in connection with federal elections and is subject to the limitations and prohibitions of the Federal Election campaign Act
2. Corporate and union contributions are acceptable under California Law to be used in connection with non-federal elections. California law permits contributions up to $32,400.00 per calendar year for use in supporting state elections and imposes no limits on contributions used for purposes other than supporting state candidates.
3. Federal law requires Political Committees to use our best efforts to collect and report the name, mailing address, occupation and employer for each individual whose contributions exceed $200 per calendar year.
Please make your check payable to:
"California Democratic Party, Account 2408"
[FPPC, State I.D. #74166. FEC, Federal I.D. C00105668]
If mailing, Send your check and enclosed this form to:
California Democratic Party
1401 21st Street, Suite 200
Sacramento, Ca 95811
I confirm that the following statements are true and accurate:
[ ] I am a United States citizen or a permanent resident alien.
[ ] This contribution is not made from the general funds of a corporation, labor union, or national bank.
[ ] This contribution is not made from the treasury of an entity or a person who is a federal contractor.
[ ] The funds I am contributing have no been provided to me by another person or entity for the purpose of making a contribution.
Signature:____________________________ FADC, CDP Member