Virtual Banquet Supporting the Re-Election of
Judy Chu
27th Congressional District of California
Tuesday, October 6, 2020 / 6:00 p.m. to 7:30p.m.
Link to virtual event will be sent 24 hours before event
RESERVATION FORM
____ $5600* - I/we will join the event as a Platinum Sponsor
____ $500 - I/we will join the event as a Benefactor
____ $250 - I will join the event as a Supporter
____ $150 - I will join the event as an
Individual
____ $50 - I will join the event as a Fan
*Contribution is a combination of giving and raising since the max per person is $2,800. Couples with joint accounts can both sign one check for $5,400
Please make checks payable to “Judy Chu for Congress” FEC ID# C00458125
Mailing Address: Judy Chu for Congress, 1531 Purdue Avenue, Los Angeles, CA 90025
To comply with Federal law, we must use best efforts to obtain, maintain, and submit the name, mailing address, occupation and name of employer of individuals whose contributions exceed $200 per calendar year.
___________________________________________________________________
*Name *Occupation and Company Name
___________________________________________________________________
*Address *City, State and Zip Code
___________________________________________________________________
Cell Phone Work Phone *Email Address
CREDIT CARD INFORMATION （if by credit card） ____Please verify contribution is from personal funds. Please fax to（310）473-9465
Name on Card: ___________________________________________
Card Number: ________________________ Expiration Date: ______
Amount: $ _______ Type: ___VISA ___MasterCard ___American Express
Signature: __________________________________________________
____ Check here to confirm that the following statements are true and accurate: 1. I am a United States citizen or permanent resident alien. 2. This contribution is not made from the general treasury funds of a corporation, labor organization or national bank. 3. This contribution is not made from the treasury of an entity or person who is a federal contractor. 4. The funds I am donating are not being provided to me by another person or entity for the purpose of making this contribution.
Contributions to Judy Chu for Congress are not deductible for federal income tax purposes. Judy Chu for Congress may receive contributions of up to $2,800 per election from any individual and $5,000 from any Multi Candidate Committee. Judy Chu for Congress may not accept contributions from corporations, labor unions, federal government contractors or foreign nationals. FEC ID #C00458125
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