Donation Form

Committee To Recall Charles Allen Contribution Form

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I certify all information on this form is true and correct to the best of my knowledge:
1. I am at least eighteen years old.
2. This contribution is made from my own funds, and funds are not being provided to me by another person or entity for the purpose of making this contribution.
3. I provided all of the above up-to-date and accurate information to the campaign for campaign finance reporting requirements.
4. I have not surpassed the contribution limit of $500 to this recall petitions from my personal accounts, business accounts or any affiliated business accounts (combined) in this election cycle (including primary and general elections)
5. If I am currently a registered D.C. lobbyist, I will self report to the DC Board of Ethics and Government Accountability (BEGA) each political contribution of $50 or more I or anyone acting on my behalf makes.
6. I have not collected contributions from others in the course of making this contribution.
7. I am a U.S. citizen or lawfully admitted permanent resident (i.e., green card holder).

By checking this box, I affirm that the information I have provided is true and correct and that I comply with the contribution rules listed above.

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Donation Summary
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Giving Frequency	One time
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Donation Total: $500