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PAC VERIFICATIONDeidre Girard2020-09-24T11:35:33-07:00

PAC Verification Form

This form is to verify that donors to the PROTEC17 Political Action Committee (PAC) fund meet current federal guidelines for political contributors.
  • Please certify the following statements are true by checking the box and signing the line that follows.

  • I am least 18 years old.

    I am a U.S. citizen or lawfully permitted resident (i.e., green card holder)

    I am making the contribution from my own funds, and funds are not being provided by another person or entity for the purpose of making this contribution.

    I am not a foreign national nor is this contribution financed in any part by a foreign national, and no foreign national was involved in making decisions regarding the contribution in any way.

    I am not a federal contractor

    I am not a registered Federal lobbyist

    I am not a registered foreign agent.
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