This information is required by law.
If you are self-employed, please list the name of the business. For occupation, please list your line of work. "Business Person" is not acceptable. Please enter the type of business instead. If you are retired, please enter "N/A" under Employer and "Retired" under Occupation; if you are a homemaker, please enter "N/A" under Employer and "Homemaker" under Occupation.
· This contribution is not being made under a false name, is not being made under another person’s name, and has not been and will not be reimbursed;
· I am not a lobbyist or lobbying firm who is prohibited from contributing under Los Angeles Charter Section 470(c)(11); and
· I am not a contract bidder, sub-contractor, principal, or underwriting firm that is prohibited from contributing under Charter Section 470(c)(12) or Charter Section 609(e).