Yes! I want to donate: ☐ $500 ☐ $250 ☐ $100 ☐ Other: $ _______ Please make checks payable to “Marie Hurabiell for College Board 2020” Mail checks to: Marie Hurabiell for College Board 2020 2633 Turk Blvd. San Francisco, CA 94118 DONOR INFORMATION The following requested information is required pursuant to disclosure requirements: Name: Street Address: City: State: Zip: Phone: Email: Employer (If self-employed, list name of business): Occupation: There is a $500 individual limit. Married couples may each give up to $500. If both names are printed on the check, a married couple can give up to $1,000 on the same check. But both spouses must sign the check. By signing below, you certify that all of the following statements are true (required for contribution): 1. I am making this contribution with my own personal funds and not from funds provided by another person for the purpose of making the contribution. 2. I am a U.S. citizen or lawfully admitted permanent resident (i.e., green card holder). 3. I am not making a business entity contribution, such as a corporate/LLC/LLP check or a corporate/LLC/LLP credit card. 4. I am not making contributions, either alone or via related entities, which aggregate more than $500 to the campaign. 5. I am not making my contribution for any vote or official action or promise to refrain from any vote or official action. 6. I am not an owner, director, officer, or named sub‐contractor of any entity that has a contract proposal pending the Community College Board which is subject to the approval of the Community College Board or of any entity that received such a contract within the last twelve months. 7. I am not registered to lobby the Community College Board and have not been registered to do so within the prior 90 days. 8. I am at least eighteen years old. Signature (required): Contributions are not tax deductible. Contributions from business entities, including corporations, LLCs and LLPs, are prohibited. Individuals and most non‐incorporated entities may contribute up to $500. Spouses and domestic partners may each contribute the maximum, even if their contributions are made from a joint account, but should submit separate contributions, each signed by the contributing spouse/partner. We may not deposit your payment without your name, street address (no PO boxes), occupation and employer, and may not accept cash, cashier’s checks or money orders of $100 or more. The legal compliance list above sets forth other prohibitions. **STAFF ONLY. LIST ANY THIRD‐PARTY WHO DELIVERED/TRANSMITTED THIS CONTRIBUTION (FOLLOW UP WITH COMPLIANCE): Paid for by Marie Hurabiell for College Board 2020, FPPC ID #Pending Financial disclosures are available at