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Duval Dems In-Kind Donation
I have paid for the following expenses as an in-kind contribution to the Duval County Democratic Executive Committee in connection with the 2022 election. By filling out the form below, I confirm that I paid these costs with personal funds on the date and in the amount indicated.
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Email *
First Name *
Last Name *
Address *
City, State, Zipcode *
Please describe your in-kind donation *
What is the total value of your in-kind donation? *
(optional) I made an in-kind contribution in the form of stamps, and printed materials used for a mailer for a total in-kind value of :
If contribution above is more than $100 complete the occupation/employer information below:
Occupation:
Employer:
By making a donation you acknowledge: I am at least eighteen years old; 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; I am a U.S. citizen or lawfully admitted permanent resident (i.e., green card holder). *
A copy of your responses will be emailed to the address you provided.
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