Contribution Form

Will Jawando for Montgomery County

Please make checks payable to Will Jawando for Montgomery County. You can mail your check to P.O. Box 10598, Silver Spring, MD 20914, or arrange a pickup by emailing info@willjawando.com.

If you made a contribution via check or cash and need to submit a contribution form, the easiest way is to fill out and sign the form below electronically.

You can also download the printable form, fill it out by hand, scan it, and email it to info@willjawando.com.

If you need any assistance, please email info@willjawando.com.

Contribution Details

Contribution Type *

Check Cash

Amount ($) *

Event or Note

Contributor Information

Contributor Name *

Home Address *

Address Line 2 (Apt, Suite, Unit, etc.)

City *

State *

Zip *

County of Residence *

Phone *

Email *

*Occupation

*Employer

Certifications

I certify that I am a resident of Montgomery County, Maryland. I am making this contribution in support of Will Jawando for Montgomery County.

(Please CHECK if you are a Montgomery County resident. If not, please leave it blank. This is for public finance purposes only.)

I understand that State law and County regulations require that a contribution be in my name and be from my own funds. I hereby affirm that this contribution is being made from my personal funds, is not being reimbursed in any manner, and is not being made as a loan; in addition, in the case of a credit card contribution, I also hereby affirm that this contribution is being made from my personal credit card account, billed to and paid by me for my personal use, and has no corporate or business affiliation.

Contribution Notice: Individual aggregate contributions to Will Jawando for Montgomery County may not exceed $500.00 per election cycle. Contributions of $500 in aggregate require reporting of employer and occupation information. Contributions must be made from the donor's own personal funds, are not reimbursed in any manner, and cannot be made from the funds of a corporation, labor organization, or another person. Contributions must be made using a personal credit or debit card for which the donor has a legal obligation to pay.

Signature

Contributor's Signature (type full name) *

Date of Contribution

By Authority: Will Jawando for Montgomery County; Michelle Rush, Treasurer.

Contribution Form

Contribution Details

Contributor Information

Certifications

Signature

Form Submitted Successfully