Offline Contribution Card – Brandy Brooks for County Council At-Large

Offline Contribution Card

Please mail your check or money order to: Brandy Brooks Power Posse PO Box 2498 Wheaton, MD 20915 Make check payable to "Brandy Brooks Power Posse"

Name *

First

Last

Email *

Phone *

Contribution Amount *

Check / Money Order Number *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Campaign Finance Affirmation *

I affirm that I am a citizen or lawful permanent resident (green card holder) of the United States. I understand that State law requires 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.

FOR RESIDENTS OF MONTGOMERY COUNTY, MD ONLY

I certify that I am a resident of Montgomery County, Maryland. I am making this donation in support of Brandy Brooks for Montgomery County At-large.

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