2013 COMMITTEE TO ELECT GWEN GOODWIN
In order to accept your contribution as matchable, we are legally required to obtain and report the following information from you. Just fill in the blanks, then click on the "SUBMIT" button. Thank you for the additional effort.
AMOUNT $ (no commas or $-sign, one decimal point optional)
Card Type: Last 4 Digits of Credit Card: Expiry:
Do you have business dealings with the City as defined in the Campaign Finance Act*?
YES:    NO:
Last Name: Given Name(s):
House Number: Street Name:  Apt.:
City: , State   ZIP:
Occupation: (if retired, student, self-employed, homemaker or unemployed, please state so.)
Employer Name and Address with City, ST ZIP.
Email: Confirm email
Phone Numbers (10 digits, no dashes, hyphens or parentheses)   Home  Other (optional)

"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 credit card account, billed to and paid by me for my personal use, and having no corporate or business affiliation; and is not being made as a loan. State law prohibits making a contribution in someone else’s name, reimbursing someone for a contribution made in your name, being reimbursed for a contribution made in your name, or claiming to have made a contribution when a loan is made."

  By checking this checkbox, I acknowledge that I have read, understand and am in compliance with the preceding paragraph.
SUBMIT

*  DOING BUSINESS CONTRIBUTION INFORMATION

A “doing business” contributor is an owner, principal officer, or senior manager of an entity or firm that presently does business with the City, or within the past 12 months, has done business with the City or has bid or applied for business with the City. “Doing business” contributors generally:

• Are registered NYC lobbyists.

• Have one or more contracts, concessions, franchises, or grants that total over $100,000 ($500,000 for construction contracts). This excludes emergency contracts and those awarded by competitive sealed bidding.

• Answer a bid or proposal request for a contract, concession, franchise, or grant as described above.

• Enter into or hold an agreement for economic development, including payments in lieu of taxes, City tax incentives, or City financing.

• Hold contracts or proposals for investment of pension funds or related services.
• Are a party to the sale, purchase, or lease of real property with or by the City, except public auction.

• Make an application subject to Uniform Land Use Review Procedure (ULURP) or an application for zoning change or special permit.

A contributor is not considered to be doing business with the City simply because they pay or receive a rebate on City taxes, work for the City, are in a City pension plan, hire a lobbyist, apply for permits for a 1, 2, or 3 family home, drive a City taxi, or apply for street activity permits or other kinds of individual activities with the City. Contributions from persons doing business with the City will not be matched with public funds.

For more details or to verify whether you are listed on the Doing Business database, see www.nyccfb.info/doingbusiness.