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IMPORTANT - Follow up may be needed

If you made individual donation(s) (non business), totaling $100 or more to the Pimlott Campaign during the current calendar year, the campaign is required to report employment information to election officials.

Use this form to provide employment information if your total contribution to the Pimlott Campaign for this calendar year is $100 or more.

Instructions for Self Employed Individuals

Individual donors who are self employed AND contribute more than $100 in the current calendar year, should report the name of their business as their employer.

Fair Political Practices Commission (FPPC) Requirements

  • If a total of $100 or more is received from a single contributor during a calendar year, report the name, street address, city, state and zip code of the contributor, the amount contributed this period, and the cumulative amount received from the contributor since January 1 of the current calendar year. Include monetary and non monetary contributions and loans when reporting the cumulative amount.

  • Contributions from Individuals:
    When itemizing a contribution from an individual, also disclose the contributor’s occupation and the name of his or her employer. If the contributor is self-employed, provide the name of his or her business. If the contributor is not employed, enter “none.”  It is not necessary to enter occupation and employer information for other types of contributors (such as business entities).