Cryptocurrency Donation – Florida Conservative Fund

Prior to accepting cryptocurrency, the Federal Election Commission requires we obtain the following information:

Name

Address

City

State

Zip

Employer

Occupation

If Contribution is From a Business, Name of Business:

By submitting this form, I hereby certify that the below statements are true and accurate: I am a United States citizen or a lawfully-admitted permanent resident; This donation is not being made in another person's name; This donation is not being made by or on behalf of a foreign national. The crypto currency is owned by me or the business contributor listed.

Contributions are not tax deductible for federal income tax purposes. Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and name of employer of each individual whose contributions exceed $200 in a calendar year.