FMI's FoodPAC Prior Approval Form

  For each year indicated by the boxes checked below, I am authorizing FoodPAC to provide myself and employees at my company information and updates on our political efforts.
About You:
First Name   
Last Name   
Company Address   
City, State Zip   
Email Address   
Create and enter any four to ten digit or character code. This PIN will be used when you confirm your prior approval submission.
FMI may not solicit contributions to FoodPAC from employees of its member companies without receiving prior approval. Federal election regulations require a signature of an authorizing agent of the company. A corporation may only grant prior approval to one trade association federal PAC per calendar year. Signing this form does not prevent you from making a personal political contribution to a federal corporate PAC or to a state PAC that supports candidates for state and local office.
Contributions to FoodPAC will be used for political purposes and must be drawn from personal, not corporate, accounts. Political contributions are not deductible for federal income tax purposes. I understand that contributions to FoodPAC are voluntary and I have the right to refuse to contribute without fear of reprisal. Federal law requires us to use best efforts to collect the name, mailing address, occupation and name of employer of individuals whose contributions exceed 200 dollars per calendar year.