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I hereby agree to make a bona fide donation to the Government of the District of Columbia for the purpose of benefiting the above selected initiative. The donor is giving the donation freely without any expectation of special treatment from the District of Columbia government or any part thereof.

The donation is being made on the condition that the District Government agrees to use the donation to support the above initiative. If the District Government does not use the full balance of the financial donation, I, the donor, give my express consent and authorization to the District Government to use the remaining balance in the same or subsequent fiscal years for the same or similar authorized purpose, as reviewed and approved by the D.C. Ethics Officer. Otherwise, the Government of the District of Columbia will mail a refund check to the donor in the amount of any remaining balance.

The donor is not aware of any pending litigation, business, tax liabilities, or related issues that might create or appear to create a conflict of interest with the DC Government related to the donation.

Please be advised that you will receive no special treatment from the District Government as a result of this donation. Should you have any questions about the foregoing, or would like to make a donation greater than $1000.00, please contact the Office of Partnerships and Grant Services (OPGS) at (202) 727-7977.

Donations to the Fund to Advance Washington DC are refundable. If you have made an error in making your donation or change your mind about contributing to the Fund to Advance Washington DC, we will honor your request for a refund made within 15 days of your donation. To request a refund, call (202) 727-7977.

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