IPC POLITICAL ACTION COMMITTEE (IPC PAC) - Prior Authorization Form

IPC PAC was created in order to provide individuals interested in the future of our industry with an avenue to support worthy candidates for Federal office. Participation is voluntary, not tax-deductible and limited to individuals whose companies are members of IPC.

In addition, IPC must receive written authorization from our corporate members prior to soliciting their executive and administrative personnel. It should be signed by someone within the company who has signing authority for the entire company (generally a President or CEO). An authorization of such a solicitation can only be given to one trade association PAC per calendar year. In order to allow the IPC PAC to communicate with you and your eligible employees, please fill out the following information.

Any questions? Please email Chris Mitchell or call (202) 661-8094.

Please check one of the following options:

I hereby grant permission to the IPC PAC to solicit voluntary contributions from myself for the following years identified below.

I hereby grant permission to the IPC PAC to solicit voluntary contributions from myself, eligible executive officers and employees at my company that I approve for the following years identified below.

Select the year(s) you want this authorization to be in effect:

Authorization 2024

Authorization 2025

Authorization 2026

Authorization 2027

Authorization 2028

Required Company Information

Company Name

First Name

Last Name

Job Title

Street

City

State

Zip Code

Email Address

Signature

Date

*Please type your name above to confirm that: you read all of the information on this page, you have authority to sign this form for your company, your company has not submitted a prior authorization form to another association for the years you identified on this form, and you agree to IPC PAC contacting you.

Printable Prior Authorization Form

If you would like to make this request with a paper form, please download this form and submit.