National Music Publishers’ Association
Political Action Committee (NMPAC)
Prior Approval Form
Federal law requires NMPAC to receive prior approval from its member corporations before soliciting
contributions. Your corporation may grant approval to only one trade association per calendar year.
Please complete and sign for each year you would like to grant NMPAC permission. Signing
this form does not obligate you or anyone else in the company to make a contribution.
I authorize NMPAC to communicate and solicit voluntary political contributions from eligible
executive and management personnel of my company.
Authorized Official Title/Position Company Street Address City, State, Zip Signature 2015 Signature 2016 Signature 2017 Signature 2018 Signature 2019 If you would like to limit who NMPAC solicits in your company, or recommend additional individuals
who would be interested in supporting NMPAC, please list the names and emails of those who may be
solicited (please attach separate sheet as needed).
Name Name Name Email Address Email Address Email Address Federal election law requires political committees to collect and report the name, mailing address, occupation and name
of employer for each individual whose contributions exceed $200 in a calendar year. Contributions to NMPAC are not
tax deductible for federal income tax purposes. All contributions to NMPAC are strictly voluntary and no one will be
advantaged or disadvantaged based upon their decision to contribute or not to contribute. Corporate and foreign
national contributions are prohibited.
Please email this form to Amelia Wang at amwang@nmpa.org and return the original to our office at:
NMPA
975 F Street, NW
Suite 375
Washington, DC 20004
*Please keep a copy of this form for your records*