DA-Japan National Donation Form
Please fill out this form if you would like to make a donation to Democrats Abroad Japan. This form will send an e-mail to our National Treasurer with all the information needed to comply with Federal Election Commission (FEC) guidelines for donations. If you would not like to use a google form, or have any questions or concerns, please mail national treasurer at
or a chapter treasurer directly.
These details help us follow up with you and book your donation, for which you will receive credit!
The name of the person who is donating.
An e-mail address to verify receipt of your donation details.
These details help us organize our information and make sure we comply with the limits mandated by the Federal Election Commission (FEC).
What is the date the donation was made?
What is the amount of the donation, in Japanese Yen? (Please state the estimated value of the item or service provided if this is an in-kind donation.)
Under what chapter is this donation from?
Please inform your chapter treasurer if you have made an expense in their region.
Kanto Chapter - Ex: Tokyo, Yokohama, Saitama (Treasurer: Matthew)
Kansai Chapter - Ex: Osaka, Kyoto, Kansai (Treasurer: Ray)
Tokai Chapter - Ex: Nagoya, Toyota, Gifu Area (Treasurer: Eric)
Other, Not Listed (National Treasurer: Dave)
Is this an anonymous donation?
If this is an anonymous donation, you will be limited to donation a maximum of $50 USD per day per person. We still need to verify the money is coming from an American national for the FEC, but on our public report your name will not be listed.
Yes, this is an anonymous donation.
No, this is not an anonymous donation.
Is this a cash donation?
If this is a cash donation, you will be limited to a donation maximum of $100 USD per day per person.
Yes, this is a cash donation.
No, this is not a cash donation, e.g., made by bank transfer.
How will you be donating today?
Wire Transfer Details: Account Name: DAJ, Mizuho Bank みずほ銀行, Branch 044 Shirogane 白金支店, Normal Account 普通 - Futsuu, Account #1524323 銀行口座番号 (Always confirm that the final name on the account shows DAJ or member #3453405 before sending money. If Hiroo does not show up or the confirmation is incorrect, attempt the parent branch 広尾支店 Hiroo.)
In cash to a Democrats Abroad Japan officer.
Via ATM transfer to the Democrats Abroad Japan domestic Mizuho bank account.
Anonymously at an event.
This is an in-kind donation for an item or service, not a monetary donation.
Why did you decide to donate today?
This answer helps us determine how to best allocate funds for spending in the executive committee.
Necessary acknowledgements for legal compliance.
Confirmation of United States Citizenship
The Federal Election Commission (FEC) states that our organization may not take any money from a foreign national. By selecting "Yes, I am a United States citizen." below, you are confirming that you are a current United States citizen and over the age of 18 and all the information above is true and correct to the best of your knowledge.
Yes, I am a United States citizen.
Confirmation of Yearly Limit
Please confirm that with the funds included in this donation your individual contribution to Democrats Abroad Japan does not exceed your total yearly limit of party contributions of $35,500 USD as regulated by the FEC.
All of my donations including this one do not exceed $35,500 for this year in total.
If your donation is greater than $200, please report your employer, or student/retired/unpaid-home worker/unemployed
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