I hereby certify that I have read and understand the applicable definitions,
http://www.bethelrepublicans.com/donation-definitions/
and that I am either a United States citizen or a foreign national with permanent resident status in the United States. and also hereby certify and state:
1) That all of the information disclosed by me and set forth on this contributor form is true and accurate to the best of my knowledge and belief.
2) I am NOT a principal of a state contractor or prospective state contractor.
3) I am NOT a communicator Lobbyist, nor the spouse or dependent child of a communicator lobbyist.
4) This contribution is being made from my personal funds, is not being reimbursed in any manner, is not being made as a loan, and is not an otherwise prohibited contribution.
5) That I have provided my residential address.
6) I am eighteen years of age or older.
7) This contribution is made on my personal debit or credit card for which I have a legal obligation to pay and intend to pay from my own personal funds, is not being reimbursed in any manner, is not being made as a loan, is not an otherwise prohibited contribution, and that payment on this card is not made from the funds of a corporation, labor organization or any other entity.