I certify that I am NOT a principal of a state contractor or prospective state contractor.
I certify that I am either a United States citizen or a foreign national with permanent resident status in the United States.
I certify that I have provided my residential address.
I certify that this contribution is being made on my personal debit or credit card for which I have 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, and is not an otherwise prohibited contribution and that payment is not made from the funds of a corporation, labor organization, or any other entity.
I hereby certify that all information disclosed by me on this contributor form is true and accurate to the best of my knowledge and belief.
* You may enter an alternate address in lieu of your residential address only if you are admitted into the Address Confidentiality Program pursuant to General Statutes § 54-240 (a) or if you are one of the individuals with protected address status articulated in General Statutes § 1-217.
** Note that under Public Act 10-1, communicator lobbyists and their immediate family members are permitted to give contributions of up to one hundred dollars in the aggregate to statewide candidates.
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