Click here for definitions of items on this form.
● Required Field
We may occasionally send you emails or texts if you supplied those contact methods. You can opt out at any time by emailing email@example.com.
Employer - If multiple employers and one is a state contractor, list the state contractor. If self-employed, provide Name of Business. Example: Dave’s Painting; Other Examples: Retired, Unemployed, Student, Homemaker
Principal Occupation - If self-employed, provide Job Description. Example: Painter; Other Examples: Retired, Unemployed, Student, Homemaker
Are you a communicator lobbyist? - 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 party committees.