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 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.
I certify that as the individual contributor, I have provided my residential address, employer and principal occupation.
I certify that I am NOT a principal of a state contractor or prospective state contractor.
I certify that 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; the name on the card is the name provided above, payment on this card is not made from the funds of a corporation, labor organization or any other entity.
I certify that if I am a communicator lobbyist or the immediate family member of a communicator lobbyist that my contributions are limited to no greater than $100.
I certify that this contribution is not being reimbursed in any manner, is not being made as a loan, and is not an otherwise prohibited contribution.
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