I certify that I am NOT a principal of a town contractor or prospective town contractor for the town of East Hartford, CT.
I certify that I am a United States Citizen or 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 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, 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.