I hereby certify and state that all of the information disclosed by me and set forth on this online contributor form is true and accurate to the best of my knowledge and belief. 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 am 18 years of age or older. I understand that this contribution is NOT tax deductible.
NOTE: Total contributions from an individual to a Town Committee may not exceed $2000 in a calendar year.