By submitting this form you agree that:
1. I am a United States citizen or an individual lawfully admitted with permanent residence status (e.g., a "green card holder")
2. This contribution is made from the funds of the donor identified above, and not those of another.
3. Donor is not a foreign national who lacks permanent resident status in the United States.
4. This contribution is not made from the treasury of an entity or person who is a federal contractor (does not apply to personal contributions by subcontractors, employees, partners, shareholders or officers of federal contractors).
5. This contribution is made on a credit or debit card of the donor listed above for which the donor has legal obligation to pay, and is not made on the card of another.
Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation and name of employer of each individual whose contributions exceed $200 in a calendar year.