I hereby certify and state that all of the information disclosed by me and set forth above on this contributor card 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 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.
