Trumbull DTC General Fund

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Are you a communicator lobbyist:? Choose one:*

Are you a spouse or dependent child of a communicator lobbyist? Choose one:*

Are you a principal of a state contractor or prospective state contractor (includes spouse or dependent child)? Choose one:*

I certify that I am not a principal of a holder of a prequalification issued by the Commissioner of Administrative Services*

I certify that I am not a principal of a holder of a prequalification issued by the Commissioner of Administrative Services

I certify that I am 18 years of age or older.*

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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 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 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 this contribution is 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 all of the information disclosed by me and set forth above on this contributior form is true and accurate to the best of my knowledge and belief.*

I certify that all of the information disclosed by me and set forth above on this contributior form is true and accurate to the best of my knowledge and belief.

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