I hereby certify that:
I am a United States citizen or permanent resident alien. The funds being contributed are my own and were not provided to me by another person or entity for the purpose of making this contribution. I am not a “business entity” as defined by N.J.S.A 19:44A-20.3 et seq. and amended by Executive order 117 , that holds or is seeking a contract with the State of New Jersey in an amount in excess of $17,500.