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Your Age Employer (if self-employed, please put in a description such as "Dave's Painting" or "Retired" or "Student") Principal Occupation (if self-employed, please put in a description such as "Dave's Painting" or "Retired" or "Student") Is this contribution being made from the account of a Sole Proprietorship? If "Yes" and the name is different than individual contributor, list NAME OF SOLE PROPRIETORSHIP Are you a Communicator lobbyist? Are you a Spouse or Dependent Child of a Communicator Lobbyist? Are you a Townwide or State Contractor? (Please note that if you answer "yes" at all, we will have to return your donation) How else would you like to help support local Democrats?

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