* I certify that I am NOT a principal of a state contractor or prospective state contractor.
* 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 have provided my residential address.
* 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, is not being reimbursed in any manner, is not being made as a loan, is not an otherwise prohibited contribution, and that payment on this card is not made from the funds of a corporation, labor organization or any other entity.
* I hereby certify that all of the information disclosed by me on this contributor form is true and accurate to the best of my knowledge and belief.
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