FEDERAL ELECTION LAW REQUIRES THE FOLLOWING INFORMATION: Full Legal Name: Street Address: City: State: Zip Code: Daytime Phone: Evening Phone: Occupation: Employer:
By making this endorsement, you confirm that the following statements are true and accurate:
- You are a citizen or permanent resident of the United States.
- The funds you are contributing are your own personal funds and not those of another person.
- Your contribution is not from the general treasury funds of a corporation, labor organization, or national bank.
- You are not a federal contractor.
- You are not a foreign national who lacks permanent resident status in the United States.
- You are at least 18 years of age.
Electronic Signature: By typing your name into this online form, you signify your endorsement of Kathleen “Suzy” Evans.