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New Jersey Election Law requires political committees to report the name, mailing address, occupation and
name of employer for each individual whose contributions aggregate in excess of $300 per calendar year.
By submitting the form above, I confirm that the above statements are true and accurate.
I am a citizen or permanent resident in the United States.
I affirm that I am making this contribution via personal/corporate credit or debit card for which I have a legal obligation to pay.
I affirm that I am making this contribution via my personal credit or debit card for which I have a legal obligation to pay, and not through a corporate or business entity card or the card of another person.
My contribution is made from personal funds, and not from the general treasury funds of a corporation, organization or national bank.
I have not received any funds from another person or entity for the purposes of making this contribution.
I am a United States citizen, or a Green Card Holder who has been lawfully admitted for permanent residence and this contribution will not be reimbursed by another person.