By checking the box below, I hereby certify the following:
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 (Green Card) status in the United States.
I certify that I have provided my residential address and am 18 years of age or older.
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 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.
Please click this link for DEFINITION OF TERMS: http://www.ct.gov/seec/lib/seec/forms/certificationforms/definition_of_terms_statewide_01042016.pdf