Contributions of $50.00 or more, made by a single individual, must include the contributor's full name and address. This is to ensure compliance with Arizona Secretary of State financial reporting and Federal Election Commission requirements. I confirm the following statements are true and accurate:   

• I am not a foreign national who lacks permanent residence in the United States.
• I am not a Federal government contractor. 
• This contribution is made from my own funds, and not those of another.
• This contribution is not made from the funds of a corporation or labor organization.
• This contribution is made on a personal credit card or debit card for which I have the legal obligation to pay, and is not made either on a corporate or business entity card or on the card of another person.
• I am at least eighteen years old.