I confirm that the following statements are true and accurate:

• This contribution is made from my own funds, and not those of another.
• My contribution is not from general treasury funds of a corporation, labor organization, or national bank.
• I am not a federal government contractor.
• If a foreign national, I have permanent resident status and hold a green card.
• If a minor, I am voluntarily making this contribution, which consists of my own funds; my contribution is not controlled by another individual and is not made from a gift given to me to make this contribution.
• I am making this contribution with 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.
• Contributions are limited to $10,000 per individual, per calendar year. The primary and general elections are separate elections, so individuals may give a total of $4600 for both elections.

Contributions to the Douglas County Democratic Central Committee are not deductible for federal income tax purposes. Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and name of employer of individuals whose contributions exceed $200 per calendar year. Corporations, unions, federal government contractors, and national banks are prohibited from contributing, as are certain foreign nationals. Contributions must be made from personal funds. The decision by a minor to contribute must be knowing and voluntary; the contributed funds, goods, services must be owned and controlled exclusively by the minor and not by any other individual; contributions may not be made from gifts made to the minor to provide funds for the contribution. All contributions must be made from personal funds and may not be reimbursed or paid by any other person.