Law requires we ask for your employer and occupation. If you don't have an employer or are retired, put N/A, and if you are self-employed, put "self-employed" in the employer and describe your occupation.
Contributions are not tax deductible for income tax purposes, and corporate contributions cannot be accepted; An individual or non-multicandidate PAC without Mega PAC status (using non-corporate/non-union funds) may contribute up to $5,300.
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You are an individual, you are a U.S. citizen or lawfully admitted permanent U.S. resident ("green card" holder);
This contribution is made from your own funds and will not be reimbursed by any other person or entity;
This contribution is not made from the treasury funds of a corporation, labor union, or national bank or from any person or entity who is a federal contractor;
You understand this donation will be reported as an in-kind contribution or as a miscellaneous income.