Please confirm that the following statements are true and accurate:

1) I am a United States citizen or a permanent resident alien.

2) This contribution is not made from the general treasury funds of a corporation, labor organization or national bank.

3) This contribution is not made from the treasury of an entity or person who is a federal contractor.

4) The funds I am donating are not being provided to me by another person or entity for the purpose of making this contribution.