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Federal law requires us to use best efforts to collect and report the name, address, occupation and employer of each individual whose aggregate contributions exceed $200 in a two-year federal election cycle. Please provide the following information:

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1. I am a U.S. Citizen or lawfully-admitted permanent resident (a “Green Card holder”).

2. I am at least 18 years of age.

3. I am making this contribution using my personal credit or debit card, which I have a legal obligation to repay, and not the card of any business entity or any other person.

4. No one has provided me with funds for the purpose of making this contribution, and I will not be reimbursed for this contribution.

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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 employer and describe your occupation.

Contributions to Pezullo for Senator are not tax deductible as charitable contributions for federal income tax purposes. Contributions will be used in connection with federal elections, and all contributions are subject to the following limits: from an individual or non-multicandidate PAC, $2,600 per election; from a married couple, with the signatures of both spouses, $5,200 per election in joint funds; from a multicandidate PAC, $5,000 per election. For purposes of these limits, the primary and general elections are considered to be separate elections. Contributions from corporations, labor organizations, national banks and other federally chartered institutions, federal government contractors, foreign nationals not lawfully admitted for permanent residency, or another person’s or entity’s funds are prohibited.

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