____By marking this space, I certify that contributions to Cindy Werner for Lt. Governor are not deductible as charitable contributions for Federal income tax purposes. I am a U.S. citizen or lawfully admitted permanent resident. This contribution is made from my funds, and funds are not being provided to me by another person or entity to make this contribution. Corporate contributions are prohibited. Contribution limits of $20,000 per election cycle apply. Wisconsin law requires that we collect and disclose the occupation for any individual contributing more than $200 in a calendar year.