By checking this box, I certify that the following statements are true and accurate:
1. I am a U.S. citizen or a lawfully admitted permanent resident of the United States (i.e., “green card holder”).
2. This contribution is made from my personal funds and is not made with the general treasury funds of a corporation, foreign national, labor union, federal government contractor (does not apply to personal contributions made by subcontractors, employees, partners, officers or shareholders of federal contractors), or a minor under the age of 18.
3. This contribution will not be reimbursed by another person or entity.
4. I am at least 18 years old.
5. This contribution is made from my personal credit card or debit card for which I have the legal obligation to pay and is not made using the credit card or debit card of a prohibited entity including a corporation, labor union, or another person or entity.
Consistent with federal law, Fired Up Pac, Inc. makes its federal contributions from one account (the “Contribution Account”) and engages in other political activity from the other account (the “Non-Contribution Account”). You may contribute up to $5,000 per calendar year to Fired Up Pac, Inc.’s Contribution Account. You may contribute an unlimited amount to Fired Up Pac, Inc.’s Non-Contribution Account. By signing above, you agree that the first $5,000 of your cumulative contribution in a calendar year will be deposited in Fired Up Pac, Inc.’s Contribution Account and the remainder in Fired Up Pac, Inc.’s Non-Contribution Account. Any contributions from corporations or nonprofit organizations will be deposited in Fired Up Pac, Inc.’s Non-Contribution Account.
Contributions to Fired Up Pac, Inc. are not deductible as charitable contributions 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 in an election cycle. Contributions in any amount from foreign nationals, federal government contracting entities, national banks and other federally-chartered institutions are strictly prohibited.