DS9 Document EFTA00301240

14 By donating I certify that: 1. I am a U.S. citizen or lawfully admitted permanent resident of the U.S. 2. I am making this contribution on a personal card with my own personal funds, not those of another person or entity. 3. I am not a federal contractor. 4. I am at least 18 years old. Contributions or gifts to Hillary for America are not tax deductible. An individual may contribute up to $2,700 per election (the primary and general are separate elections). By submitting your contribution, you agree that the first $2,700 of a contribution will be designated for the 2016 primary election, and any additional amount up to $2,700 will be designated for the 2016 general election. By providing your phone number, you are consenting to receive calls, including automated calls to that number from Hillary for America. 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. Mail: To contribute by mail, please send a personal check made payable to "Hillary for America" to: Hillary for America PO Box 1700 Merrifield, VA 22116-9552 Please include your full name, address, phone number, email address, occupation and employer in the envelope. EFTA00301240