CONTRIBUTOR:
State: AK AL AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY N/A
Zip/Post:
1. I am a United States citizen or a permanent resident alien.
2. I am making this contribution (and paying this credit charge) with my own personal funds, and I am not using funds provided by any another person or from any corporation, labor union or national bank to make this contribution.
3. I am not a federal contractor.
4. I am making this contribution on my own personal credit card and not with a corporate or business credit card or a credit card issued to anyone else.
5. I am at least 18 years of age.
Paid for by F.O.L.C., Jordan R. Carpenter, Treasurer. 2432 Perot St. Philadelphia, PA 19130, 267.970.2890 Design and hosted by Stone Solutions Group