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I confirm that:

• I am a U.S. Citizen or lawfully admitted permanent resident
• This contribution is made from my personal funds, not from an account maintained by a corporation, laborunion, or national bank, and is not being reimbursed by another person or entity.
• I am not a federal government contractor.
• The maximum amount an individual may contribute is $6,550.00 per election.
• Contributions to Gillis for Goodyear are not tax deductible for federal income tax purposes. Contributions from corporations, labor unions, federal contractors, and foreign nationals are prohibited.