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Your information
Law requires we ask for your employer and occupation. If you don’t have an employer or are retired, put N/A, and if you are self-employed put "self-employed" in employer and describe your occupation.
Contributions are not tax deductible.
Payment details
I am a U.S. citizen or lawfully admitted permanent resident (i.e., green card holder). This contribution is made from my own funds, and funds are not being provided to me by another person or entity for the purpose of making this contribution. I am at least eighteen years old. Law requires we ask for your employer and occupation. If you don’t have an employer or are retired, put N/A, and if you are self-employed put "self-employed" in employer and describe your occupation. Contributions are not tax deductible.