I affirm the following statements are true and accurate:

1) Federal Law requires that you verify the following statements are true and accurate. I am a United States citizen or an individual lawfully admitted with permanent resident status (e.g. green card holder). This contribution is made from my own personal funds with a personal credit card, and not with a corporate credit card or funds provided to me by another person or entity. I am not a federal government contractor. I am at least 18 years old.

2) Contributions to Nicole for New York are not tax deductible for federal income tax purposes. Contributions to Nicole for New York will be used in connection with federal elections and are subject to the limitations and prohibitions of federal law. The maximum an individual may contribute is $5,600 for the primary and general elections. Contributions from corporations, labor unions, federal government contractors, national banks, and foreign nationals without permanent residency status are prohibited.

Please note: A spouse must contribute as a separate transaction.