If you are self-employed, please list the name of the entity that is on your paycheck. Please list your line of work. "Business Person" is not acceptable, please enter the type of business instead. If retired, please list your last employer or line of work.

• I do not have a case pending before Judge Rhinehart.
• I am not a foreign national who lacks permanent residence in the United States.
• This contribution is made from my own funds, and not those of another.
• This contribution is not made from the funds of a business entity, corporation or labor organization.
• This contribution is made on a personal credit card or debit card for which I have the legal obligation to pay, and is not made either on a corporate or business entity card or on the card of another person.
• I am at least eighteen years old.

Contributions or gifts are not tax deductible.