MINOR’S STATEMENT OF GOOD FAITH
CONTRIBUTION TO CANDIDATE FOR MAYOR OR CITY COUNCIL OF
THE CITY OF
Name of minor making
contribution (Print)
I, ,
am under 18 years of age and wish to make a contribution of $ to
Name of candidate (Print)
, a candidate for Mayor/City Council
of the City of
I hereby verify that this
contribution is being made with my personal funds and that no other individual
has provided these funds to me for the purpose of making
this contribution.
Date Printed Name of Minor
Date Signature of Minor