Please Join

Brian Griffin, Patricia Griffin, Muftiah McCartin, Boeing, Holly Fechner & Alexion
(host committee in formation)

For A Fundraising Reception Honoring

HON. ROSA DELAURO

Connecticuts 3rd Congressional District

MEMBER, HOUSE APPROPRIATIONS COMMITTEE RANKING MEMBER, LABOR, HEALTH AND HUMAN SERVICES SUBCOMMITTEE MEMBER, AGRICULTURE, RURAL DEVELOPMENT, FOOD AND DRUG ADMINISTRATION SUBCOMMITTEE CO-CHAIR, HOUSE DEMOCRATIC STEERING & POLICY COMMITTEE

Tuesday November 19, 2013 5:30 p.m. 7:00 p.m. Art & Soul The Liaison Capitol Hill ~ 415 New Jersey Avenue NW Washington, DC Host ~ write/raise $2,500 Sponsor ~ write/raise: $1,000 Friend ~ write/raise: $500 PAC $1,000
Please RSVP to: Jasmine Zamani ~ (202) 236-1205 ~ jnzamani@gmail.com Please make your check payable to: Friends of Rosa DeLauro 7240 Evans Mill Road McLean VA, 22101
Authorized and Paid for By Friend of Rosa DeLauro Patrick Charmel, Treasurer
Contributions or gifts to Friends of Rosa DeLauro are not tax deductible. We may accept contributions from an individual totaling up to $2,600 per election; $5,200 per election cycle. Federal PACs may contribute up to $5,000 per election; $10,000 per cycle. Federal law prohibits contributions to the campaign from corporations, labor organizations and national banks; from any person contributing another persons funds; from foreign nationals who lack permanent resident status; from federal government contracto rs. Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation and name of employer of individuals whose contributions exceed $200 in an election cycle

Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.

Tuesday, November 19th, 2013 ~ Fundraising Reception Contributions made payable to Friends of Rosa DeLauro can be mailed to: Friends of Rosa DeLauro 7240 Evans Mill Road McLean VA 22101 -or atwww.rosadelauro.com
You can also FAX this complete form back to : (202) 747-3865 For any questions please call Jasmine Zamani at (202 236-1205
Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and name of employer for individuals whose contributions exceed $200 in an election cycle

Name:_________________________________________________ Amount: _______________________ Address: _____________________________________________________________________________ City/State/Zip: _________________________________________________________________________ Occupation: __________________________ Employer: _______________________________________ Home Phone: _________________________ Work Phone: ____________________________________ Fax: ________________________________ Email: _________________________________________

If you prefer to pay by personal credit card, please fill out the following information: Name on Card: _________________________________________ Amount: ___________________ Visa American Express MasterCard

Card Number:___________________________________ Exp. _________ 3 Digit Code:________

YOU MUST ALSO SIGN BELOW: BY SIGNING BELOW,
I affirm that I am making this contribution with my own personal funds, and I am not using funds provided by any other person. I agree that the initial $2,600 of my contribution is designated for the primary and any additional amount up to $2,600 is designated for the general election campaign, up to a total of $5,200 for both elections. (For credit card contributors only): I am affirming that I am making this contribution on my own personal credit card and not with a corporate or business card or a credit card issued to or paid by anyone else (except for my spouse). Contributor Signature (REQUIRED): ________________________________________________________________________
Contributions are limited to $2,600 per individual and $5,200 per couple per election. The primary and general elections are separate elections, so individuals may give a total of $5,200 for both elections, while couples may give a total of $10,400. Federal multi-candidate political action committees (PACs) may contribute $5,000 per election. Contributions from corporations, labor organization treasury funds, foreign nationals, and federal government contractors are prohibited.

Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.