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Please join us for

A breakfast honoring




Senator Debbie Stabenow (D-MI)

Thursday September 17
th
, 2009
8:30 AM

Monocle
107 D Street, NE
Washington, DC

Suggested Contribution $1,000 PAC/Personal


Please RSVP to:
Jeremy Gold at (202) 546-9292 or
jeremysgold@yahoo.com


Contributions to Stabenow for US Senate are not tax deductible for federal income tax
purposes. Federal law requires us to collect and report the name, mailing address, occupation,
and name of employer of individuals whose contributions exceed $200 in an election cycle.
Contributions by corporations and foreign nationals are prohibited. Not printed at government
expense.


Please make checks payable to:
Stabenow for US Senate
426 C Street NE
Washington, D.C. 20002
Paid for and authorized Stabenow for US Senate



September 17, 2009 EVENT TO BENEFIT Senator Debbie Stabenow



___ Yes, I would like to attend with a $________ contribution.

___ Sorry, I am unable to attend the event, but enclosed is my
contribution of $___________.

Federal law requires us to use our best efforts to collect and report the name and mailing
address, occupation and name of employer of individuals who make contributions.

Corporate contributions and contributions from non-U.S. citizens who are not lawfully
admitted for permanent residence are prohibited. All contributions by individuals must
be made from personal funds and may not be reimbursed or paid by any other person.


Name_________________________________________________________

Employer_____________________________________________________

Occupation_______________________________________________________

Address_______________________________________________________

City, State, ZIP__________________________________________________

Phone________________________ Fax______________________________

Email_________________________________________________________

Guest(s)_______________________________________________________

Make checks payable to Stabenow for US Senate and mail to:
426 C Street NE, Washington, DC 20002

OR FAX THIS FORM TO: Attn: Jeremy Gold 202-543-8455


Please bill $______ to my: ___Visa ___ Mastercard ____ AMEX

Account # ___________________________________________

Exp.____________ Security Code_________

Billing Address (if different than above) _________________________

___________________________________________________

Signature____________________________________________

This personal, not corporate, card belongs to__________________

Contributions to Stabenow for US Senate are not deductible
for federal income tax purposes.

Paid for and authorized by Stabenow for US Senate

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