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Dea & Ron Berberian Hon. Tom Berryhill Floyd Kvamme Hon.

Dan Logue Stephanie & Je Miller

Hon. Jim Nielsen Alexis & Barry Ruhl Susie & Dean Spanos Helen & Michael Spanos Rock Zierman

cordially invite you to a luncheon with

Governor Rick Perry

Thursday, December 1, 2011 The Park Ultra Lounge
1116 15th Street, Sacramento

11:30 a.m. VIP Photo Opportunity $1,000 per person

11:45 a.m. Luncheon $500 per couple

RSVP Lindsey Seitchik (916) 476-5240 Lindsey@SeitchikHQ.com

Business Attire Please See The Attached Reply Form For Important Contributor Information.

Paid for by RickPerry.org Inc.

I support Rick Perry! Please reserve tickets at the following level:

Please reserve ____ ticket(s) at $500 per couple for the Luncheon. Please reserve ____ tickets(s) at $1,000 per person for the VIP photo opportunity.

Attending will be ______________________ & __________________________.


Please include me as a member of the Host Committee. I commit to raising/bundling the following for this event: EVENT CHAIR ($25,000)
5 photos at the VIP Photo Opportunity (2 people per photo) 10 tickets to the Luncheon

EVENT HOST ($10,000)

2 photos at the VIP Photo Opportunity (2 people per photo) 8 tickets to the Luncheon

For information on bundling programs or ticketing, please call Lindsey Seitchik (916) 476-5240
I/we are unable to attend. Please accept my/our contribution of: $__________________

Bundler Tracking #: ________________ Referred by: _________________________________

Federal law requires us to obtain and report the name, mailing address, occupation and name of employer for each individual whose contributions aggregate in excess of $200 per election cycle. Please complete the following:

Name: _______________________________________________________________________ Occupation: __________________________ Employer: _____________________________ Employer: ___________________ E-mail: ______________________ Joint Contributor Only: Occupation: _________________ City: _______________ State: _______ Zip: __________ Daytime Phone: _______________________ Contributor Information
This contribution is made by check or credit card from my personal funds and is not drawn on an account maintained by an incorporated entity. I am a US citizen or permanent resident and this contribution will not be reimbursed by another person. Signature: __________________________________ By law, the maximum amount an individual may contribute is $2,500 ($5,000 per couple) per election. For a contribution from a joint account to be attributed to two individuals, both must sign this form, indicating agreement with the above statement. Joint Contributor Signature: _____________________________________

Address: ______________________________________________________________________ Mobile Phone: _________________________ Credit Card Reply Fax To: 916-238-1397
Please charge my contribution of $_______ to my credit card. Select one: Visa MasterCard AMEX Discover

Account Number: _________________________ Expiration Date: ________ Security Code: ______ Name on Card: _____________________________ Signature: _________________________________
Contributions are not tax deductible as charitable contributions for federal income tax purposes. Contributions by corporations, foreign nationals (nongreen card holders), labor unions, federal government contractors, and some, but not all, minors under the age of 18 are prohibited.

Make Checks Payable & Mail To: RICKPERRY.ORG INC. c/o Lindsey Seitchi P.O. Box 162137, Sacramento, CA 95816

For questions, please call Lindsey Seitchik at (916) 476-5240.

Paid for by RickPerry.org Inc.