Obama for America

Cordially invites you to

a luncheon with special guests

Jane Lynch
and

First Lady Michelle Obama

Tuesday, June 26th, 2012
11:00 in the morning
Fultons on the River
315 North LaSalle
Chicago, IL
Please contact Jeremy Hallahan with any questions at
JHallahan@barackobama.com
RSVP online at: https://my.barackobama.com/June26ChicagoLuncheon
Paid for by Obama Victory Fund 2012, a joint fundraising committee authorized by Obama for America, the Democratic
National Committee, and the State Democratic Parties in the following states: CO, FL, IA, NV, NH, NC, OH, PA, VA, and WI.

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

Yes! I/we would like to attend the luncheon on June 26th:

$5,000 per person: Event Host, includes one photo for group of up to 5 guests + 5 tickets for the luncheon (preferred seating)
$2,500 per person: Event Sponsor, includes one photo + one ticket for the luncheon (preferred seating)
$1,000 per person: includes one ticket to the luncheon (preferred seating)
$250 per person: includes one ticket to the luncheon (general seating)
I am unable to attend, but would like to support Obama Victory Fund 2012 by contributing: $___________
Name(s) of attendee(s): ____________________________________________________________________________
I was invited to attend by: __________________________________________________________________________
Please make checks payable to:
Obama Victory Fund 2012
130 E Randolph Street, Suite 600 | Attn: Jeremy Hallahan
Chicago, IL 60601
Fax: (312) 361-8075
Total Amount: $________________

Invited
by: _____________
Click here to contribute online:
https://my.barackobama.com/June26ChicagoLuncheon
Obama Victory Fund 2012 does not accept contributions from currently registered federal lobbyists, registered foreign agents,
political action committees, or minors under the age of 16. Corporate and labor union contributions are prohibited.
Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation and employer of
individuals whose contributions exceed $200 in an election cycle.
First & Last Name: _________________________________________________________________________________________________________________________________________________________
Address: ______________________________________________________________________________ _____________________________________________
City/State/Zip: _________________________________________________________________________________________________________
Employer: _____________________________________________ Occupation: ____________________________________________________
Work Phone: ___________________________________________ Work Fax: _____________________________________________________
Home Phone: __________________________________________ Email: _________________________________________________________

Federal law prohibits foreign nationals, except lawfully admitted permanent residents of the U.S., from contributing to the
Obama Victory Fund 2012. By signing below, I certify that I am a U.S. citizen or lawfully admitted permanent resident of the
U.S., the funds I am donating are not being provided to me by another person or entity for the purpose of making this
contribution, and that my contribution shall be allocated as stated below.

Signature: _____________________________________________________________________________________________
Second Signature, If Contributing From Joint Account*: _________________________________________________________
Contribute by Personal Check:
Please make checks payable to Obama Victory Fund 2012 and mail to the address listed above.
Contribute by Credit Card:
Please bill my personal credit card:
Visa
MasterCard
AMEX
Discover
Card Number: _____________________________________________________________________Exp: _______________________
Name as it appears on the card: _______________________________________________________________________________
Signature: _______________________ ________________________________________ _________________
Second Name on Account, if Joint Account*: ______________________________________________________________________________
*Contributions will be evenly attributed between names.
Second Name Employer: ______________________________________ Second Name Occupation: ______________ _________________
Second Signature for Joint Account: ___________________________________________________________________________

IL238

Contributions or gifts to Obama Victory Fund 2012 are not tax deductible. The first $5,000 of a contribution to OVF 2012 will be
allocated to Obama for America (with the first $2,500 designated for the primary, and the next $2,500 for the general election). The next
$30,800 of a contribution will be allocated to the Democratic National Committee. Any additional amounts from a contributor will be
divided among the State Democratic Party Committees as follows, up to $10,000 per committee and subject to the biennial aggregate
limits: FL (17%); OH (16%); PA (13%); CO (11%); NC (11%); VA (11%); NV (6%); WI (6%); IA (5%); and NH (4%). A contributor may
designate his or her contribution for a particular participant. The allocation formula above may change if following it would result in
an excessive contribution. Contributions will be used in connection with a Federal election.
Paid for by Obama Victory Fund 2012, a joint fundraising committee authorized by Obama for America, the Democratic
National Committee, and the State Democratic Parties in the following states: CO, FL, IA, NV, NH, NC, OH, PA, VA, and WI.
Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.