EFTA01199076.pdf

DIANA C O N G R E S S Please join Pamela Church • Julie Muraco Claire Silberman • Rosina Rubin Hon. Elizabeth Holtzman • Mike Klein Marcia Sudolsky • Judi Allen Barbro Ehnbom • Tri State Maxed-Out Women Inc. Host Committee in Formation For a reception with Congresswoman Diana DeGette ChiefDeputy Whip on Thursday, April 245h, 2014 6:30 P.M. - 8:00 P.M. at The Home of Pamela Church Contribution Levels Chair - $2,500 • Host - $1,000 Supporter - $500 • Friend - $250 Authorized by Diana DeGette for Congress. Inc. EFTA01199076  To RSVP, please contact Emma Lowe at or blegysTE C O N G R E S S Thank you for your Support! I would like to attend the event as a Chair and contribute $2,500. I would like to be listed as an event Chair: Yes No I would like to attend the event as a Host and contribute $1,000. I would like to be listed as an event Co-Host _Yes No I would like to attend the event as a Supporter and contribute $500. I would like to attend the event as a Friend and contribute $250. I am unable to attend but would like to contribute $ Name: Address: City, State Zip: Phone number. Email: Occupation: Employer: Please make checks payable to: Contributions can be made online: Diana DeGette for Congress www.degette.com PO Box 61337 Denver, CO 80206 Please bill my personal credit card: O Visa O MasterCard O AMEX O Discover Amount: $ Card Number: Expiration: Security Code: (for American Express only): Name as it appears on the card: Signature: Maximum contribution $5,200 per person — $2,600 Primary Election, $2,600 General Election By signing above, you authorize us to charge your card in the amount indicated. You also affirm that your contribution is made from personal funds and not from funds otherwise prohibited by law. Under federal law, an individual may give up to $2,600 per election (primary and general) for a total of $5,200 to a federal candidate and no more than $48,600 during a two-year cycle to all federal candidates. 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. Authorized by Diana DeGette for Congress, Inc. EFTA01199077 Authorized by Diana DeGette for Congress, Inc. EFTA01199078