EFTA02694613.pdf

HAROLD SIEGEL INVITES YOU TO A LUNCHEON TO HONOR CONGRESSMAN ALLEN WEST (R-FL-22) ARMED SERVICES & SMALL BUSINESS COMMITTEES Born and raised in Atlanta, Allen West was elected to Congress in 2010 and proudly represents Florida's 22ed district (including Fort Lauderdale, Boca Raton, Palm Beach, West Palm Beach). He serves on the House Armed Services Committee and the House Committee on Small Business. Cong. West served our country for more than 20 years in the US Army and retired as a Lieutenant Colonel. He served in Operation Desert Storm, Operation Iraqi Freedom and in Afghanistan and has been honored many times including a Bronze Star, three Meritorious Service Medals, three Army Commendation Medals (one with Valor) and a Valorous Unit Award. He now resides in Brow ard County, FL with his wife Angela and two daughters. Monday, November 14, 2011 12:00-1:30 PM The Friars Club 57 East 55th Street, New York The Milton Berle Room Suggested Donation: $500, $1,000, $2,500 Please RSVP to Carolyn Machado by sending the completed reservation form via email to machadoRSVP@aol.com, fax to 703 266-5873 or mail to 6111 Newman Road, Fairfax, VA 22030. Please call 703 266-5872 with any questions or for more information. Paid for and authorized by Allen West for Congress. RECEPTION WITH CONGRESSMAN ALLEN WEST EFTA_R1_02042669 EFTA02694613  MONDAY, NOVEMBER 14, 2011 12:00-1:30 PM THE FRIARS CLUB RESERVATION FORM Yes, I/We will attend the reception for Cong. West. Enclosed is $, for person(s). Guests will be: No, I will be unable to attend but do support Cong. West. Enclosed is $ for his campaign. Method of payment: personal check PAC check personal credit card Please make checks payable to: Allen West for Congress Please complete the following information: O Visa O Master Card O American Express Name on Card Amount S Card Number Security Code Exp. Date Signature of Contributor: My signature verifies that this contribution represents nrypetronalfiordr andis not drawn on an account maintained by an incorporated entity or otherprohibited soarers. All contributors must complete the following information. We are required to report the name, address, occupation and employer of all contributors, * and the other contract information is necessary for us to reach you. Full Name: Spouses' Name (if joint contribution): Spouses' Signature (if joint contribution): Employer. Occupation: Spouse's Employer. (if joint contribution): Address: (Iity: State: Zip: I lame Phone: Work Phone: Fax: I:-Mail: Cell Phone: *Federal law requires political committees to do their best efforts to obtain and report the name, mailing address, occupation and employer for each individual whose contributions aggregate in excess of 5200 in an election cycle. Contributions to Allen West for Congress arc not deductible as charitable donations for federal income tax purposes. Maximum contribution per individual is $2,500 per election cycle and multi-candidate PAC is $5,000 per election cycle. Contributions from corporations and foreign nationals are prohibiter, Paid for by Allen West for Congress. E FTA_R1_02042670 EFTA02694614