6_20 WJC Invite by CelesteKatz

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     Anne  Hess  &  Craig  Kaplan  •  Sarah  &  Victor  Kovner    
             Tri-­‐‑State  Maxed-­‐‑Out  Women  PAC  
                                   (Host  Committee  in  formation)  

            Cordially  invite  you  to  a  reception  
                                           With  Special  Guest  

        President  Bill  Clinton  
                                      In  support  of  
Congresswoman  Louise  Slaughter  
            Ranking  Member  of  the  House  Rules  Committee  
              Co-­‐‑Chair  of  the  Congressional  Arts  Caucus  
             Wednesday,  June  20th,  2012  
                   5:30  PM  –  7:00  PM  
           Home  of  Marie  and  Harley  Lippman  
                    Exact  address  provided  upon  RSVP  
                                    New  York,  NY  

                    Please  RSVP  to  Jackie  Brot  Weinberg  at  
                (917)  699-­‐‑1462  or  jackie@jbwconsultingllc.com  
           Chris  Harris  at  (417)-­‐‑861-­‐‑0062  or  Chris@VoteLouise.com,  

                 Paid  for  and  Authorized  by  Louise  Slaughter  Re-­‐‑Election  Committee  

          Louise  Slaughter  Re-­‐‑Election  Committee  Contribution  Form  
               Co-Chair: $5,000• Co-Host: $2,500 • Supporter $1,000 • Friend: $500

                    □  Yes,  I  would  like  to  attend  this  event  and  contribute  $__________  
                              □  No,  I  can’t  attend,  but  I  will  contribute  $__________  
                                 Please  make  personal  or  PAC  checks  payable  to  
                                    “Louise  Slaughter  Re-­‐‑Election  Committee”  
                                   Or  contribute  online  at  www.votelouise.com  
Name:  _______________________________________________________________________________________  
Address:  _____________________________________________________________________________________  
City:  _________________________________________  State:  ____________  Zip:  _________________________  
 Work  Phone:  __________________________________Home  Phone:  __________________________________  
Cell  Phone:  ___________________________________  Fax:  ___________________________________________  
Email:  _______________________________________________________________________________________  
Employer:  ____________________________________  Occupation:  ____________________________________  
 Contributions  to  the  Louise  Slaughter  Re-­‐‑Election  Committee  are  not  tax  deductible.    Federal  law  requires  political  committees  to  report  
the  name,  address,  employer,  and  occupation  of  any  individual  who  contributes  more  than  $200.00  in  a  calendar  year.    Please  supply  this  
     information  with  your  contribution.  Individuals  may  contribute  up  to  $  2,500  per  election,  and  federal  multi-­‐‑candidate  PACs  may  
contribute  up  to  $5,000  per  election.  Contributions  from  corporations,  labor  unions,  national  banks,  government  contractors  and  foreign  
nationals  who  are  not  admitted  for  permanent  residence  are  prohibited.  All  contributions  must  be  made  from  personal  funds  and  may  not  
                                                           be  reimbursed  by  any  other  person.  


 Signature:  _________________________________  Name  (Print):  _____________________________________  

                                     Louise  Slaughter  Re-­‐‑Election  Committee  
                                          1150  University  Ave,  Building  5  
                                                  Rochester,  NY  14607  
                                       TO  CONTRIBUTE  BY  CREDIT  CARD:  
           Please  charge  _______________  to  my:  MasterCard          Visa          American  Express          (please  circle)  
Name  on  Card:  ____________________________________________________________________________________  
 Card  Number:  _______________________________________  Expiration  Date:  ___________  Security  Code:  _____  
 Billing  Address/City/State/Zip:  ______________________________________________________________________  
Authorized  Signature:  _________________________  Second  Authorized  Signature  __________________________  
                             PLEASE  VISIT  WWW.VOTELOUISE.COM  

              Contributions  or  gifts  to  Louise  Slaughter  Re-­‐‑Election  Committee  are  not  tax  deductible.  

                               Paid  for  and  Authorized  by  Louise  Slaughter  Re-­‐‑Election  Committee  


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