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					  Reps. Steve Israel, John Larson, Chris Van Hollen, Jim Clyburn, Sandy Levin, Pete Stark,
    Jim McDermott, John Lewis, Joe Crowley, Emanuel Cleaver, Charles Gonzalez, Jose
  Serrano, Ed Pastor, Carolyn Maloney, Jan Schakowsky, G.K. Butterfield, Gregory Meeks,
   Nita Lowey, Sheila Jackson-Lee, Barbara Lee, Eddie Bernice Johnson, Donna Edwards,
  Frederica Wilson, Rob Andrews, Corrine Brown, Bennie Thompson, Chaka Fattah, Karen
      Bass, Terri Sewell, Shelley Berkley, Steve Cohen, Lois Capps, Jim McGovern, Jim
   Langevin, Elijah Cummings, Bill Pascrell, Brad Sherman, Mike Capuano, Bobby Scott,
                        Richard Neal, Mike Thompson, Pedro Pierluisi
                                           (list in formation)

            Cordially Invite You to a Birthday Reception for

                           Charlie Rangel
                       Chairman Emeritus, House Ways and Means Committee
         Democratic Candidate for Congress, 13th Dist. of New York

                 Wednesday, June 20, 2012 @ 6:00 pm
     Hosts: Honorable Dick Gephardt, Honorable Martin Frost, Honorable Alan Wheat,
   John Jameson, David W. Jones, Vincent Eng, Sudafi Henry, Chuck Brain, Thomas Kim,
William Oldaker, Rosa Whitaker, Bill Signer, Ken Bowler, Alex St. James, Rob Leonard, Javier
Llano, Steve Bailey, Florence W. Prioleau, Dan Moldonado, Bernie McKay, Michael Williams,
    Brian Moran, Bob McGlotten, Erin Graefe, Mike McKay, John Raffaelli, Jon Talisman,
  Jamie Harrison, Jon Sheiner, Jim Arbury, Stu Eizenstat, Larry Thompson (list in formation)

                             At the Home of John Jameson
                              616 North Carolina Ave SE
                                 Washington, DC 20003

                          Individual: $250, PAC: $500
                      Young Professional (under 30): $100
              Host: Individual (write or raise), $1,000 PAC $2,500
         Please RSVP by emailing Jackson Barnett at jksnbrntt@me.com
                              or calling 941-268-6481
                       Paid for and Authorized by Rangel for Congress. Printed In-House
                                   Rangel for Congress
                                           June 20th Reception

PLEASE 1) Go online and make your contribution at www.charlierangel.org (preferred),
                       2) FAX this form to 212-862-4845, or
               3) Send your check payable to “Rangel for Congress” to:

                                    Rangel for Congress
                   P.O. Box 5577 Manhattanville Station New York, NY 10027

_____ Yes, I/we would like to attend the reception, enclosed is my contribution of $________

_____ No, I/we are not able to attend, please accept a contribution of $ _________

Contributions to Rangel for Congress are limited to $5,000 per individual ($2,500 for the primary election and $2,500
for the general election) and federal multi-candidate PACs may contribute $10,000 ($5,000 for the primary election
and $5,000 for the general election). A husband and wife may contribute $10,000 ($5,000 each) by one check drawn
from a joint account and signed by both individuals. Federal law requires us to use our best efforts to collect and
report the name, mailing address, occupation, and name of employer for individuals whose contributions exceed
$200 in an election cycle. If this is a contribution from a husband and wife by one check drawn from a joint account
and signed by both individuals, please provide the requested information below for both individuals.

Name: ______________________________________________________________________

Mailing Address:_______________________________________________________________

City: __________________________________ State: _____________ Zip Code:___________

Occupation: ___________________________ Employer: _______________________________

Home Phone: __________________________ Work Phone: _____________________________

Fax: __________________________________ Cell Phone: ______________________________

Email: ________________________________________________________________________

If you prefer to pay by credit card, please complete the following:

Credit Card Type: _____ Visa _____ MasterCard _____

Name on card: ____________________________________________________ Amount: _________

Billing Address (if different):

Card Number: _______________________________________ Exp. Date: ________ Code:_________

Federal law prohibits contributions to Rangel for Congress from corporations, labor organizations and national
banks; from any person contributing another person's funds; from foreign nationals who lack permanent resident
status; and from federal government contractors. By signing below, I affirm that my contribution is from personal
funds and not from funds otherwise prohibited under law.
Contributor Signature (REQUIRED):

Contributions or gifts to Rangel for Congress are not tax deductible as charitable contributions.

                      Paid for and Authorized by Rangel for Congress. Printed In-House.

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