CHAIRS KEN LANGONE DAVID MOORE

MARIA VICTORIA & LEE BARBA

JAMES TISCH JOHN WHITEHEAD CO-CHAIRS GAIL HILSON MARIANA & GEORGE KAUFMAN JULIA KOCH SHARON & JOHN LOEB LYNN & BILL MANGER ANNA & BILL MANN MARIA MITCHELL TIFFANY MOLLER MITCH MODELL MARC MUKASEY ANN DALY PRINTON COMMITTEE
CHERYL & BART SCHWARTZ JEANNE & HERB SIEGEL CANDY STRAIGHT LYNNE TARNOPOL BARBARA & DONALD TOBER MICHAEL VOLPE BILL WELSH CYNTHIA WHITEHEAD HOWARD WILSON DENNISON YOUNG CLELIA AND TOM ZACHARIAS

TONY COLES ALISON DIAMOND ANNE EISENHOWER JANICE ELLIG LINDA FRASER GEOFF HESS LUEZA & BRUCE GELB JUDITH & RUDY GIULIANI SUSAN ZISES GREEN

REGINA & RAINER GREEVEN

KATE ANSON ADAM BARSKY THERESA BEHRENDT CARMINE BILARDELLO ANDREW M. BLUM TIMOTHY BROWN LIZ BRUDER-FRYDMAN FRED CERULLO NOELLE & MATTHEW COLEMAN GIOVANNA CUGNASCA MELISSA DAVIS RICHARD R. DAVIS

WALTER L. DEANE BILL DIAMOND CHARLES E. DORKEY III TANA & BILL DYE DAVID EBER MOLLENA FABRICANT LISA FITZIG LILIAN & PORTER FLEMING MAYME & MONTE HACKETT LESLIE HEANEY FERNANDA KELLOGG & KIRK HENCKELS YAZ HERNANDEZ

DAVID HUNT JOEY KAISER HEATHER & TOM LEEDS GALE TURK LONDON KAY & CLARK MANDIGO HELEN MARX JOHN MASCIALINO JOCK MCCOWN CALVERT & GEORGE MOORE CLARE BRUDER MULLARNEY ROCHELLE PATRICOF MAHSA PELOSKY

DIDI SCHAFER KAREN SHAW LINDA SILVERMAN ELIZABETH SHIELDS LINDA & JOHN TAVLARIOS JOHN THORBECK JIM TOZER VANESSA VAN BRUNT NICHOLAS VIEST WILLIAM G. WALTERS GAIL ESSES WEINER LANCE WILSON

INVITE YOU TO A GET OUT THE VOTE BREAKFAST

WITH

C ANDIDATE FOR M AYOR OF THE C ITY OF N EW Y ORK

JOE LHOTA

MONDAY, SEPTEMBER 9, 2013 8:00 A.M. 9:30 A.M.

(7:30 A.M. DOORS OPEN; 8:30 A.M. PROGRAM BEGINS) 1335 AVENUE OF THE AMERICAS (BETWEEN 53RD AND 54TH STREETS)

NEW YORK HILTON HOTEL

TICKETS PER PERSON: $250 MINIMUM TABLE HOST LEVELS START AT $2,500
(MAXIMUM ALLOWABLE CONTRIBUTION PER PERSON: $4,950)

ONLINE: CLICK HERE TO RSVP & DONATE

FOR MORE DETAILS ON THE EVENT, PLEASE CONTACT: MICHALLE MAKAROV EMAIL: RSVP@JOELHOTAFORMAYOR.COM PHONE: (646) 448-4916
PAID FOR AND SPONSORED BY JOE LHOTA FOR MAYOR , INC.

 ENY076

NEW YORK CITY ~ SEPTEMBER 9

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Yes, I/we will attend and participate in a table for 10 at the: MAYORAL level ($25,000 raise and/or contribute) PERFECT MATCH level ($13,000 raise and/or contribute)
(Table must be purchased with matchable contributions of $250 from 10 NYC residents who have not yet contributed to JLFM)

PRIMARY level ($10,000 raise and/or contribute) GENERAL level ($5,000 raise and/or contribute) CANDIDATE level ($2,500 raise and/or contribute) Yes, I/we will attend the Breakfast ($250/$500/$1,000/$2,500/$4,950 per individual)
* Maximum allowable contribution per person is $4,950

Name:
Individual: $4,950

Spouse/Guest:
$2,500 $1,000 $500 Other __________

Unfortunately, I am unable to participate but am enclosing a contribution in the amount of: __________

PAYMENT INFORMATION
Please make checks payable to Joe Lhota for Mayor
Please send checks to: Joe Lhota for Mayor 132 E. 43rd St. PO Box 2013 New York, NY 10017

To securely email or fax your information: Email: RSVP@JoeLhotaforMayor.com Fax: (914) 462-4081 To RSVP by phone: (646) 678-4796

Contributions by Personal Credit Card: Name on Card: Card #: Signature: Exp. Date: Security Code:

CONTRIBUTOR INFORMATION
Each contributor must provide a name, address, employer and occupation. Contributor: Address: City: Telephone Number: Employer: Employer Address: Employer State:
I understand that State law requires that a contribution be in my name and be from my own funds. I hereby affirm that this contribution is being made from my personal funds, is not being reimbursed in any manner, and is not being made as a loan; in addition, in the case of a credit card contribution, I also hereby affirm that this contribution is being made from my personal credit card account, billed to and paid by me for my personal use, and has no corporate or business affiliation. Please verify the following statements are true and accurate by signing below. _______________________________________________________ __________________________ Signature Date

Referred By/Tracking #:

State: E-Mail Address: Occupation: Employer City: Employer Zip:

Zip:

Contributions from political committees are not permitted unless they are registered with the New York City Campaign Finance Board. The first $175 contributed by an individual NYC resident is matched at a 6 to 1 rate. Corporate, LLC, LLP and partnership contributions are not permitted or any cash contributions exceeding $100. The maximum allowable contribution is $4,950 per person, unless a contributor is "doing business" with NYC, in which case, the maximum allowable contribution is $400. Federal law prohibits contributions from Foreign nationals. Contributions to Joe Lhota for Mayor are not tax deductible. If a contributor has business dealing with the city as defined by the Campaign Finance Act, the contribution limit is $400. If you would like to check if you are in the Doing Business database please go to this link: www.nyc.gov/portal/site/DBusinessSite. If you are listed in the database, please list the agency with which you do business and the business category.

_______________________________________________
City Agency/Agencies

_____________________________________________________
Business Category

PAID FOR AND SPONSORED BY JOE LHOTA FOR MAYOR, INC.