You are cordially invited to join

GOVERNOR ANDREW M. CUOMO

for our annual

Hudson Valley for Cuomo Reception

April 3, 2014 5:30pm Host Committee Reception 5:45pm General Reception Doubletree Tarrytown 455 South Broadway Tarrytown, NY 10591 Sponsorship Levels with Host Committee Reception starting at $25,000 Supporter Ticket: $2,500 Guests Ticket: $1,000 For more information on joining the Host Committee, or to RSVP, call 212-551-9441 or email tom@andrewcuomo.com

Andrew Cuomo 2014 Contribution Form April 3, 2014

PO Box 4105, New York, NY 10163 P (212) 551-9441, F (646) 597-6195
YES, I would like to support Governor Andrew Cuomo! I/we have enclosed my/our contribution(s) of: ____$25,000 ____$10,000 ____$2,500 ____$1000 _____$5,000 Other $_________

Each contribution must be accompanied by a completed and signed contribution form. CREDIT CARD CONTRIBUTION
Please charge $______________ on my __________________________________credit card. Card #: ________________________________________________________ Exp. Date: ___________ This card is: ____ Personal ____Corporate ____ Partnership ____ Other Name of Entity/Individual billed ____________________________________________________ Credit card contributions can be faxed to: (646)597-6195
For compliance with NYS Election Law, please provide the following information: Name/Contributing Entity:_______________________________________________________________________________ Address:_____________________________________________________________________________________________ Employer/Occupation:__________________________________________________________________________________ To help us better communicate with you, please provide the following: Bus.Phone___________________________________________Email:____________________________________________ Res.Phone___________________________________________Cell:______________________________________________ The account being used to make this contribution is registered to and managed by a/an: Individual Partnership Sole Proprietorship Corporation PAC or Labor Union LLC Candidate Committee Party Committee

Contribution limits and guidelines for Andrew Cuomo 2014: Andrew Cuomo 2014 will accept no more than $60,800 for the 2014 election cycle ($19,700 for the primary/$41,100 for the general) from individuals, LLCs, unions, political action committees, and trade associations. Partnerships that contribute in excess of $2,500 total over the course of the cycle will be required to specifically identify the partner(s) responsible for the contribution(s), and the attributed amount will be counted against each partners individual contribution limit. Total contributions from a corporation may not exceed $5,000 per calendar year aggregate to all New York state and local candidates and committees. It is strictly prohibited to reimburse another individua ls or entitys contribution. All contributors must be either US citizens or permanent resident aliens (green card holders). No State agency officer or employee who serves at the pleasure of the Governor or their appointing authority or members of State public authority or other boards appointed by the Governor may contribute to and/or fundraise for the Governors campaign. Contributions are not deductible for federal income tax purposes. By signing below, you hereby affirm that your contribution does not violate the terms specified above. Signature Required: __________________________________________________Date: ___________________

Please make checks payable to Andrew Cuomo 2014 and mail to: PO Box 4105, New York, NY 10163 For further information, please contact Tom Giordano at (212) 551-9441or tom@andrewcuomo.com
Paid for by Andrew Cuomo 2014. Designed in-house. HV