HOSTS (HOST COMMITTEE STILL IN FORMATION)

Raanan Agus Wayne Berman Bruce Bialosky Joe Cayre Joseph Chehebar Dr. Ben Chouake Lew Eisenberg David Flaum Ambassador Sam Fox Lance Hirt Loren Flaum Steven Mitzner Roy Katzovicz Shelley Kamins Randy Levine Marc Lipschultz David Lobel Jason Lyons Ira Mitzner NORPAC Steven Price Philip Rosen Ambassador Mel Sembler Diane Sembler-Kamins Ambassador Ned L. Siegel Stephanie Siegel Ambassador Cliff Sobel Donna Sternberg Eric Tanenblatt C. Howard Wietschner Fred Zeidman Justin M. Siegel Jay Zeidman

YOUNG PROFESSIONAL HOSTS

INVITE YOU TO JOIN

GOVERNOR MITT ROMNEY

AND THE JEWISH LEADERSHIP TEAM
FOR AN EVENING RECEPTION

MONDAY, SEPTEMBER 26, 2011 WEIL, GOTSHAL & MANGES LLP 767 FIFTH AVENUE (AT 58TH STREET), NEW YORK CITY, NY 6:00 PM
CO-HOST: $10,000 (RAISE) PHOTO OPPORTUNITY & INVITATION TO OCTOBER POLICY ROUNDTABLE YOUNG PROFESSIONAL CO-HOST: $2,500 (RAISE) (*MUST BE UNDER 30 YRS. OLD) ADMISSION TO RECEPTION & PHOTO OPPORTUNITY ATTENDEE: $1,000 ADMISSION TO RECEPTION YOUNG PROFESSIONAL ATTENDEE: $100 (*MUST BE UNDER 30 YRS. OLD) ADMISSION TO RECEPTION PLEASE RSVP TO LISA SPIES AT LISA@THELSGROUP.COM OR (202) 744-7373
Contributions are not tax deductible as charitable contributions for federal income tax purposes. By law, the maximum amount an individual may contribute is $2,500 ($5,000 per couple) per election. Federal multi-candidate PACs may contribute $5,000 per election. Contributions by corporations, foreign nationals (non-green card holders), labor unions, federal government contractors, and minors under the age of 18 are prohibited.
Romney for President, Inc. Post Office Box 149756 Boston, MA 02114-9756

AT THE OFFICES OF PHILIP ROSEN

Paid for by Romney for President, Inc. www.MittRomney.com

Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.

Reception Monday, September 26, 2011

REPLY INFO Yes, I will Co-Host the September 26th reception. I plan to raise $10,000 as a Co-Host. Enclosed is my contribution of $_______________. I plan to raise $2,500 as a Young Professional Co-Host. Enclosed is my contribution of $_______________. Yes, I will be attending the September 26th reception. Enclosed is my contribution of $ __________ ($1,000 per person / $100 per Young Professional). No, I am unable attend, but enclosed is a contribution of $_______________. Please make your check payable to: Romney for President, Inc. Name_________________________________________________________________________________________ Address_______________________________________________________________________________________ City____________________________________State______________________Zip__________________________ Home Phone____________________________________ Work Phone___________________________________ E-mail_________________________________________________________________________________________ CONTRIBUTOR INFO This contribution is made by check or credit card from my personal funds and is not drawn on an account maintained by an incorporated entity. I am a U.S. citizen or permanent resident and this contribution will not be reimbursed by another person. Signature_______________________________________________________________________ By law, the maximum amount an individual may contribute is $2,500 ($5,000 per couple) per election. For a contribution from a joint account to be attributed to two individuals, both must sign this form, indicating agreement with the above statement. Joint Contributor Signature_________________________________________________________ Federal law requires us to obtain and report the name, mailing address, occupation and name of employer for each individual whose contributions aggregate in excess of $200 per election cycle. Please complete the following: Occupation__________________________________________ Joint Contributor Occupation___________________________ CREDIT CARD REPLY Please charge my contribution of $___________ to my credit card. Visa MasterCard AMEX Discover Employer______________________________________ Joint Contributor Employer_______________________

Account Number________________________________________

Expiration Date__________________________

Name on Card____________________________________________________________________________________ Signature_________________________________________________________________________________________

Mail to: Romney for President, Inc., c/o Lisa Spies 736 North Columbus Street Alexandria, VA 22314 Or fax this form to: 202-747-5777

Fundraiser ID: 794003 Source Code: ENY029

Contributions are not tax deductible as charitable contributions for federal income tax purposes. Contributions by corporations, foreign nationals (non-green card holders), labor unions, federal government contractors, and minors under the age of 18 are prohibited. Paid for by Romney for President, Inc. www.MittRomney.com
Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.