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CONTRIBUTE $1,000 PER INDIVIDUAL
Paid for by Romney Victory, Inc., a joint fundraising committee authorized by and composed of Romney for President, Inc., the Republican National Committee, the Idaho Republican Party, the Massachusetts Republican Party, the Oklahoma Leadership Council, the Vermont Republican Federal Election Committee, the National Republican Senatorial Committee, and the National Republican Congressional Committee.
Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.
Info for Secret Service: SSN______________________________ Date of Birth_______________________ If you prefer to give this information verbally, please call Leslie Sullivan at 512-415-2804 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_______________________________________________________________________ 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 collect and report the name, mailing address, occupation, and name of employer of each contributor whose contributions aggregate in excess of $200 in a calendar year (RNC and state parties) or election cycle (RFP). Please complete the following Occupation__________________________________________ Joint Contributor Occupation____________________________ Employer______________________________________ Joint Contributor Employer_________________________
CREDIT CARD REPLY Please charge my contribution of $___________ to my credit card. Circle one: Visa MasterCard AMEX Discover Account Number________________________________________ Expiration Date____________________________ Name on Card_____________________________________________________________________________________ Signature_________________________________________________________________________________________
Mail to: Romney Victory, c/o Leslie Sullivan, P.O. Box 340069, Austin, TX 78734-0069 Or fax to (512) 428-8111
Fundraiser ID: ______________
Proceeds to RV shall be allocated by the following formula: 1) Individuals and non-multicandidate PACs - The first $2,500 will go to RFPs general account. Prior to August 31, 2012, the next $2,500 will go to RFPs primary account. Beginning on August 31, 2012, should Romney for President have primary debt, that next $2,500 will go to RFPs primary debt retirement account. The next $30,800 will go to the RNC. The remaining amount will be split evenly among the federal accounts of the Republican Parties of Idaho, Massachusetts, Oklahoma, and Vermont, up to a maximum of $10,000 per committee. 2) Multicandidate PACs - The first $5,000 will go to RFPs general account. Prior to August 31, 2012, the next $5,000 will go to RFPs primary account. Beginning on August 31, 2012, should Romney for President have primary debt, that next $5,000 will go to RFPs primary debt retirement account. The next $15,000 will go to the RNC. The remaining amount will be split evenly among the federal accounts of the Republican Parties of Idaho, Massachusetts, Oklahoma, and Vermont, up to a maximum of $5,000 per committee. Notwithstanding this allocation formula, a contributor may designate a contribution for a specific participant or participants. In addition, the allocation formula may change if RFPs primary account receives sufficient funds to retire its outstanding primary debt or if any contribution would exceed applicable contribution limits. Contributions from corporations, labor unions, federal contractors, and foreign nationals are prohibited. Federal law requires us to collect and report the name, mailing address, occupation, and name of employer of each contributor whose contributions aggregate in excess of $200 in a calendar year (RNC and state parties) or election cycle (RFP).
Source Code:
ETX029 _
Paid for by Romney Victory, Inc., a joint fundraising committee authorized by and composed of Romney for President, Inc., the Republican National Committee, the Idaho Republican Party, the Massachusetts Republican Party, the Oklahoma Leadership Council, the Vermont Republican Federal Election Committee, the National Republican Senatorial Committee, and the National Republican Congressional Committee.
Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.