HOST COMMITTEE

RODGER & HILLARY KROUSE w MARC J. LEDER LOTHAR & CARLYN MAYER w AMBASSADOR NED & STEPHANIE SIEGEL
CORDIALLY INVITE YOU TO AN EVENING RECEPTION WITH

GOVERNOR MITT ROMNEY

THURSDAY, MAY 17, 2012 WOODFIELD COUNTRY CLUB
3650 CLUB PLACE
VIP RECEPTION
(WITH PHOTO OPPORTUNITY) v

AT THE

BOCA RATON, FLORIDA

EVENING RECEPTION 6:30 P.M. 7:30 P.M.
CONTRIBUTE

6:00 P.M.
CONTRIBUTE

$10,000 PER PERSON

OR RAISE

$2,500 PER PERSON

$25,000 PER PERSON

KINDLY RSVP TO:

MEREDITH OROURKE AT MEREDITHOROURKE@YAHOO.COM OR (561) 818-6064 OR CRIS FLANDERS AT CRIS@THEOROURKEGRP.COM OR (813) 391-5892
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Romney Victory, Inc. Post Office Box 149757 Boston, MA 02114-9757

Contributions to Romney Victory, Inc. (RV) are not tax deductible for federal income tax purposes. RV is a joint fundraising committee composed of Romney for President, Inc. (RFP), the Republican National Committee (RNC), the official Republican Parties in four states (the Idaho Republican Party, the Massachusetts Republican Party, the Oklahoma Leadership Council, and the Vermont Republican Federal Election Committee), the National Republican Senatorial Committee (NRSC), and the National Republican Congressional Committee (NRCC). However, contributions solicited by this invitation will be deposited into the accounts of Romney for President, Inc., the Republican National Committee, the National Republican Senatorial Committee, and the National Republican Congressional Committee only. This invitation does not solicit funds for the four state Republican parties.

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.

q Yes, I will be attending the May 17th VIP Photo Reception. Enclosed is my contribution of $ _________($10,000 per person). q Yes, I will be attending the May 17th Evening Reception. Enclosed is my contribution of $ _________($2,500 per person / $5,000 per couple). q No, I am unable attend, but enclosed is a contribution of $ __________. Please make your check payable to: Romney Victory, 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_______________________________________________________________________ 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 in a calendar year (RNC, NRSC, and NRCC) or election cycle (RFP). Please complete the following: Occupation__________________________________________ Joint Contributor Occupation___________________________ Employer______________________________________ Joint Contributor Employer_______________________ q MasterCard q AMEX q Discover

CREDIT CARD REPLY Please charge my contribution of $___________ to my credit card. q Visa Account Number___________________________________________

Expiration Date___________________________

Name on Card____________________________Signature____________________________________________________ Mail to: Romney Victory, Inc. c/o Meredith ORourke 526 E. Park Avenue, Suite 200 Tallahassee, FL 32301 * Or Fax: 850-270-6908; or Scan/Email to: cris@theorourkegrp.com Or Contribute Online Via Secure Site: https://secure.mittromney.com/donate/victory Fundraiser ID: ____________ Source (or Event) Code: ____EFL033 ____ Proceeds shall be allocated by the following formula: 1. Individuals and non-multicandidate PACs - The first $2,500 will go to RFPs primary account. The next $2,500 will go to RFPs general account. The next $30,800 will go to the RNC. The remaining amount will be split evenly between the NRSC and NRCC, up to a maximum of $20,000 per committee. Multicandidate PACs - The first $5,000 will go to RFPs primary account. The next $5,000 will go to RFPs general account. The next $15,000 will go to the RNC. The remaining amount will be split evenly between the NRSC and NRCC, up to a maximum of $15,000 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 any contribution would exceed applicable contribution limits. However, no part of any contribution made pursuant to this Notice will be allocated to any Committee not identified in the above formula. 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 employer of each contributor whose contributions aggregate in excess of $200 in a calendar year (RNC, NRSC and NRCC) or election cycle (RFP). Contributions solicited by this invitation will be deposited into the accounts of RFP, the RNC, the NRSC, and the NRCC only. This invitation does not solicit funds for the four state Republican parties. 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.

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