Paid for by The Baker Committee & The Polito Committee

www.charliebakerma.com | www.karynpolito.com

PETER PICKNELLY TONY RAVOSA ANDY YEE

Invite you to an Oktoberfest cocktail reception and private dinner

With special guest

________________________________

Governor

CHARLIE BAKER

_________________________________

WEDNESDAY, SEPTEMBER 30, 2015

THE STUDENT PRINCE & THE FORT

8 Fort Street

Springfield, Massachusetts

Maximum donat ion per calendar year to the Baker Committee i s:

$1,000 per person / $2 ,000 per couple

R.S.V.P. Sarah Hunt | sh@massgop .com | (617) 523-5005

5:00 P.M. COCKTAIL RECEPTION

SPONSOR LEVEL | $500 per person

6:00 P.M. COCKTAIL RECEPTION & PRIVATE D INNER

PATRON LEVEL| $1,000 per person

*Priva te Dinner i s l imited to 25 gues ts

 

Paid for by The Baker Committee & The Polito Committee www.charliebakerma.com | www.karynpolito.com

YES, I/we want to help Charlie & Karyn sustain victory and will ____ will not ____ attend the event on September 30, 2015.

q $____________ to The Baker Committee (maximum donation: $1,000 per person/$2,000 per couple)

and/or q $____________ to The Polito Committee (maximum donation: $1,000 per person/$2,000 per couple)

CONTRIBUTOR INFORMATION NAME ____________________________________________________SIGNATURE ________________________________________________

OCCUPATION (required) ___________________________________ EMPLOYER (required) ________________________________________

ADDRESS _________________________________________________CITY, ST, ZIP _______________________________________________

PHONE Office Cell Home __________________________________ EMAIL ________________________________________________

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.

JOINT CONTRIBUTOR (SPOUSE) INFORMATION For a contribution from a joint account to be attributed equally to two individuals, both must sign this form.

NAME ____________________________________________________SIGNATURE ________________________________________________

OCCUPATION (required) ___________________________________ EMPLOYER (required) ________________________________________

PHONE Office Cell Home __________________________________ EMAIL ________________________________________________

CONTRIBUTION – SELECT ONE q ONLINE: The Baker Committee: https://charliebaker.ichooseapex.com/charlie-baker?EVI=EMA1124&FRI=4125 The Polito Committee: https://karynpolito.ichooseapex.com/karyn-polito?EVI=EMA1124&FRI=4125 q CHECKS: Please make separate checks payable to The Baker Committee and/or The Polito Committee

q CREDIT CARD: Please charge my contribution of $_____________ to my credit card. MasterCard Visa Discover American Express

Credit Card #: ___________________________________________________ Exp. Date: ____________ CVV: _______

Billing Address (if different than above): _______________________________________________________________

Authorized Signature (same as name on the card): ______________________________________________________

RETURN: Please mail to: Sarah Hunt, The Baker/Polito Committee, 85 Merrimac St., Suite 400 Boston, MA 02114 Or scan & e-mail to: sh@massgop.com Event Code: EMA1124 Fundraiser ID: 4125 Contributions to The Baker Committee and The Polito Committee are not deductible as charitable contributions for federal income tax purposes. An individual may contribute up to $1,000 per calendar year each to The Baker Committee and The Polito Committee. Contributions from corporations, labor organizations, other business entities (LLCs and partnerships), out-of-state PACs, and foreign nationals are prohibited. Contributions must be made from personal funds and may not be reimbursed by any other person or entity.

 

Contribution Form Enc losed i s my/our contr ibut ion of : $______________ Donat ions o f up to $43 ,400 per person or $20 ,000 per Mul t icandidate PAC may be accepted on th is fo rm . Contributor Information Name: ________________________________________________________Signature____________________________________________________ Address: __________________________________________________________________________________________________________________ City, State, Zip: ____________________________________________________________________________________________________________ Phone: qOffice qCell qHome___________________________________ E-mail: ______________________________________________________

Federal law requires the Massachusetts Victory Committee to obtain and report the name, mailing address, occupation and employer for each individual whose contribution exceeds $200 in a calendar year

Occupation (required)______________________________________Employer (required)_____________________________________________

Spouse/Joint Contributor Information (if applicable) Spouse/Joint Donations up to $86 ,800 per couple can be accepted on this form Joint Contributor Name_________________________________________Signature_____________________________________________________ Occupation (required)___________________________________________Employer (required)_________________________________________ Phone: qOffice qCell qHome___________________________________ E-mail: ______________________________________________________  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. For a contribution from a spouse/joint account to be attributed equally to two individuals, both must sign this form, indicating agreement with the above statement.

Contribution

q On l ine : https://mavictory.ichooseapex.com/donate?EVI=EMA1124&FRI=4125

- Or - q Check : P lea se make checks payab l e to Mass V ic to ry  - Or - q C red i t Card Cont r ibut ion :  

Please charge my contribution of $_____________to my credit card. qVisa qMasterCard qAmerican Express qDiscover  Card Number: __________________________________________________________________ Exp. Date: __________ CVV: ________   Billing Address (if different than above): __________________________________________________________________________________ Signature(s):_____________________________________________________________________________________________________

Mail to: Massachusetts Victory Committee, c/o David Drummond, 85 Merrimac Street, Suite 400, Boston, MA 02114

Or e-mail to: ddrummond@massvictory.com  

Contributions to Massachusetts Victory Committee are not tax deductible for federal income purposes. Massachusetts Victory Committee is a joint fundraising committee composed of the Massachusetts Republican Party and the Republican National Committee. Proceeds shall be allocated by the following formula: 1. Individuals and Non-Multicandidate PACs: The first $10,000 shall go to the Massachusetts Republican Party- Federal Account. The next $33,400 shall go to the Republican National Committee. 2. Multicandidate PACs: The first $5,000 shall go to the Massachusetts Republican Party- Federal Account. The next $15,000 shall go to the Republican National Committee. 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. All contributions permissible under the FECA but that would cause a contributor to exceed any applicable Federal contribution limit to a specific committee, shall be reallocated to the remaining committee to the extent permitted to the FECA according to this formula. Any contribution that would otherwise cause a contributor to exceed Federal contribution limit or not be permissible under the FECA shall be refunded to the contributor. All funds received in response to this solicitation will be subject to federal contribution limits and prohibitions. Contributions from corporations, labor unions, federal contractors, and foreign nationals are prohibited. The maximum an individual can contribute to this joint fundraising committee is $43,400 per year.

 Paid for by the Massachusetts Victory Committee, a joint fundraising committee composed of the Massachusetts Republican

Party and Republican National Committee. Not authorized by any candidate or candidate’s committee. 310 First Street, SE Washington D.C. 20003