EVENT CHAIRS RNC SECRETARY DEMETRA DEMONTE VINCENT KOLBER

(HOST COMMITTEE IN FORMATION)

HOST COMMITTEE
JEFF DIERMEIER GREG DOOLIN DAVID HERRO NOEL MOORE JOHN POWERS PATRICK G. RYAN MICKEY STRAUB CHRISTINE SVENSON BETSEY THURMAN DIANE WAMBERG MARY BETH WEISS THE HONORABLE CORINNE WOOD

CORDIALLY INVITE YOU TO AN EVENING

IN SUPPORT OF

GOVERNOR MITT ROMNEY

WITH SPECIAL GUESTS

GOVERNOR SCOTT WALKER* SENATOR RON JOHNSON CONGRESSMAN PAUL RYAN

AND

RNC CHAIRMAN REINCE PRIEBUS

*INDICATES INVITED GUEST

SATURDAY, JUNE 30, 2012

VINCENT AND PATRICIA KOLBER
N1931 LORAMOOR DRIVE ~ LAKE GENEVA, WISCONSIN
5:00 P.M. VIP PRIVATE RECEPTION HOST COMMITTEE ($25,000 PER PERSON/$50,000 PER COUPLE, GIVE OR RAISE) 5:30 P.M. VIP PHOTO OPPORTUNITY ($5,000 PER PERSON/$10,000 PER COUPLE) Romney Victory, Inc. P.O. Box 446 Batavia IL 60510
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), and the official Republican Parties in four states (the Idaho Republican Party, the Massachusetts Republican State Congressional Committee, the Oklahoma Leadership Council, and the Vermont Republican Federal Election Committee).
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 State Congressional Committee, the Oklahoma Leadership Council, and the Vermont Republican Federal Election Committee.
1 1

AT THE HOME OF

6:00 P.M. GENERAL RECEPTION ($1,000 PER PERSON / $2,000 PER COUPLE)

KINDLY R.S.V.P. TO KIRSTIN HOPKINS AT KHOPKINS@MITTROMNEY.COM OR (202) 503-8127

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

Reception Saturday, June 30, 2012 REPLY INFO Yes, I will serve on the host committee for the June 30th event, contribute/raise $25,000 per person and attend the VIP Reception, Photo opportunity and General Reception in support of Governor Romney. Enclosed is my contribution of $ ______. Yes, I will attend the June 30th VIP Photo Reception. Enclosed is my contribution of $ ______ ($5,000 per person / $10,000 per couple). Yes, I will attend the June 30th General Reception. Enclosed is my contribution of $ ______ ($1,000 per person / $2,000 per couple). No, I am unable to attend, but enclosed is a contribution of $______. PLEASE MAKE CHECKS 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 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____________________________________ MasterCard AMEX Discover

CREDIT CARD REPLY Please charge my contribution of $___________ to my credit card. Visa Account Number___________________________________________ Mail to: Romney Victory, Inc. P.O. Box 446 Batavia IL 60510

Expiration Date____________________________________

Name on Card____________________________Signature_____________________________________________________________

or to: Proud to be Republican 15W256 N. Frontage Rd. Burr Ridge, IL 60527 Call Jim Long at (630) 570-7668 for information Fundraiser ID: _7807______ Source (or Event) Code: ____ EWI005_________ Proceeds to RV shall be allocated by the following formula: 1. Individuals and non-multicandidate PACsThe 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 among the federal accounts of the Republican Parties of Idaho, Massachusetts, Oklahoma, and Vermont, up to a maximum of $10,000 per committee. Multicandidate PACsThe 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 among the federal accounts of the Republican Parties of Idaho, Massachusetts, Oklahoma, and Vermont, up to a maximum of $5,000 per committee.

2.

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. 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). 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 State Congressional Committee, the Oklahoma Leadership Council, and the Vermont Republican Federal Election Committee.

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