Breakfast Reception at the offices of Better Homes & Garden | Rand Realty& Rand commercial services in support of
New York state attorney generalAndrew m. CuomoAt: 268 South Main Street, New City, NY 10956 from 9:30AM to 11:30AM Yes! we would like to attend:Please reserve ________ tickets at the following levels ______$1,000 friend ______$2,500 Sponsor______$5,000 host, raise or contribute Name(s) of attendees: ____________________________________________________ We can not attend but we would like to support Andrew CUOMO2010 with acontribution of: ________________.
CREDIT CARD CONTRIBUTION
Please charge $_________ on my __________________________________credit card.Card #: ________________________________________________________ Exp. Date: ___________ This card is: ____ Personal ____Corporate ____ Partnership ____ OtherName of Entity/Individual billed ____________________________________________________
Credit card contributions can be faxed to: (212) 238-3100.
Please fax your response to (212) 238-3100 or call Jennifer Bayer-michaels at (212) 238-3270.
For compliance with NYS Election Law, please provide the following information:
Name:_________________________________________________________________________________________ Address:_______________________________________________________________________________________ Employer/Occupation:____________________________________________________________________________ To help us better communicate with you, please provide the following:Res.Phone___________________________________________Email:______________________________________ Bus.Phone___________________________________________Fax________________________________________
The account being used to make this contribution is registered to and managed by a/an:
□ Individual□ Sole Proprietorship□ PAC or Labor Union□ CandidateCommittee□ Partnership□ Corporation□ LLC□ Party Committee
*For non-individuals, please provide the contributing entity’sname(s)___________________________________________________
*Contributor’s note to Andrew Cuomo 2010: I notify Andrew Cuomo 2010 that to the best of my knowledge neither I personally nor any entity which I own or control has any matter presently pending with the NYS Attorney General’s office or has had any matter resolved within the last 90days. Additionally, pursuant to NYS law, I represent that this contribution is from my own funds or from funds of the contributing entity indicated above.Signature Required:__________________________________________________________________________________ This does not extend to attorneys representing persons or entities with matters before the NYS Attorney General’s office.
Contributions to Andrew Cuomo 2010 are not deductible for federal income tax purposes.Andrew Cuomo 2010 accepts no more than $55,900 per election from individuals, unions, political action committees, and tradeassociations. Partnerships and LLCs that make contributions will be required to specifically identify the partners responsible for thecontribution, and that amount will be counted against each partner’s individual contribution limit. Thus, the $55,900 per electionlimit applies to each partner, individually, and not to the partnership or LLC entity itself. Total contributions from a corporation maynot exceed $5,000 per calendar year aggregate to all New York state and local candidate committees. Corporations, other entitiesand individuals are strictly prohibited from reimbursing another person/entity for making a contribution to Andrew Cuomo 2010. Allcontributors must be US citizens or permanent resident aliens (green card holder).
Please make checks payable to
Andrew Cuomo 2010
and mail to:Church Street Station, PO Box 683, New York, NY 10008.
Paid for by Andrew Cuomo 2010. Designed in-house.