PLEASE JOIN

RGA CHAIRMAN
GOVERNOR CHRIS CHRISTIE, NEW JERSEY
FOR A
PRIVATE ROUNDTABLE

WITH
GOVERNOR SAM BROWNBACK, KANSAS
WEDNESDAY, AUGUST 20, 2014
11:30 AM 12:00 PM
SUGGESTED MINIMUM CONTRIBUTION - $25,000
CONTRIBUTIONS IN ANY AMOUNT BY
INDIVIDUALS OR CORPORATIONS ARE ACCEPTABLE
IN SUPPORT OF
THE REPUBLICAN GOVERNORS ASSOCIATION
THE RESIDENCE OF DRS. DONNA AND DANIEL THOMAS
5944 OVERHILL ROAD
MISSION HILLS, KANSAS

RSVP TO DIANNE GRAHAM
202-538-3454 OR DG@GRAHAMADVISORSLLC.COM

Contributions to RGA are not deductible as charitable contributions for federal income tax purposes. Contributions will not be
used for federal electioneering communications. Contributions may be placed in one of RGAs affiliated PACs. Contributions
from foreign nationals are prohibited.

PAID FOR BY THE REPUBLICAN GOVERNORS ASSOCIATION


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




2014 REPUBLICAN GOVERNORS ASSOCIATION
CONTRIBUTOR FORM
PLEASE ACCEPT MY CONTRIBUTION OF: $______________________________
PLEASE MAKE CHECKS PAYABLE TO: REPUBLICAN GOVERNORS ASSOCIATION
PLEASE RETURN THIS FORM TO: REPUBLICAN GOVERNORS ASSOCIATION
ATTN: GRAHAM ADVISORS LLC
550 NORTH 159
TH
STREET EAST, SUITE 215
WICHITA, KS 67230
FEDEX ACCOUNT #: 020003910
PH: 202-538-3454 FAX: 202-558-2106
PLEASE COMPLETE THE FOLLOWING INFORMATION:
CONTACT INFORMATION
NAME TITLE
COMPANY
ADDRESS
CITY STATE ZIP
PHONE FAX EMAIL
CONTRIBUTION INFORMATION
THE RGA IS REQUIRED TO COLLECT AND REPORT THE NAME, MAILING ADDRESS, OCCUPATION AND NAME OF
EMPLOYER OF INDIVIDUALS WHOSE AGGREGATE CONTRIBUTIONS EXCEED $200 IN A CALENDAR YEAR.
EMPLOYER:
OCCUPATION:
PLEASE CHECK IF YOU ARE AN SEC-REGISTERED INVESTMENT ADVISOR OR COVERED ASSOCIATE.
CREDIT CARD CONTRIBUTION
IF YOU WISH TO CONTRIBUTE BY CREDIT CARD, PLEASE PROVIDE THE FOLLOWING INFORMATION:
TYPE OF CREDIT CARD: { } MASTERCARD { } VISA { } AMERICAN EXPRESS { } DISCOVER
AMOUNT $ ______________________ { } CORPORATE CARD { } PERSONAL CARD
CARD #: ________________________________________ EXPIRATION DATE: ______________
NAME AS IT APPEARS ON CARD: _____________________________________________________
SIGNATURE: ____________________________________________________________________
CONTRIBUTIONS TO RGA ARE NOT DEDUCTIBLE AS CHARITABLE CONTRIBUTIONS FOR FEDERAL INCOME TAX
PURPOSES. CONTRIBUTIONS MAY BE PLACED IN ONE OF RGAS AFFILIATED STATE PACS. RGA DOES NOT ENGAGE IN
FEDERAL ELECTION ACTIVITY. CONTRIBUTIONS FROM FOREIGN NATIONALS ARE PROHIBITED.
Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.