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  • Taxpayers Event 4 11 12

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    ahawkins8223
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    This document is an invitation to a fundraising event for Tom DiNapoli's political campaign. It provides details of the event such as date, time, location and different contribution levels ranging from $100 to $2,500. It includes a registration form where attendees can provide their contact information and preferred method of payment. The form also includes disclaimers about contribution limits and prohibitions.

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    This document is an invitation to a fundraising event for Tom DiNapoli's political campaign. It provides details of the event such as date, time, location and different contribution levels ranging from $100 to $2,500. It includes a registration form where attendees can provide their contact information and preferred method of payment. The form also includes disclaimers about contribution limits and prohibitions.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    14 views1 page

    Taxpayers Event 4 11 12

    Uploaded by

    ahawkins8223
    This document is an invitation to a fundraising event for Tom DiNapoli's political campaign. It provides details of the event such as date, time, location and different contribution levels ranging from $100 to $2,500. It includes a registration form where attendees can provide their contact information and preferred method of payment. The form also includes disclaimers about contribution limits and prohibitions.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    of 1

    Please join

    Taxpayers for DiNapoli


    For Cocktails in honor of TOM!
    Wednesday April 11th, 2012 6:00pm to 8:00pm
    The Woodlands 1 South Woods Rd, Woodbury, NY
    Entry Level_____$100 M anager_____$250 Vice-President_____$500
    President_____$1,000

    Philanthropist_____$2,500

    _______# attendees
    Names of Attendees________________________________________________________
    I cant attend but would like to support Tom with a contribution of $___________

    To RSVP or for more info e-mail: Matthew@dinapoli2014 or call 518-813-5729.


    Please charge $__________________ to my:

    ___ Visa

    ___ MasterCard

    ___ American Express

    Account#______________________________________________________Exp.__________
    Signature_______________________________________________________________
    Name on card_______________________________________________________________
    Contributor Name_______________________________________________________________
    PAC, Part., or LLC Name(if applicable)__________________________________________________
    Address__________________________________________________________________
    City, State, Zip________________________________________________________________
    Occupation__________________________________Employer__________________________
    Phone______________________________________Fax____________________________
    E m a i l_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

    Please make checks payable to DiNapoli 2014 and mail to:


    DiNapoli 2014
    c/o Peggy May PO Box 1776 Mineola, NY 11501
    or you may fax this form to (516) 873-9524
    CONTRIBUTION DISCLAIMER:
    Contributors Confirmation DiNapoli 2014 does not accept contributions from: (1) any person employed by the Office of State Comptroller; or (2) any
    person or entity who responds to a Request for Proposals (RFP) for legal business on behalf of the New York State Common Retirement Fund (the
    Fund) (this restriction applies from the date the RFP is issued until the contractor is selected, and continues for the person or entity selected for such
    contract with the Fund through the ninetieth day after such contract goes into effect). I hereby confirm that this contribution was made from the
    contributors own funds, is not being reimbursed in any manner, and is not in either of the two prohibited categories (1) and (2) listed above.
    Signature Required__________________________________

    Print Name______________________________________

    Contributions to DiNapoli 2014 are not deductible for federal income tax purposes. The maximum permissible contribution is $60,800. Partnerships that
    make contributions exceeding $2,500 will be required to specifically identify the partners responsible for the contribution, and that amount will be
    counted against each partners individual contribution limit. Total contributions from a corporation may not exceed $5,000 per calendar year to all New
    York state and local political committees. Corporations, other entities and individuals are strictly prohibited from reimbursing another person or entity for
    making a contribution. All contributors must be US citizens or permanent resident aliens (green card holder). Pursuant to SEC Rule 206(4)-5,
    contributions by investment advisors and covered associates are regulated; the Rule should be consulted.
    Paid for by DiNapoli 2014.

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