SAVE THE DATE

For A Reception Honoring

Mayor Alvin Brown
Mayor of Jacksonville, FL

April 24th, 2013
8:00am-9:00am
At the office of

Hon. Scott Maddox
502 North Adams Street
Tallahassee, FL 32303
Maximum Contribution $500
(per individual and per business)
To RSVP or for additional information please contact
Greg Goddard at gregorygoddard@gmail.com,
or by phone at 561.212.8892
Political advertisement paid for and approved by Alvin Brown, Democrat, for Mayor.

□ Yes, I will attend as a guest. Enclosed is my contribution of $500.
I cannot attend, but I support Alvin Brown for Mayor. Enclosed is my contribution of $ ___________

Name: _______________________________________________________________________________________
Address: _____________________________________________________________________________________
City: _________________________________________ State: ____________ Zip: _________________________
Work Phone: __________________________________Home Phone: __________________________________
Cell Phone: ___________________________________ Fax: ___________________________________________
Email: _______________________________________________________________________________________
Employer: ____________________________________ Occupation: ____________________________________
A candidate may not accept a contribution in excess of $500 from any one person per election. A "person" is an individual or a corporation, association, firm,
partnership, joint venture, joint stock company, club, organization, estate, trust, business trust, syndicate or other combination of individuals having
collective capacity. The purchase of a ticket for, or contribution to, the campaign fundraiser is a contribution to the campaign of Alvin Brown. Contributions
are not tax deductible for federal income tax purposes.

Signature: _________________________________ Name (Print): _____________________________________
CHECKS SHOULD BE MADE PAYABLE TO ALVIN BROWN FOR MAYOR AND SENT TO:

31 West Adams Street #1207
Jacksonville, FL 32202
TO CONTRIBUTE BY CREDIT CARD:
Please charge _______________ to my:

Mastercard

Visa

American Express

(please circle)

Name on Card: ____________________________________________________________________________________
Card Number: _______________________________________ Expiration Date: ___________ Security Code: _____
Billing Address/City/State/Zip: ______________________________________________________________________
Authorized Signature: _________________________ Second Authorized Signature __________________________

Political advertisement paid for and approved by Alvin Brown, Democrat, for Mayor.
31 WEST ADAMS STREET #1207• JACKSONVILLE, FLORIDA 32202

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