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Master Card Visa
Please make checks payable to:
Massa for Congress
P.O. Box 636 Annandale, VA 22003
Contact: Cliff & Pattie at (703) 354-7444 or Cliffi'{fc4pf.l1el
Fax responses to: (703) 354-5569
Corporate contributions or gifts to Massa for Congress are not accepted. Federal law requires
Massa for Congress to use our best efforts to collect and report the name, mailing address,
occupation, and name of employer of individuals "'nose contributions exceed $200 in a
calendar year. Contributions are not tax deductible.
Type of Card:
Credit Card Number Date
Arnount Signature _
Name of Employer _
Occupation. _
Contributions:
$1,000 Host - $1,500 Guest
Wednesday, November 18, 2009
8:30 - 9:30 am
Hotel George
15 E NWWashington, DC
Please RSVP: Cliff, Pattie or Lucas
(703) 354-7444 Cliff(iDCHPF.net
Fax: (703) 354-5569
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Massa for Congress
P.O. Box 636- Annandale, VA 22003
* Wax Paid for by the DCCC and authorized by Massa for *
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* CTJA lDIIAAN ll/E C'l/EL""""O,AT Congressman Eric Massa *

* rI/"1.JrI1YJ/"1. JI\..l vI\..l J. lV WednesdayNovember18,20098:3D-9:30am *
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CONlial(y Inl'ites you to attend a SJ"IALL Hotel George *
S1:.'ATED breakfast Honoring Yes, I plan to attend. __Enclosed is my contribution for $ _
** Congressman Eric Massa __EnclOSedismYContribUtiOnfOr$ **
(NY-29) Street Address _
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Armed Services, Homeland Security
Email F
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& Agriculture Committees ll,X(H) *
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