You Are Cordially Invited to Attend An

Evening Reception
Supporting

CONGRESSMAN MICHAEL GRIMM (R-NY)

Monday, September 22, 2014
6:30 PM VIP Reception ~ 7:30 PM General Reception

Hilton Garden Inn

1100 South Avenue
Staten Island, NY

Requested Contribution Levels:

VIP Reception: $2,600 Gold ~ $1,500 Silver ~ $1,000 Bronze
General Reception: $500 Friend ~ $250 Contributor ~ $150 Supporter
To RSVP: Please Call (718) 612-5096 or Email grimmcongress2014@gmail.com
[ ] Yes. I would like to join. Enclosed is my contribution of $ ___________.
[ ] No. I am unable to join. Enclosed is my contribution of $ ___________.
Name:
_________________________________________________________________________________________
Title:
___________________________________Occupation: _______________________________________
Address: _________________________________________________________________________________________
City:
____________________________________ State: _____________ Zip: __________________________
E-Mail: ______________________________________ Cell Phone: _______________________________________
Credit Card: Visa Master Card American Express
Personal Credit Card Number: ___________________________________________________________________
Expiration Date: _____________ Security Code: ______________
Name on Card: _______________________________________ Signature: ________________________________
Please Make Checks Payable To:
Michael Grimm for Congress
P.O. Box 61806 ~ Staten Island, NY 10306
Paid for by Michael Grimm for Congress
www.grimmforcongress.com
Contributions to Michael Grimm for Congress are not tax deductible as charitable contributions for federal income tax purposes. Federal law
requires us to obtain and report the name, mailing address, occupation and name of employer for each individual whose contributions
aggregate in excess of $200 per election cycle. Contributions by corporations, foreign nationals (non-green card holders), labor unions and
federal government contractors are prohibited. The maximum an individual may contribute is $2,600 per election, with the primary and general
elections treated separately.

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