PLEASE JOIN

SENATOR JOE MANCHIN III (D-WV)

FOR AN EVENING RECEPTION BENEFITTING

HIS 2012 RE-ELECTION CAMPAIGN

AT

LOUNGE 201
201 MASSACHUSETTS AVENUE, NE
WASHINGTON, DC
WEDNESDAY MARCH 16, 2011 6:00 PM

$5,000 HOST/$2,500 SPONSOR/$1,000 GUEST

FOR MORE INFORMATION OR TO RSVP
PLEASE CONTACT JEREMY S. GOLD
JEREMYSGOLD@YAHOO.COM
P. 202-546-9292

PLEASE SEND ALL CHECKS PAYABLE TO:

MANCHIN FOR WEST VIRGINIA
426 C STREET, NE
WASHINGTON, DC 20002
Contributions to Manchin for West Virginia are not deductible
for federal income tax purposes.

PAID FOR AND AUTHORIZED BY MANCHIN FOR WEST VIRGINIA

Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.
 MARCH 16, 2011 RECEPTION FOR MANCHIN FOR WEST VIRGINIA

___ YES, I WOULD LIKE TO ATTEND WITH A $___________ CONTRIBUTION.

___ SORRY, I AM UNABLE TO ATTEND THE EVENT, BUT ENCLOSED IS MY CONTRIBUTION OF

$_____________.

FEDERAL LAW REQUIRES US TO USE OUR BEST EFFORTS TO COLLECT AND REPORT THE NAME, MAILING ADDRESS,
OCCUPATION, AND NAME OF EMPLOYER OF INDIVIDUALS WHOSE CONTRIBUTIONS EXCEED $200 IN AN ELECTION
CYCLE.

CORPORATE CONTRIBUTIONS, CONTRIBUTIONS FROM INDIVIDUALS UNDER THE AGE OF 18, AND CONTRIBUTIONS FROM
NON-U.S. CITIZENS WHO ARE NOT LAWFULLY ADMITTED FOR PERMANENT RESIDENCE ARE PROHIBITED. ALL
CONTRIBUTIONS BY INDIVIDUALS MUST BE MADE FROM PERSONAL FUNDS AND MAY NOT BE REIMBURSED OR PAID BY
ANY OTHER PERSON.

NAME_________________________________________________________

ORGANIZATION_________________________________________________

TITLE_________________________________________________________

ADDRESS______________________________________________________

CITY, STATE, ZIP_______________________________________________

PHONE_________________________ FAX___________________________

EMAIL________________________________________________________

Make checks payable to “Manchin for West Virginia” and mail to:

426 C Street, NE, Washington, DC 20002

Or fax this form to: Jeremy S. Gold (202) 543-8455

Please bill $_________ to my: ____Visa _____ MasterCard _____ AMEX

Account # _________________________________Exp._____________

Signature__________________________________________________

This personal, not corporate, card belongs to________________________

Contributions to Manchin for West Virginia are not deductible

for federal income tax purposes.

PAID FOR AND AUTHORIZED BY MANCHIN FOR WEST VIRGINIA

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