Please join hosts Tony & Heather Podesta Izzy Klein Nancy Jacobson and Council for a Livable

World
(host committee in formation)

for a reception in honor of

Angus King
Independent Candidate for United States Senate from Maine Wednesday, July 18th, 2012 5:00 - 6:30pm 131 C Street, S.E. Washington, DC 20003
Host: $2,500 | Friend: $1,000 | Supporter: $500
To RSVP, please contact Courtney Ryan or Fran Katz Watson at 202-546-0474 or Courtney@katzwatsongroup.com

To learn more please visit: www.angus2012.com or Facebook.com/AngusKing2012

Paid for by the Angus King for U.S. Senate Campaign

Angus King for U.S. Senate Campaign Contribution Form

Id like to contribute $ for the 2012 election cycle.

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. Please complete the following: Full Name: Address: City: State: Zip:

Preferred Phone (please check one): Cell Home Office E--Mail: _ Occupation (required): Employer (required):

Joint Contributor (spouse/partner) Information: For a contribution from a joint account to be attributed equally to two individuals, both must complete this form. Full Name: Address: City: State: Zip:

Preferred Phone (please check one): Cell Home Office E--Mail: Occupation: (required) Employer: (required) Please make checks payable to Angus King for U.S. Senate Campaign Mail to Angus King for U.S. Senate, PO Box 368, Brunswick ME 04011 I represent that the following statements are true and accurate: I am a U.S. citizen or lawfully admitted permanent resident and at least 18 years old. This contribution is made from my personal funds, is not drawn on an account maintained by a corporation, labor organization, national bank, federal contractor, political action committee or federal lobbyist or foreign agent, and will not be reimbursed by another person. Signature of Contributor: ______________________________________ Joint Contributor: ___________________________________________ Contributions to the Angus King for US Senate Campaign are not tax deductible as charitable contributions for federal income tax purposes. By federal law, the maximum amount an individual may contribute is $2500 per election. If youd like to get in touch with us, contact Katie Fellows at (207) 607-4306 or kfellows@angus2012.com Online Contributions: http://www.angus2012.com/contribute Event Code: FORM

PAID FOR BY THE ANGUS KING FOR U.S. SENATE CAMPAIGN