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RUDY GIULIANI PRESIDENTIAL COMMITTEE REPLY FORM

UDY G IULIANI P RESIDENTIAL C OMMITTEE R EPLY F ORM  Yes! Rudy can count

Yes! Rudy can count on me/us participating at the following level:

$9,200 (Maximum Contribution for General and Primary Election Funds per couple)can count on me/us participating at the following level: $4,600 (Maximum Contribution for General and Primary

$4,600 (Maximum Contribution for General and Primary Election Funds per individual)for General and Primary Election Funds per couple) I have already contributed the maximum amount to

I have already contributed the maximum amount to the primary election and want to contribute an additionalfor General and Primary Election Funds per individual) $ (up to $2,300) for the general election.

$ (up to $2,300) for the general election.

$2,300 (Maximum Contribution Primary Election Funds per individual)an additional $ (up to $2,300) for the general election. $1,000 Please make check(s) payable to:

(Maximum Contribution Primary Election Funds per individual) $1,000 Please make check(s) payable to: “Rudy Giuliani

$1,000

Contribution Primary Election Funds per individual) $1,000 Please make check(s) payable to: “Rudy Giuliani

Please make check(s) payable to:

“Rudy Giuliani Presidential Committee, Inc.” P.O. Box 1023 Merrifield, VA 22116-9565

$500

Inc.” P.O. Box 1023 Merrifield, VA 22116-9565 $500 O THER Federal law requires us to obtain

OTHER

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 in an election cycle.

Name: Prefix:

First:

Middle:

Last:

Address:

City:

State:

Zip:

Home #:

Cell #:

Work #:

Fax #:

Email:

Employer:

Occupation:

My signature below attests that this contribution is made by check or credit card from my personal funds and is not drawn on an account maintained by an incorporated entity. I am a US Citizen or permanent resident and this contribution will not be reimbursed by another person. In order for a contribution from a joint account to be attributed equally to two individuals, both individuals must sign this form.

Signature:

Spouse Contributor Information for Joint Contributions

Name: Prefix:

First:

Middle:

Last:

Nickname:

Home #:

Work #:

Email:

Employer:

Occupation:

If this contribution is intended to be a contribution from a couple, signature of spouse must be provided.

Signature:

Credit Card Contributions: (please check one)

Card Number:

Card Number: VISA MasterCard American Express Expiration Date: Discover

VISA

Card Number: VISA MasterCard American Express Expiration Date: Discover

MasterCard

Card Number: VISA MasterCard American Express Expiration Date: Discover

American Express Expiration Date:

Card Number: VISA MasterCard American Express Expiration Date: Discover

Discover

Amount: $

Cardholder Name:

 

Signature:

Contributions are not deductible for federal income tax purposes. Federal Election Law requires us to report the name, address, occupation, and employer for contributions that aggregate in excess of $200 in an election cycle. The maximum an individual may contribute is $2,300 per election, with the primary and general elections treated separately. As a result, any initial contribution up to $2,300 is designated for the primary and any additional amount is designated for the general, up to a total of $4,600 per person. A couple may contribute $9,200, designated per person in accordance with the proceeding sentence. Federal multi-candidate PACs may contribute $5,000 for the primary and $5,000 for the general. Contributions from corporations, labor organizations, federal government contractors, and foreign nationals without permanent residency status ("green cards") are prohibited.

Solicitor:

Tracking #:

Event Code:

Paid for by the Rudy Giuliani Presidential Committee, Inc.

www.JoinRudy2008.com