Senator Michael Bennet

Chair, Democratic Senatorial Campaign Committee

&

Senator Dick Durbin

Assistant Majority Leader, U.S. Senate

Cordially invite you to an evening benefiting the

Democratic Senatorial Campaign Committee & Friends of Dick Durbin
with

President Barack Obama

Thursday, May 22, 2014
Reception | 5:00 PM

Home of Michael & Tanya Polsky

Chicago, Illinois
Address provided upon RSVP

Dinner| 6:30 PM

Home of Fred Eychaner

Chicago, Illinois
Address provided upon RSVP
*Due to timing restrictions all guests may only attend one event*

For further information, please contact

Rachel H. Weiser at Weiser@dscc.org or (202) 314-3234
Nancy Kohn at NKohn@kohnconsulting.com or (312) 527-3667
Paid for by Durbin Senate Victory, a joint fundraising committee authorized by Friends of
Dick Durbin and the Democratic Senatorial Campaign Committee, Inc.

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

Thursday, May 22, 2014 | Chicago, IL

Dinner Guest: $35,000 per couple ($17,500 per person)
Guests will attend dinner at the Eychaner home with a photo opportunity
Reception Co-Chair: $15,000 per person
Ticket to co-chair reception, general reception and photo opportunity at the Polsky home
Reception Sponsor: $10,000 per person
Ticket to general reception and photo opportunity at the Polsky home
Reception Guest: $1,000 per person
Ticket to general reception at the Polsky home
I cannot attend the reception or dinner, but I would like to make a contribution of $__________.

Please make checks payable to Durbin Senate Victory and mail with completed form to:
DSCC c/o Rachel H. Weiser
120 Maryland Avenue, NE Washington, D.C. 20002
For PERSONAL credit card contributions please fax this completed form to: (202) 314-3231.
Federal regulations require that all contributions drawn on joint accounts be personally signed by each contributor.

To make an online contribution via PERSONAL credit card, please visit:

https://secure.actblue.com/contribute/page/chicagomay22

By signing this form I attest that I am a United State citizen or legal permanent resident of the United States. This contribution is
drawn from personal funds not from the funds of a corporation, labor organization, national bank or federal contractor, which are
prohibited by law. 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.

Name______________________________________________________________________________________
Address____________________________________________________________________________________
City/State/Zip______________________________________________________________________________
Date of Birth____________________________________Social Security #_____________________________
Occupation_____________________________________Employer____________________________________
Work Phone____________________________________Home Phone_________________________________
Fax____________________________________________E-mail______________________________________

Visa American Express MasterCard

Number___________________________________________

Expiration Date_______________Name on Card__________________________________________________

Signature___________________________________________________________________________________
The first $2,600 of each contribution from a person will be allocated to the Friends of Dick Durbin Committee and will be considered
designated for the general election. The next $32,400 of each contribution from a person will be allocated to the Democratic Senatorial
Campaign Committee, Inc.
Any contributor may designate his or her contribution for a particular participant. The allocation formula above may change if any
contributor makes a contribution that, when allocated, would exceed the amount that the contributor may lawfully give to any
participant.
Durbin Senate Victory will not accept contributions from currently registered federal lobbyists, registered foreign agents, political action
committees, or minors under the age of 16 in connection with this event.
Contributions from corporations and labor unions are prohibited under federal law.
Contributions or gifts to Durbin Senate Victory are not tax deductible.

Paid for by Durbin Senate Victory, a joint fundraising committee authorized by Friends of
Dick Durbin and the Democratic Senatorial Campaign Committee, Inc.
Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.