HOST COMMITTEE

THE HON. RICHARD BENNETT THE HON. PETER & MRS. CAROLYN CIANCHETTE CHRIS COLLINS THE HON. RON COLLINS THE HON. JON COURTNEY THE HON. DEAN CRAY THE HON. DAVE EMERY CYNTHIA FAULKNER THE HON. STACEY FITTS THE HON. LES FOSSEL THE HON. KEN FREDETTE DAWN GILBERT THE HON. RICHARD ROSEN THE HON. TOM SAWYER THE HON. LOIS SNOWE-MELLO JAN STAPLES THE HON. JOSH TARDY NATHANIEL WALTON KATHY WATSON

YOU ARE CORDIALLY INVITED TO AN EVENING RECEPTION WITH

ANN ROMNEY
ON BEHALF OF

GOVERNOR MITT ROMNEY
WEDNESDAY, OCTOBER 12, 2011
THE MARRIOTT AT SABLE OAKS 200 SABLE OAKS DRIVE SOUTH PORTLAND, ME
HOST COMMITTEE RECEPTION: 5:00 P.M. ($1,000 PER PERSON / $2,000 PER COUPLE) GENERAL RECEPTION: 5:30 P.M. (SUGGESTED DONATION: $500 PER PERSON / $1,000 PER COUPLE) KINDLY RSVP TO CINDY FAULKNER AT 207-233-1040 OR CCYNTHIAFAULKNER@AOL.COM
Contributions are not tax deductible as charitable contributions for federal income tax purposes. By law, the maximum amount an individual may contribute is $2,500 ($5,000 per couple) per election. Federal multi-candidate PACs may contribute $5,000 per election. 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, federal government contractors, and minors under the age of 18 are prohibited. Romney for President, Inc. Post Office Box 149756 Boston, MA 02114-9756

Paid for by Romney for President, Inc. www.MittRomney.com

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

Reception ‚ Wednesday, October 12, 2011
REPLY INFO ‰ Yes, I will be attending the Oct. 12th Host Committee Reception. Enclosed is my contribution of $ ______ ($1,000/person – $2,000/couple). ‰ Yes, I will be attending the Oct. 12th General Reception. Enclosed is my contribution of $ ______ (Suggested $500/person $1,000/couple). ‰ No, I am unable attend, but enclosed is a contribution of $_______________. Please make your check payable to: Romney for President, Inc. Name_________________________________________________________________________________________ Address_______________________________________________________________________________________ City____________________________________State______________________Zip__________________________ Home Phone____________________________________ Work Phone___________________________________ E-mail_________________________________________________________________________________________ CONTRIBUTOR INFO 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 U.S. citizen or permanent resident and this contribution will not be reimbursed by another person. Signature_______________________________________________________________________ By law, the maximum amount an individual may contribute is $2,500 ($5,000 per couple) per election. For a contribution from a joint account to be attributed to two individuals, both must sign this form, indicating agreement with the above statement. Joint Contributor Signature_________________________________________________________ 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. Please complete the following: Occupation__________________________________________ Joint Contributor Occupation___________________________ CREDIT CARD REPLY Please charge my contribution of $___________ to my credit card. ‰ Visa ‰ MasterCard ‰ AMEX ‰ Discover Employer______________________________________ Joint Contributor Employer_______________________

Account Number________________________________________

Expiration Date__________________________

Name on Card____________________________________________________________________________________ Signature_________________________________________________________________________________________ Mail to: Romney for President, Inc. c/o Trent Christensen, Post Office Box 149756, Boston, MA 02114-9756 Fundraiser ID: 588019 Source Code: ____EME001____

Contributions are not tax deductible as charitable contributions for federal income tax purposes. Contributions by corporations, foreign nationals (non-green card holders), labor unions, federal government contractors, and minors under the age of 18 are prohibited.
Paid for by Romney for President, Inc. www.MittRomney.com

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

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