This document is an invitation to a fundraising reception in Washington D.C. in support of Rick Perry's presidential campaign. It lists the host committee members and provides details about the event, including time, location, and contribution amounts. Attendees are asked to RSVP and provide their contact and contributor information in compliance with federal election laws.

1. Stan Anderson Brian Conklin Matt Mackowiak Bob Rusbuldt
Kirk Blalock Lindi L. Harvey Gail & Jeff MacKinnon The Honorable
David Bockorny Graham Hill Fred McClure Gregory W Slayton
Les Brorsen Aleix Jarvis Jim Miller Alan Sobba
Roy Coffee Matt Keelen Kevin O'Neill Dirk Van Dongen
Manus Cooney Marc Lampkin Jim Pitts Jade West
Chris Israel Edwina Rogers
(Host Committee in formation)
Cordially invite you to the
WASHINGTON KICKOFF
in support of Republican Presidential candidate
GOVERNOR RICK PERRY
Tuesday, September 27, 2011
5:00 – 5:30pm
Host Committee Photo-Op
5:30pm - 6:30pm
General Reception
Host Committee- Raise $10,000
Guest- $1,000
The Willard
1401 Pennsylvania Ave, NW
Please RSVP to Chris Timmerman at 202-347-4071 or chris@pearson-associates.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 some, but not all, minors under the age of 18 are prohibited.
Paid for by Rick Perry.org, Inc.
www.rickperry.org

2. REPLY INFORMATION
Yes, I will attend the Reception. Enclosed is my contribution of $ _________ ($1,000 per Person)
No, I am unable to attend, but enclosed is a contribution of $_________
PLEASE MAKE CHECKS PAYABLE TO: RICKPERRY.ORG,INC.
Name: ____________________________________________________________________________________
Address: ___________________________________________________________________________________
City: ____________________________State_____ Zip: ___________ E-mail: ____________________________
Daytime Phone: ______________________________ Mobile Phone: _________________________________
CONTRIBUTOR INFORMATION:
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.
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 _____________________________________Employer ____________________________________
Joint Contributor Occupation_______________________Joint Contributor Employer______________________
CREDIT CARD INFORMATION:
Please charge my contribution of $_________ to my credit card.
Circle one: Visa Mastercard AMEX Discover Security Code:_______
Account Number ___________________________________________Expiration Date_______________________
Name on Card_________________________________________________________________________________
Signature____________________________________________________________________________________
Mail to: RickPerry.org, Inc.
c/o Chris Timmerman 900 19th Street, NW – 8th Floor, Washington, DC 20006
Or bring to the event with you.
Tracking #: ______________ Source Code: EDC01
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 some, but
not all, minors under the age of 18 are prohibited.
Any questions should be addressed to Chris Timmerman at chris@pearson-associates.com
Paid for by RickPerry.org, Inc.
www.rickperry.org