Come Join Wendy Long

Candidate for United States Senate, New York

August 28th, 2012

5:30 p.m. VIP Reception 6:30p.m. General Reception
The Center 400 Park Avenue Corning, NY 14830 RSVP: 917.387.6370/Lynn@wendylongfornewyork.com $75 individual VIP Reception $100 couple VIP Reception $25 individual General Reception
Please make checks payable to: Wendy Long for New York, PO Box 4491, NewYork, NY 10163 or donate online: www.WendyLongforNewYork.com
PAID FOR BY WENDY LONG FOR NEW YORK, INC.
Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.

_____ Yes I will attend the Reception on August 28th _____ No, I cannot attend the Reception on August 28th, but please accept my generous donation
$10,000 (Maximum Contribution for Primary and General Election Funds (per couple) $5,000 (Maximum Contribution for Primary and General Election Funds (per couple) $2,500 $1,000 $500 $250 $100 $ Other: ___________ Please Make Checks(s) Payable to: Wendy Long for New York, Inc. P.O. Box 4491, New York, NY 10163

Federal law requires us to obtain and report the name, mailing address, occupation and name of employer for each individual whose contribution aggregate in excess of $200 in an election cycle. By submitting your contribution, you agree that the first $2,500 is designated for the primary, and any additional amount up to $2,500 is designated for the general election.

Name: Prefix: _____ First: __________________ Middle: _____ Last: __________________ Address: _______________________________________________________________ _ City: __________________________________ State: _______ Zip: __________________ Home #: _________________ Cell #: __________________ Work #: _________________ Email: __________________________________________________________________ Employer: _______________________________________________________________
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 from a joint account to be attributed equally to two individuals, both individuals must sign this form.

Signature: ___________________________________ Spouse Contribution Information for Joint Contribution Name: Prefix: _____ First: __________________ Middle: _____ Last: __________________ Address: _______________________________________________________________ _ City: __________________________________ State: _______ Zip: __________________ Home #: _________________ Cell #: __________________ Work #: _________________ Email: __________________________________________________________________ Employer: _______________________________________________________________ Signature: ___________________________________ American Express Discover MasterCard Cardholder Name: ___________________________________________________________
Cardholder Number:

Visa

______________________________________ Expiration Date: __________ __________ Amount: $ _______________

Security Code (3 digit code on back of card or 4 digit code on front of AMEX)

Contributions to Wendy Long for New York, Inc. are not tax deductible as charitable contributions for federal income tax purposes. 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. We may accept contributions from individuals of $5,000 ($2,500 for the primary and $2,500 for the general election). A couple contributing from a joint account may contribute $10,000 ($5,000 for the primary, $5,000 for the general). A multi-candidate federal PAC may contribute $10,000 ($5,000 for the primary and $5,000 for the general). Contributions from corporations, labor organizations, federal government contractors, and foreign nationals without permanent resident status are prohibited.

PAID FOR BY WENDY LONG FOR NEW YORK, INC.

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