CITY COUNCIL PRESIDENT PAUL GUANCI

AND CITY COUNCILOR AT-LARGE MATT ST. HILAIRE

cordially invite you to an event for

RICHARD R. TISEI
CANDIDATE FOR THE MASSACHUSETTS 6TH CONGRESSIONAL DISTRICT

THURSDAY, MARCH 20, 2014 6:00 8:00 PM ACAPULCOS 900 CUMMINGS CENTER BEVERLY, MASSACHUSETTS
FRIEND $50 SPONSOR $100
Kindly RSVP to Ashley Korb at akorb@tiseiforcongress.com

Contributions to the Tisei for Congress Committee are not tax deductible as charitable contributions for federal income tax purposes.

Paid for by Tisei Congressional Committee

www.tiseifocongress.com

Dear Richard, I am pleased to support your campaign for the United States Congress. To help ensure you have the resources you need, please accept my generous contribution of:
$10,400 (Couple Only) $5,200 $2,600 $1,000 $500 $250 $100 $50 Other

Contribution Information: Name:______________________________________ Signature:_____________________________________ Address:__________________________________________________________________________________ City:________________________________ State:_____________ Zip:________________ Email:______________________________ Phone: Office Cell Home ______________________________ Occupation (required)_________________________ Employer (required)______________________________
Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and employer for individuals whose contributions exceed $200 in a calendar year.

Joint Contribution (spouse) Information: (Joint Donations up to $10,400 can be accepted on this form) Name:______________________________________ Signature:_____________________________________ Address:_________________________________________________________________________________________ City:________________________________ State:_____________ Zip:________________ Email:____________________ Phone: Office Cell Home ________________________________________ Occupation (required)_________________________ Employer (required)______________________________
For a contribution from a joint account to be attributed equally to two individuals, both must sign this form, indicating agreement with the above statement.

Credit Card Contribution: Please Charge my Contribution of $_______________ to my credit card. MasterCard Visa American Express

Credit Card #:____________________________________ Expiration Date:______________________ CSV #:__________________________ Billing Address (if different than above)___________________________________________________ Authorized Signature (Same as name on card):______________________________________________

Event Code: CE1007

Make Checks Payable to: Tisei Congressional Committee, 182 Newbury St, Peabody, MA 01960
Any Questions please contact: akorb@TiseiforCongress.com
[ ] Please check to confirm the following statements are true: (1) I am a United States citizen or an individual lawfully admitted with permanent residence status (e.g., a green card holder); (2) This contribution is made from my own personal funds and is not made from the general treasury funds of a corporation, labor organization, or national bank; (3) If I have paid by credit card, I also certify that this contribution is made on a personal credit or debit card for which I have the legal obligation to pay, and is not made on a corporate or business entity card; (4) I am not a federal government contractor; (5) I am at least 18 years old.

Contributions to the Tisei for Congress Committee are not tax deductible as charitable contributions for federal income tax purposes. By federal law, the maximum amount an individual may contribute is $2,600 per election (the primary and general elections are separate elections) or a total amount of $5,200 per election cycle ($10,400 per couple). Political Action Committee (PACs) may contribute up to $5,000 per election ($10,000 max). Contributions from corporations, labor unions, foreign nationals and federal government contractors are prohibited.

Paid for by Tisei Congressional Committee