HOST COMMITTEE

Melissa and Stephen Babson State Senator Don Benton Linda and Lee Bird Ria and Brent Boger Ambassador Molly and Matt Bordonaro Geoff Boisi Liz and David Carlson John Carter John Connors Jeanne and Bill Firstenburg Eric Fuller Mike Gaston Michele and Greg Goodwin Diane and Ryan Hart Lynn and Steve Pratt Karen Hinsdale and Michael Preisz Jo Marie and Steve Hansen Henry Hooper Julie and Frank Jungers Gayle and Greg Kimsey Voula and Nick Konidaris Greg Kubicek Sharon and Bob Lewis Shawn Lindsay Stephanie Lipman Dolly and Ed Lynch Cyndy and Ed Maletis Kathy McDonald The Honorable Rob McKenna Patricia and David Nierenberg Tina and Matt Olson Chris and Wayne Perry Chris Pollard Terry and Ron Prill Ron Saxton John Stanton Julie and Peter Stott Jon and Colleen Thrift Fran and John VonSchlegell Becky Weis Kaycee and Tom Wiita Rick Wollenberg

The Honorable Gordon Smith Former United States Senator

cordially invite you to an

Afternoon Reception
with

Governor Mitt Romney

to benefit his

Free and Strong America PAC

Saturday, June 12, 2010

The Home of Patricia and David Nierenberg

19605 NE 8th Street Camas, Washington Photo Opportunity 4:00 pm $5,000 per couple Afternoon Reception 5:00 pm $1,000 per person
Kindly RSVP to Tiffany Stark at tiffany@tstarkfundraising.net or 503-224-5489(Phone) or 801-443-4455(Fax)
Paid for by Free and Strong America PAC, Inc. Not authorized by any candidate or candidate's committee. www.FreeStrongAmerica.com

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

Afternoon Reception Saturday, June 12, 2010

REPLY INFO
Yes, I will be attending the June 12th Photo Opportunity and Afternoon Reception. Enclosed is my contribution of $ ____________ ($5,000 per couple). Yes, I will be attending the June 12th Afternoon Reception. Enclosed is my contribution of $ _____________ ($1,000 per person). No, I am unable attend, but enclosed is a contribution of $_______________. Please make your check payable to: Free and Strong America PAC

Name_____________________________________________________________________ Address___________________________________________________________________ City______________________________State__________________Zip________________ Home Phone___________________________ Work Phone__________________________ E-Mail_____________________________________________________________________ (EPWA001) 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 $5,000 ($10,000 per couple) per calendar year. 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. 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 calendar year. Please complete the following: Occupation____________________________________________ Employer_______________________________________

Joint Contributor Occupation________________________________ Joint Contributor Employer_______________________________

CREDIT CARD REPLY

Please charge my contribution of $___________ to my credit card.
Visa MasterCard AMEX Discover

Account Number________________________________________

Expiration Date____________________

Name on Card____________________________________________________________________________ Signature________________________________________________________________________________

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 16 are prohibited.

Mail to: Free and Strong America PAC, Inc. c/o Tiffany Stark P.O. Box 13470 Portland, OR 97213

Paid for by Free and Strong America PAC, Inc. Not authorized by any candidate or candidate's committee. www.FreeStrongAmerica.com
Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.