Paid for by The Baker Committee & The Polito Committee

www.charliebakerma.com | www.karynpolito.com

Roger CrandallINVITES YOU TO AN EVENING RECEPTION WITH SPECIAL GUESTS

________________________________

Governor

CHARLIE BAKER AND

Lt. Governor

KARYN POLITO

_________________________________

WEDNESDAY, OCTOBER 21, 2015

SPRINGFIELD MARRIOTT

2 BOLAND WAY

SPRINGFIELD , MASSACHUSETTS

5:30 PM – 7:00 PM

SUGGESTED CONTRIBUTION TO THE BAKER AND POLITO COMMITTEE :

$125|$250|$500|$1,000 per person

Ma ximu m d o n at io n p er ca l end a r yea r t o th e Ba ker a nd Pol i t o Co mmi t t ee i s

$ 1 ,0 00 p er p erso n / $ 2 ,00 0 per co u p l e

R.S.V.P. Sarah Hunt | sh@massgop .com | (617) 523-5005

 

Paid for by The Baker Committee & The Polito Committee www.charliebakerma.com | www.karynpolito.com

YES, I/we want to help Charlie & Karyn sustain victory and will ____ will not ____ attend the event on Wednesday, October 21, 2015.

q $____________ to The Baker Committee (maximum donation: $1,000 per person/$2,000 per couple) and/or q $____________ to The Polito Committee (maximum donation: $1,000 per person/$2,000 per couple)

CONTRIBUTOR INFORMATION NAME ____________________________________________________SIGNATURE ________________________________________________

OCCUPATION (required) ___________________________________ EMPLOYER (required) ________________________________________

ADDRESS _________________________________________________CITY, ST, ZIP _______________________________________________

PHONE !Office ! Cell ! Home __________________________________ EMAIL ________________________________________________

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.

JOINT CONTRIBUTOR (SPOUSE) INFORMATION For a contribution from a joint account to be attributed equally to two individuals, both must sign this form.

NAME ____________________________________________________SIGNATURE ________________________________________________

OCCUPATION (required) ___________________________________ EMPLOYER (required) ________________________________________

PHONE !Office ! Cell ! Home __________________________________ EMAIL ________________________________________________

CONTRIBUTION – SELECT ONE q ONLINE: The Baker Committee: https://charliebaker.ichooseapex.com/charlie-baker/?EVI=EMA1154&FRI=1158

The Polito Committee: https://karynpolito.ichooseapex.com/karyn-polito/?EVI=EMA1154&FRI=1158 q CHECKS: Please make separate checks payable to The Baker Committee and/or The Polito Committee

q CREDIT CARD: Please charge my contribution of $_____________ to my credit card. ! MasterCard ! Visa ! Discover ! American Express

Credit Card #: ___________________________________________________ Exp. Date: ____________ CVV: _______

Billing Address (if different than above): _______________________________________________________________

Authorized Signature (same as name on the card): ______________________________________________________

RETURN: Please mail to: Sarah Hunt, The Baker/Polito Committee, 85 Merrimac St., Suite 400 Boston, MA 02114 Or scan & e-mail to: sh@massgop.com Event Code: EMA1154 Fundraiser ID: 1158 Contributions to The Baker Committee and The Polito Committee are not deductible as charitable contributions for federal income tax purposes. An individual may contribute up to $1,000 per calendar year each to The Baker Committee and The Polito Committee. Contributions from corporations, labor organizations, other business entities (LLCs and partnerships), out-of-state PACs, and foreign nationals are prohibited. Contributions must be made from personal funds and may not be reimbursed by any other person or entity.