Mitt Romney headlines a high-end fund-raiser in Florida on Jan. 12....

Below, hosts and host committee listed in invite:

EVENT CHAIRS
DARLENE & JERRY JORDAN
ALONG WITH
EMILIA & PEPE FANJUL KARA & STEVE ROSS EVENT CO-CHAIRS
HOST COMMITTEE
CORDIALLY INVITE YOU TO AN EVENING RECEPTION WITH
GOVERNOR MITT ROMNEY
THURSDAY, JANUARY 12TH
, 2012
AT THE HOME OF
KARA & STEVE ROSS
xxxxxx PALM BEACH, FLORIDA
5:00 P.M. - 7:00 P.M.
SUGGESTED CONTRIBUTION TO ROMNEY FOR PRESIDENT: $2,500 PER PERSON
EVENT CO-CHAIR: RAISE $50,000 HOST COMMITTEE: RAISE $25,000
KINDLY R.S.V.P. TO MEREDITH O'ROURKE AT MEREDITHOROURKE@YAHOO.COM OR (561) 818-6064
OR ANNIE MOLONEY AT ANNIEMARIEMOLONEY@GMAIL.COM OR (561) 504-1498
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 minors under the age
of 18 are prohibited.
Romney for President, Inc.
Post Office Box 149756
Boston, MA 02114-9756
Paid for by Romney for President, Inc.
www.MittRomney.com
NOLAN D. ARCHIBALD
JANELLE & CARLOS BERUFF
M. ANTHONY BURNS
LOURDES & PEPE FANJUL
JULIE & AMIN KHOURY
TERRY & JOHN RAKOLTA, JR.
ALEX SANCHEZ
CHRISTINE & STEPHEN A. SCHWARZMAN
STEPHANIE & AMBASSADOR NED SIEGEL
WOMEN FOR ROMNEY
SUZANNE & MICHAEL AINSLIE
JENNY & GEORGE BANKS
CAROLYN & DAVID BRODSKY
HOWARD COX
MAUREEN CRONIN
MARGO & ASHTON DE PEYSTER
NANCY HEFFNER DONOVAN
STEVE DUNCKER
DIANA & LLWYD ECCLESTONE
LEWIS M. EISENBERG
ELIZABETH FAGO
CONSTANCE & MIKE FERNANDEZ
T. MARTIN FIORENTINO
JENNIFER & DAVID FISCHER
MARJORIE FISHER
MIKE FITZGERALD
PAMELA & BOB GOERGEN
JAMES D. GREENE
PHIL HANDY
NANCY & JOEL B. HART
LT. GOVERNOR KERRY & SEAN HEALEY
BILL HEAVENER
MARGI HELSCHIEN
CHAIRMAN WILLIAM M. ISAAC
SUZANNE & WOODY JOHNSON
GINNY & DAVID KNOTT
SANDRA & STEPHEN M. LESSING
LEORA R. LEVY
NICOLA & JEFF MARCUS
HOLLY & GEORGE MATTSON
HENRY S. MILLER
MUFFY & DONALD MILLER
DOROTHY & THOMAS M. MULROY
SALLY & THOMAS NEFF
SANDY & JOE O'CONNOR
TODD PETER
NATALIE & MALCOLM PRAY
BONNIE RE
MELANIE SABELHAUS
DEBORAH SIGMUND
PAUL SPRAGUE
BEN STARLING III
MICHAEL STEIN
RICK STONE
JIM TAGGART
TONY TAMER
CINDY TINDELL
DRS. LESLIEBETH & PETER A. WISH
DR. ZACHARIAH P. ZACHARIAH
BRIDGET & BILL KOCH
ELAINE & KEN LANGONE
JAMES B. LEE, JR.
LAURA & LEE MUNDER
KATHY & JOE O'DONNELL
Evening Reception Thursday, January 12th, 2012
REPLY INFO
q Yes, I will be attending the Evening Reception. Enclosed is my contribution of $ __________ ($2,500 per person).
q No, I am unable attend, but enclosed is a contribution of $________.
Please make your check payable to: Romney for President, Inc.
Name_________________________________________________________________________________________
Address_______________________________________________________________________________________
City____________________________________State______________________Zip__________________________
Home Phone____________________________________ Work Phone___________________________________
E-mail_________________________________________________________________________________________
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 $2,500 per person ($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 REPLY
Please charge my contribution of $___________ to my credit card.
q Visa q MasterCard q AMEX q Discover
Card Number____________________________________________ Expiration Date__________________________
Name on Card____________________________________________________________________________________
Signature_________________________________________________________________________________________
Mail to: Romney for President, Inc.
c/o Meredith O'Rourke, 526 E. Park Ave., Suite 200, Tallahassee, FL 32301
Fundraiser ID: 5836
Source Code: EFL021
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 18 are prohibited.
Paid for by Romney for President, Inc.
www.MittRomney.com