THE TRANSITION FINANCE COMMITTEE
JEREMY M. JACOBS
PAUL HARDER
EVENT CHAIR
EVENT CO-CHAIR
CONGRESSMAN CHRIS COLLINS
HONORARY CHAIR
AND
PHIL ACKERMAN
GERRY BUCHHEIT
JANE & PHIL CORWIN
JIM DOMAGALSKI
ILENE & DAVID FLAUM
KENT FREY
HONORABLE TONY GIOIA
CHRIS GRANT
BILL GRESSER
NICK LANGWORTHY
BRIAN LIPKE
ALEXANDER MARKOWITZ
BARBARA & DR. PAUL MAURER
TIFFANY & KRISTIAN G. MEYER
HONORABLE SUSAN MOLINARI
RYAN MORFIN
HONORABLE BILL PAXON
ANDREA & DR. ANTHONY PETRAGLIA
PAUL REID
JOHN SCHMIDT
NICK SINATRA
DENNIS VACCO
EVENT VICE CHAIRS
INVITE YOU TO A LUNCH
WITH SPECIAL GUEST
KELLYANNE CONWAY
THURSDAY, JANUARY 5, 2017
BUFFALO, NEW YORK
RECEPTION TICKET ~ $5,000 PER PERSON
KINDLY RESPOND TO CAM HENDERSON AT [email protected].
Thank you for supporting Trump For America, Inc. (TFA).
Yes, I will attend the reception and contribute $5,000 per person. Enclosed is my contribution of $____________.
No, I cannot attend, but would like to support Trump For America, Inc. Enclosed is $________.
CONTRIBUTOR INFORMATION
Prefix
First Name
Last Name
Preferred Name
Employer (Required)
Occupation (Required)
Address
City
State
Zip
Cell Phone
Work Phone
Home Phone
Email
Signature
JOINT CONTRIBUTOR INFORMATION (If applicable) Joint contributions require the signatures of both contributors.
Prefix
First Name
Last Name
Preferred Name
Employer (Required)
Occupation (Required)
Cell Phone
Work Phone
Home Phone
Email
Joint Contributor Signature
PAYMENT INFORMATION
Pay by check. Please make payable to Trump For America, Inc. and send to Cam Henderson at PO Box 28163
Washington D.C. 20038
Pay by credit card (check one).
Visa
MasterCard
American Express
Discover
Pay by credit card (online). https://transaxt.com/Donate/PPC8SP/TrumpforAmericaInc/
Personal
Name on Credit Card
Card Number
Contribution Amount: $
Expiration Date
Security Code
Corporate
Signature
Questions: Please email Cam Henderson at [email protected].
Paid for by Trump for America, Inc., an organization established and maintained under Section 501(c)(4) of the Internal Revenue Code and the Presidential
Transition Act of 1963. TFA assists in the presidential transition and the preparation for the assumption of official duties of the President. Pursuant to the
Presidential Transition Act of 1963, contributions are limited to $5,000 per individual, organization, or entity and will be reported publicly. By signing this form, you
certify that (a) the donor is a U.S. citizen or lawfully admitted permanent resident or, for an organizational contributor, is controlled by U.S. citizens or lawfully
admitted permanent residents; (b) the contribution is made from your personal funds (or, for organizational contributors, from the organization's own funds) and is not
being reimbursed by another person or entity; and (c) the donor is not a federal lobbyist.
Contributions to TFA are not deductible as charitable contributions for federal income tax purposes.
