Please join
Sean Jewell
For a
Fire Fighters, Friends, and
Family event
in support of
Congressman Ed Perlmutter
Saturday, February 18, 2012
3:00 – 5:00 pm
Café Del Sol
608 Garrison Street
Lakewood, Colorado
Suggested Contribution $25
All contributions are welcome!
RSVP to Julie DeWoody at 303-459-4729 or
julie@perlmutterforcolorado.com

Ed Perlmutter for Congress
Reception February 18, 2012
_____ Yes, I will attend the event. Enclosed is my contribution of $__________.
_____ I am unable to attend, but enclosed is my contribution of $__________.
Please make checks payable to “Perlmutter for Congress” and return this form to:
Ed Perlmutter for Congress
3440 Youngfield Street #264
Wheat Ridge, CO 80033
FAX: 303-233-3530
Required information:
Name__________________________________________________________________
Address_______________________________________________________________
City ___________________________ State _______ Zip ______________
Occupation______________________________________________________________
Employer _______________________________________________________________
Home Phone ________________________ Work Phone _________________________
Fax ____________________ E-mail__________________________________________
If you prefer to contribute by personal credit card, please provide the following
information:
_____ Visa _____ MasterCard _____ AmEx
Card Number ______________________________________ Expiration _________
Name as it appears on card_________________________________________________
I designate my contribution, composed of personal funds, to Perlmutter for Congress
as follows: the first $2,500 for the 2012 primary election and any additional amount,
up to another $2,500 for the 2012 general election.
Signature ______________________________________________________________

Contributions to Perlmutter for Congress are not tax deductible. Federal law requiresus to use our best efforts to collect and report the name, mailing address, occupation, and name of employer of individuals whose contributions exceed $200 in an election cycle. Contributions from corporations and foreign nationals are prohibited. Persons are prohibited from making contributions in the name of another person. Contributions from federal government contractors are prohibited. Individuals may contribute up to $2,500 per election and up to $5,000 per election cycle. Federal PAC limits permit up to $5,000 per election.

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