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You Are Invited

to a Luncheon with Special Guest

Governor Jeb Bush

to benefit

Pat Roberts
for

U.S. Senate

Monday, September 29th

Luncheon 12:30pm - 2:00pm

Murfin Stables

14515 E. 13th Street N, Wichita, KS 67230

Suggested Contribution Amounts


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*Fill your own table of 10 with family and friends

RSVP to Annie Harper at

aharper@robertsforsenate.com or call (785) 354-4PAT.
Paid for by Pat Roberts for U.S. Senate, Inc.
NOT PRINTED OR DISTRIBUTED AT GOVERNMENT EXPENSE.
Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.

Yes, I/We would like to attend the event with Senator Roberts at the following level:
HEADTABLE:
ATTENDEE:

$2,600 / person
$100 / person

TABLE SPONSOR:

$1,000 / person

Sorry, Pat, I cant join you, but want to support your re-election campaign with a
contribution of: $ __________________
Please write your name(s) as you would like it (them) to appear on your nametag(s).
_______________________________ ______________________________
Attendee 1

Attendee 2

If contributing check make payable to: Pat Roberts for U.S. Senate, Inc.
CREDIT CARD INFORMATION

_________________________________________ $___________________
Card Number

____ /____
Expiration Date

Amount

_______ ___________________________________________

CID

Cardholder Name

CONTRIBUTOR INFORMATION Federal law requires us to obtain and report the following information

_______________________________ ______________________________
Name

Address

_______________________________ ________
City

State

(_____)________________________
Phone

____________________

Zip

______________________________

Email

________________________________ ______________________________
Contributor Employer (Required)

Contributor Occupation (Required)

________________________________ ______________________________
Joint Contributor Employer (Required)

Joint Contributor Occupation (Required)

This contribution to Pat Roberts for U.S. Senate, Inc. represents my personal funds, is not drawn on an account maintained by an incorporated entity and
will not be reimbursed by another.

__________________________________
Signature of Contributor

_________________________________
*Signature of Joint Contributor

*If joint contribution, must be signed by both contributors. Contributions are not deductible as charitable contributions for federal income tax
purposes. Contributions from corporations and foreign nationals are prohibited. Federal law requires us to make 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.

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or (785) 354-4PAT.
By law, the maximum amount an individual may contribute is $2,600 ($5,200 per couple) per election.
Federal multi-candidate PACs may contribute $5,000 per election.
RSVPBush92914

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