NYS and Nassau County Democratic Chairman Jay Jacobs Nassau County Executive Tom Suozzi Congressman Steve Israel (NY02) Cordially invite you to attend a reception to benefit the Election of
Bill Owens, Candidate for Congress (NY-23) Sunday, October 18, 2009 2:00 – 4:00 PM At the Home of
Jay Jacobs 1362 Ridge Rd Syosset, NY 11791 Please RSVP to Lisa Deutsch (631) 434-7500 or
[email protected]
□ $1,000 Silver □ $2,400 Gold $4,800 Platinum
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Checks should be made payable to Bill Owens for Congress, and should be mailed to PO Box 1575, Plattsburgh, NY 12901. Please remember that all donations must be in the form of a personal check or money order. Federal Law prohibits corporate contributions.
____Yes, I will attend. Please accept my contribution of $_________ Name: ____No, I cannot attend, but enclosed is my contribution of $_______ ____ Please authorize $_________ to my Visa/ MasterCard Credit Card #_____________________________________ Expiration date_______________________ Name: ______________________________________________________________________________________________________ Address: ____________________________________________________________________________________________________ City: _______________________________________________ State___________ ZIP______________________________________ Occupation (Title):_____________________________________Employer (Company Name):____________________________________________ Daytime Phone: __________________________ Fax: _____________________________Email:______________________________________________
Contributions are not tax deductible. Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and name of employer of individual whose contributions exceed $200 in a calendar year. CORPORATE CHECKS ARE STRICTLY PROHIBITED. Paid for by Bill Owens for Congress