Please Join

Please join

Romita Shetty & Nasser Ahmad Peter Briger Celerie Kemble & Boykin Curry Cathy & Marc Lasry John Legend Tracy Maitland Brian Mathis Michael Novogratz Maureen White For an evening in support of the Congressional Exploratory Committee of

Reshma Saujani Wednesday, December 2, 2009 6:30 pm At the home of Cathy & Marc Lasry 4 East 74th Street New York City For more information or to RSVP please call Bridget Siegel at 646.678.0180 or email [email protected] Paid for by Reshma for Congress Exploratory Committee

For Individual Contributions Only ! Yes! I will attend. Please reserve _____ host seats. ($4,800 per person) ! Yes! I will attend. Please reserve _____ supporter seats. ($2,400 per person) ! Please contact me about joining the host committee. ! I cannot attend but I’d like to support Reshma. Enclosed is my contribution of $________. Individual contributions are limited to $2,400 per federal election. The primary and general election are considered separate federal elections with each having a separate contribution limit of $2,400. By signing this form, you agree to designate the first $2,400 of your contribution the primary election and any amount above $2,400 to the general election.

Signature: ____________________________________________________________________ Please make checks payable to: Reshma for Congress Exploratory Committee To contribute via credit card, please charge $________________ to ! AMEX ! MasterCard ! Visa Credit Card #:__________________________________________ Expiration Date: ________________ Name (as it appears on card): ____________________________________________________________

Signature: _____________________________________________________________________ ! Please sign me up for e-mail updates on the campaign. E-Mail: _______________________________________________________________________ For compliance with Federal Election Law, please complete the following: Name __________________________________________________________________________ Home Address ___________________________________________________________________ City ____________________________________ State _______________ Zip _______________ Home Phone _____________________________ Work Phone ____________________________ Employer ________________________________ Occupation_____________________________ Federal law requires that we request and report the name, address, occupation and employer for any donor who contributes, in the aggregate, in excess of $200 in any election cycle. Federal law requires our committee to attribute a contribution to the individual who signs the check. If a contribution is being made by both spouses, each spouse should sign the check. In this case, the committee will attribute the contribution equally amongst each spouse. If a contribution is to be allocated to both spouses then each spouse should fill out a separate donor form. Federal PACs are limited to $5,000 per federal election (primary and general are separate). Contributions from the treasury funds of corporations and labor organizations, federal contractors (not including employees), and contributions from foreign nationals who are not permanent resident aliens are prohibited. FOR FURTHER INFORMATION PLEASE EMAIL [email protected]

TO RETURN THIS FORM MAIL TO PO BOX 20245, NEW YORK, NY 10009 Contributions to Reshma for Congress Exploratory Committee are not tax deductible for federal or state income tax purposes.

Paid for by Reshma for Congress Exploratory Committee