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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 CAMH1578@GMAIL.COM.

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 camh1578@gmail.com.


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.

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