Please join in for

A breakfast honoring




Congressman Frank Pallone (D-NJ)
Chairman of Health Subcommittee
of Energy and Commerce

Wednesday February 11
th
at 8:30 AM
Tortilla Coast
400 First Street SE
Washington, DC

Suggested Contribution $1,000 PAC/Personal

Please RSVP to:
Jeremy Gold at (202) 546-9292 or
jeremysgold@yahoo.com

Contributions to Pallone for Congress are not tax deductible for federal income tax purposes.
Federal law requires us to collect and report the name, mailing address, occupation, and name
of employer of individuals whose contributions exceed $200 in an election cycle.
Contributions by corporations and foreign nationals are prohibited. Not printed at government
expense.


Please make checks payable to:
Pallone for Congress
426 C Street, N.E.
Washington, D.C. 20002
Paid for and authorized Pallone for Congress


February 11, 2009 EVENT TO BENEFIT Congressman Frank Pallone



___ Yes, I would like to attend with a $________ contribution.

___ Sorry, I am unable to attend the event, but enclosed is my
contribution of $___________.

Federal law requires us to use our best efforts to collect and report the name and mailing
address, occupation and name of employer of individuals who make contributions.

Corporate contributions, contributions from individuals under the age of 18, and
contributions from non-U.S. citizens who are not lawfully admitted for permanent
residence are prohibited. All contributions by individuals must be made from personal
funds and may not be reimbursed or paid by any other person.


Name_________________________________________________________

Employer_____________________________________________________

Occupation_______________________________________________________

Address_______________________________________________________

City, State, ZIP__________________________________________________

Phone________________________ Fax______________________________

Email_________________________________________________________

Guest(s)_______________________________________________________

Make checks payable to Pallone for Congress and mail to:
426 C Street, NE, Washington, DC 20002

OR FAX THIS FORM TO: Attn: Jeremy Gold 202-546-1666


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Contributions to Pallone for Congress are not deductible
for federal income tax purposes.

Paid for and authorized by Pallone for Congress