Contributions or gifts to Win Virginia 2014 are not deductible as charitable contributions for federal income tax purposes.

Paid for and authorized by Win Virginia 2014, a joint fundraising committee authorized by Friends
of Mark Warner and Virginia Victory 2014.

WIN VIRGINIA 2014
Please join:
Brian Athey~ A. Scott Bolden
Rohini and Aneesh Chopra~ Jane and Dan Dixon
Catherine Read and Tom Greeson~ Andy Hurst
Edward Mullen~ Abby Raphael
Larry Rouvelas~ Rip Sullivan~ Sandy Thomas

for a reception honoring
Senator Mark R. Warner
To benefit Win Virginia 2014
A joint committee of Friends of Mark Warner and Virginia
Victory 2014

Thursday, September 25, 2014
6:00 PM-8:00 PM

Reed Smith LLP
3110 Fairview Park Drive~ Suite 1400
Falls Church, VA

!Suggested Contribution!
Host: $2,600
Sponsor: $1,000
Benefactor: $500
Guest: $250
If you have any questions or to R. S. V. P. , please contact Andrew Cyphers at
703-636-7620 or via email at andrew@markwarnerva.com
Contributions or gifts to Win Virginia 2014 are not deductible as charitable contributions for federal income tax purposes.
Paid for and authorized by Win Virginia 2014, a joint fundraising committee authorized by Friends of Mark
Warner and Virginia Victory 2014.

Win Virginia 2014 Reception with Senator Warner

Yes, I/we will attend. Please find enclosed a contribution of $______ to Win Virginia 2014.

No, I am unable to attend, but enclosed is my contribution of $______ to Win Virginia 2014.

The first $2,600/$5,000 of each contribution from a person/multicandidate committee will be allocated to the
general election of Friends of Mark Warner. The next $10,000 of each contribution from a person and the next
$5,000 from a multicandidate committee will be allocated to the Democratic Party of Virginia.

Any contributor may designate his or her contribution for a particular participant. The allocation formula above may
change if any contributor makes a contribution that, when allocated, would exceed the amount that the contributor
may lawfully give to any participant

Please make your personal check payable to Win Virginia 2014
& send along with this completed form to:
Win Virginia 2014
Attn: Andrew Cyphers
2034 Eisenhower Ave. Ste. 222
Alexandria, VA 22314

Also you can fax your personal credit card contribution to (703) 940-3467 or go online to
https://secure.actblue.com/contribute/page/92514st

Please charge my personal contribution of $________ to my: Visa, MC, AMEX

Credit Card Number:_____________________________________ Exp:__________ Sec #:______

Cardholders name (as it appears on card) _______________________________________________

Cardholders signature ____________________________________________________________

Federal law requires us to use 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.

Name: _______________________________________________________________________

Address: ______________________________________________________________________

City: ____________________________________ State: _________ Zip: ___________________

Employer: ___________________________ Occupation: _________________________________

Home Phone: ___________________________ Office Phone: _____________________________

Fax Phone: ________________________Email: _______________________________________

YOU MUST ALSO SIGN BELOW
Your contribution will be used in connection with federal elections and is subject to the limitations and prohibitions of the Federal
Election Campaign Act. Federal law prohibits contributions to Win Virginia 2014 from corporations, labor organizations and national
banks; from any person contributing another person's funds; from foreign nationals who lack permanent resident status; and from federal
government contractors. By signing below, I affirm that my contribution is from personal funds and not from funds otherwise prohibited
under law.


Contributor Signature (REQUIRED): ____________________________________________________________

9.25.14ST