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GLENDA & FRITZ CORRIGAN

BILL HEYMAN

MICHAEL GORMAN

SUSAN & KEVIN GREEN

AIMEE & BILL GUIDERAMARK KAPLAN

SARAH & MICHAEL LEBENS

MARY & TOM MCGILL

SHYAN & MIKE O’SHAUGHNESSY

CHRISTINE & JAMES RENIER

JESSICA RENIER

JENNIFER & DAVID ROWLAND

MAUREEN & DICK SCHULZEMARY LYNN & WARREN STALEY

HON. BEN WHITNEY

*COMMITTEE IN FORMATION

INVITE YOU TO AN EVENING RECEPTION WITH

JEB BUSHWEDNESDAY, DECEMBER 2, 2015

6:00 PM

MINNEAPOLIS CLUB729 2ND AVENUE SOUTH

MINNEAPOLIS, MINNESOTA

$10,800 CO-CHAIR GIVE & RAISE

HOST COMMITTEE RECEPTION, PHOTO & EVENING RECEPTION 

$2,700 CO-HOST GIVE

HOST COMMITTEE RECEPTION, PHOTO & EVENING RECEPTION 

$1,000 SUPPORTER GIVE

PHOTO & EVENING RECEPTION 

$500 GUEST GIVE

EVENING RECEPTION 

FOR MORE INFORMATION, PLEASE CONTACT EMMA NELSON AT

ENELSON@JEB2016.COM OR 816-550-0801

DONATE ONLINE AT WWW.JEB2016.COM/DONATE/122MINNEAPOLIS 

XXXXXXXXXXXXXXXXXXXXXXXXXX 

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REPLY INFO:

!  Yes, I /we will serve as a co-chair for the Minneapolis Reception and raise $10,800 for the event.

!  Yes, I /we will attend the Minneapolis Reception. Enclosed is my contribution of $_________________ ($2,700 per person /$5,400 per couple)

!  Yes, I /we will attend the Minneapolis Reception. Enclosed is my contribution of $1,000 for the event.

!  Yes, I /we will attend the Minneapolis Reception. Enclosed is my contribution of $500 for the event.

!  No, I am unable to attend, but enclosed is my contribution of $___________________.

Step 1: Enter contributor information: 

Prefix: First Name:

Last Name: Informal Salutation:

Address:

City: State: Zip:

Email: Cell Phone:

Occupation: (Required)  Employer: (Required) 

This contribution is made by check or credit card from my personal funds and is not drawn on an accountmaintained by an incorporated entity. I am a U.S. citizen or permanent resident and this contribution will not be

 reimbursed by another person. Signature:_______________________________________________________

Step 2: Enter joint contributor information (if applicable):

If your contribution is drawn on a joint account, please consider making a joint contribution.

Prefix: First Name:

Last Name: Informal Salutation:

Email: Cell Phone:

Occupation: (Required)  Employer: (Required) 

 Joint contributions require the signatures of both contributors. Please sign below indicating agreement with the above

 statement.

Signature:_______________________________________________________

Step 3: Contribution:

o Check – Please make checks payable to: Jeb 2016, Inc.

OrCredit Card (check one): o Visa o MasterCard o American Express o Discover

Card Number: ______________________________________________ Expiration Date: ______________ CVV:______________

Cardholder Name: _______________________________________________________________ Billing Zip:_________________

Contribution Amount: $________________________________

By law, the maximum amount an individual may contribute is $2,700 ($5,400 per couple) per election. Federal multi-

candidate PACs may contribute $5,000 per election.

Step 4:  Return this form:Please donate: online at http://www.jeb2016.com/event/122minneapolis, mail your contribution to: Jeb2016 Inc. c/o Emma Nelson PO Box 440644, Miami, FL 33144 Fax to: 630-472-8843, Scan/Email form to:enelson@jeb2016.com

Fundraiser ID: ____2006____________________ Source Code: ________________ 2015EMN001 ___________________If this contribution should be attributed to a volunteer fundraiser please note their name or tracking number above.Contributions to Jeb 2016, Inc. are not tax deductible as charitable contributions for federal income tax purposes. Fede

law requires us to use our best efforts to collect and report the name, mailing address, occupation and name of employer

individuals whose contributions aggregate in excess of $200 per election cycle. Contributions from corporations, forei

nationals (non-green card holders), federal government contractors and minors under the age of 16 are prohibited.

Home Phone:

Home Phone:

Business Phone: 

Business Phone: