You Are Cordially Invited To Attend A Reception

WITH

GOVERNOR MITT ROMNEY

AND SPECIAL GUESTS

DAVID FOSTER
David Foster is a 16 time Grammy Award winning songwriter, producer and musician who has produced some of the most successful artists in the world and is noted for discovering singers Celine Dion, Josh Groban and Michael Buble.

& TERRY FATOR

Best known for his victory on Americas Got Talent, Terry Fator has captured the hearts and funny bones of America. Entertaining millions with his unique brand of talent, he makes his signature puppets come to life through comedy, singing and uncanny celebrity impressions all without moving his lips.

SEGERSTROM CENTER FOR THE ARTS RENE & HENRY SEGERSTROM CONCERT HALL 600 TOWN CENTER DRIVE COSTA MESA, CALIFORNIA

Monday, September 17, 2012

Private Reception 5:45 p.m. Photo and General Reception 6:15 p.m.
GIVE $50,000 or RAISE $100,000 2 Tickets to the Private Reception 2 Tickets to the Photo Reception 1 Photo Opportunity (2 people per photo) 4 Tickets to the General Reception (preferred seating) GIVE $10,000 2 Tickets to the Photo Reception 1 Photo Opportunity (2 people per photo) 2 Tickets to the General Reception (preferred seating)

INDIVIDUAL TICKETS: $2,500 per person (includes Romney lapel pin) $1,000 per person All RSVPs and contributions must be received by Friday, September 14, 2012 No RSVPs or contributions will be taken at the door

For additional information or to RSVP, contact Stacy Davis at 949.474.6930 or stacy@stacy-davis.com

Romney Victory, Inc. Post Office Box 149757 Boston, MA 02114-9757

Contributions to Romney Victory, Inc. (RV) are not tax deductible for federal income tax purposes. RV is a joint fundraising committee composed of Romney for President, Inc. (RFP), the Republican National Committee (RNC), the official Republican Parties in four states (the Idaho Republican Party, the Massachusetts Republican Party, the Oklahoma Leadership Council, and the Vermont Republican Federal Election Committee), the National Republican Senatorial Committee, and the National Republican Congressional Committee. Paid for by Romney Victory, Inc., a joint fundraising committee authorized by and composed of Romney for President, Inc., the Republican National Committee, the Idaho Republican Party, the Massachusetts Republican Party, the Oklahoma Leadership Council, the Vermont Republican Federal Election Committee, the National Republican Senatorial Committee, and the National Republican Congressional Committee.
Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.

Reception with Governor Mitt Romney Monday, September 17, 2012 at The Rene & Henry Segerstrom Concert Hall

Yes, I would like to GIVE $50,000 or RAISE $100,000 to support Romney Victory.
Includes: 2 tickets to the Private Reception, 2 tickets to the Photo Reception with 1 photo opportunity and 4 tickets to the General Reception (preferred seating)

Yes, I/we would like to make a donation in the amount of $10,000 to support Romney Victory.
Includes: 2 tickets to the Photo Reception with 1 photo opportunity and 2 tickets to the General Reception (preferred seating)

Yes, I/we would like to attend. Please make reservations for __ individuals at $2,500 per person (includes Romney lapel pin). Yes, I/we would like to attend. Please make reservations for __ individuals at $1,000 per person. No, I/we cannot attend but will contribute: $50,000 $25,000 $10,000 $5,000 $2,500 $1,000 ____Other
Federal law requires us to collect and report the name, mailing address, occupation, and name of employer of each contributor whose contributions aggregate in excess of $200 in a calendar year (RNC and state parties) or election cycle (RFP). Please complete the following:

Name_____________________________________________ Spouse Name_____________________________________________ Address_____________________________________________________________________________________________________ City_____________________________________________ State______________________ Zip_____________________________ Work Phone_______________________ Mobile Phone_________________________ Home Phone_________________________ Fax Phone_________________________ Email_____________________________________________________________________ Occupation__________________________________________ Employer_______________________________________________ Joint Contributor Occupation___________________________ Joint Contributor Employer_______________________________ CONTRIBUTOR INFO This contribution is made by check or credit card from my personal funds and is not drawn on an account maintained by an incorporated entity. I am a U.S. citizen or permanent resident and this contribution will not be reimbursed by another person. Signature_________________________________________________________________________________________________
For a contribution from a joint account to be attributed to two individuals, both must sign this form, indicating agreement with the above statement.

Joint Contributor Signature_________________________________________________________________________________ CREDIT CARD REPLY Please charge my contribution of $___________ to my credit card. Visa MasterCard AMEX Discover

Account Number______________________________________________________ Expiration Date________________________ Name on Card_____________________________________ Signature_________________________________________________

For additional information or to RSVP, contact Stacy Davis at 949.474.6930 or stacy@stacy-davis.com

Make contributions payable to Romney Victory and mail to: c/o Stacy Davis 24651 Evereve Circle, Suite #1 Lake Forest, CA 92630 *USPS Mail Preferred Or Fax: 949.305.9919; or Scan/Email to: stacy@stacy-davis.com

Fundraiser ID: ______

Event Code: ECA060

Proceeds to RV shall be allocated by the following formula: 1) Individuals and non-multicandidate PACs - The first $2,500 will go to RFPs general account. Prior to August 31, 2012, the next $2,500 will go to RFPs primary account. Beginning on August 31, 2012, should Romney for President have primary debt, that next $2,500 will go to RFPs primary debt retirement account. The next $30,800 will go to the RNC. The remaining amount will be split evenly among the federal accounts of the Republican Parties of Idaho, Massachusetts, Oklahoma, and Vermont, up to a maximum of $10,000 per committee. 2) Multicandidate PACs - The first $5,000 will go to RFPs general account. Prior to August 31, 2012, the next $5,000 will go to RFPs primary account. Beginning on August 31, 2012, should Romney for President have primary debt, that next $5,000 will go to RFPs primary debt retirement account. The next $15,000 will go to the RNC. The remaining amount will be split evenly among the federal accounts of the Republican Parties of Idaho, Massachusetts, Oklahoma, and Vermont, up to a maximum of $5,000 per committee. Notwithstanding this allocation formula, a contributor may designate a contribution for a specific participant or participants. In addition, the allocation formula may change if RFPs primary account receives sufficient funds to retire its outstanding primary debt or if any contribution would exceed applicable contribution limits. Contributions from corporations, labor unions, federal contractors, and foreign nationals are prohibited. Federal law requires us to collect and report the name, mailing address, occupation, and name of employer of each contributor whose contributions aggregate in excess of $200 in a calendar year (RNC and state parties) or election cycle (RFP).

Source: Sunlight Foundation's Party Time www.politicalpartytime.org. The Sunlight Foundation collects these invitations from anonymous lobbyist sources.

Paid for by Romney Victory, Inc., a joint fundraising committee authorized by and composed of Romney for President, Inc., the Republican National Committee, the Idaho Republican Party, the Massachusetts Republican Party, the Oklahoma Leadership Council, the Vermont Republican Federal Election Committee, the National Republican Senatorial Committee, and the National Republican Congressional Committee.