Please join

Honorable Sam Crowe & Ron Wall

in a reception supporting

Christina Gagnier Candidate for AD-40

Friday, May 29, 2015 5:30 PM

1131 W. 6th St, 4th Floor, Ontario, CA 91762

Tickets

*Supporter $50 *Friend $100 *Sponsor $250 *Host $500

Contributions to Christina Gagnier for Assembly 2016 (ID# 1376725) are not tax deductible as charitable contributions for federal income tax purposes. The California Political Reform Act places limits on contributions to candidates for state office. Individuals, corporations, unions, PACs, and other entities may contribute a maximum of $4,200 to the committee per election, primary and general, for a total of $8,200. A registered small contributor committee may contribute a maximum of $8,400 per election. Spouses and domestic partners may each contribute from a joint account but both must sign the check or credit card authorization form. Contributions must be made voluntarily from the donor’s own funds and may not be reimbursed by any other person or business. Contributions from foreign nationals or persons under the age of eighteen are not permitted. Christina Gagnier for Assembly 2016 (ID# 1376725)

Computer Generated Entirely In-House

Christina Gagnier for Assembly 2016 Candidate for Assembly District 40

Please make checks payable to:

Christina Gagnier Assembly 2016

550 S. Hope Street, Ste. 1910 Los Angeles, CA 90071

FPPC ID# 1376725

State Election Law Requires The Following Information

*Contributor Name(s): ________________________________________

*Street Address: ____________________________________________ *City/State/Zip: _____________________________________________ Cell Phone: _____________________ Email: ____________________ *Occupation: _____________________*Employer: ________________

ID#, if committee: ___________________________________________

*If Self-Employed, nature of business: ________________________________ BOTH SECTIONS MUST BE COMPLETED FOR CREDIT CARD CONTRIBUTIONS

Name on Card: ________________________________________________________

Billing Address: ________________________________________________________

Please charge my: _____ VISA _____ MasterCard _____ AmEx Amount: $_____

Credit Card Number: ___________________________________Exp.Date:__________

Signature: _________________________________________________V-Code:______ Contributions to Christina Gagnier for Assembly 2016 are not deductible as charitable contributions for income tax purposes. The California Political Reform Act (Proposition 34) places limits on contributions (including loans) to candidates for state office and imposes certain prohibitions. This request does not seek a contribution in excess of applicable limits or from prohibited sources. An individual, union, political action committee, association, partnership, business or corporation may contribute a maximum of $4,200 to the committee per election, primary and general. A registered Small Contributor Committee may contribute a maximum of $8,400 per election to the committee. Lobbyist registered to lobby the California State Legislature may not contribute. FPPC ID# 1376725. Paid for by Christina Gagnier for Assembly 2016, 525 E. Seaside Way, Ste. 101-C, Long Beach, CA 90802.

For more information, please contact Mona Sanchez (818) 523-3753 mona.sanchez.ca@gmail.com