Tuesday, September 9, 2014 | Washington, DC □ I would like to attend the DSCC event as a WSN Chair with a contribution of $32,400 per couple. □ I would like to attend the DSCC event as a WSN Vice- Chair with a contribution of $10,000 per person. □ I am unable to attend the DSCC event, but would like to support the DSCC with a contribution of $___________.   To contribute by personal credit card via our secure website, please contribute online at: https://www.dscc.org/-/dcseptember9 Please make checks payable to “DSCC” and mail with this completed form to: The Democratic Senatorial Campaign Committee c/o Addy Rummel 120 Maryland Avenue, NE | Washington, D.C. 20002 Or fax this completed form to 202-314-3231   Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and name of employer for individuals whose contributions exceed $200 in a calendar year. Name ________________________________________________________________________ Address _______________________________________________________________________ City/State/Zip _________________________________________________________________ Occupation _____________________________Employer _______________________________ Work phone ___________________________ Home Phone _________________________ Fax ____________________________________ E-mail ___________________________  Visa American Express MasterCard Number _____________________________________________________________________ Expiration Date _______________________ Name on Card ____________________ Signature _____________________________________________________________________ I attest that I am a United States citizen or legal permanent resident. This contribution is made from my personal funds and not from the funds of a corporation, labor union, national bank, or federal contractor, or from funds provided by any other person, which is prohibited by law. An individual can contribute as much as $32,400 per calendar year to the DSCC's general fund for use in the DSCC's sole discretion. A couple can contribute as much as $64,800 per calendar year to the DSCC's general fund. All amounts in excess of this (up to another $32,400) will be for the DSCC’s recount fund and will be used to pay expenses in connection with election recounts and contests. Donations to the recount fund will not be used for the purpose of influencing a federal election. A contribution of $32,400 enrolls an individual as a DSCC “Majority Trust” member and, along with other benefits, allows for attendance at the DSCC’s signature retreats. Contributions or gifts to the DSCC are not tax deductible. Paid for by the Democratic Senatorial Campaign Committee, www.dscc.org, and not authorized by any candidate or candidate’s committee.