SAVE THE DATE

For A Reception Honoring

Mayor Alvin Brown Mayor of Jacksonville, FL

April 24th, 2013

8:00am-9:00am

At the office of

Hon. Scott Maddox

502 North Adams Street

Tallahassee, FL 32303

Maximum Contribution $500

(per individual and per business)

To RSVP or for additional information please contact

Greg Goddard at gregorygoddard@gmail.com,

or by phone at 561.212.8892

Political advertisement paid for and approved by Alvin Brown, Democrat, for Mayor.

□ Yes, I will attend as a guest. Enclosed is my contribution of $500.

I cannot attend, but I support Alvin Brown for Mayor. Enclosed is my contribution of $ ___________

Name: _______________________________________________________________________________________

Address: _____________________________________________________________________________________

City: _________________________________________ State: ____________ Zip: _________________________

Work Phone: __________________________________Home Phone: __________________________________

Cell Phone: ___________________________________ Fax: ___________________________________________

Email: _______________________________________________________________________________________

Employer: ____________________________________ Occupation: ____________________________________ A candidate may not accept a contribution in excess of $500 from any one person per election. A "person" is an individual or a corporation, association, firm,

partnership, joint venture, joint stock company, club, organization, estate, trust, business trust, syndicate or other combination of individuals having collective capacity. The purchase of a ticket for, or contribution to, the campaign fundraiser is a contribution to the campaign of Alvin Brown. Contributions

are not tax deductible for federal income tax purposes.

Signature: _________________________________ Name (Print): _____________________________________

CHECKS SHOULD BE MADE PAYABLE TO ALVIN BROWN FOR MAYOR AND SENT TO:

31 West Adams Street #1207

Jacksonville, FL 32202

TO CONTRIBUTE BY CREDIT CARD:

Please charge _______________ to my: Mastercard Visa American Express (please circle)

Name on Card: ____________________________________________________________________________________

Card Number: _______________________________________ Expiration Date: ___________ Security Code: _____

Billing Address/City/State/Zip: ______________________________________________________________________

Authorized Signature: _________________________ Second Authorized Signature __________________________

31 WEST ADAMS STREET #1207• JACKSONVILLE, FLORIDA 32202

Political advertisement paid for and approved by Alvin Brown, Democrat, for Mayor.