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Please join

Gustavo Rivera
Candidate for New York State Senate
And

1199 SEIU • SEIU 32BJ • CWA Local 1180


Hotel Motel Trade Council • UFCW Local 1500
Tenants PAC

Wednesday, August 18th


6:00pm-8:00pm

At the home of Sanford Rubenstein, Esq.


188 East 64th Street, Penthouse 3
(between Lexington & 3rd Avenues)
New York, NY
(Please note new address)

___Yes, I will attend the reception on August 18th


___I will be unable to attend
Enclosed please find my contribution of:__$500 __$1,000 __$2,500 __$6,000 __Other: $______

Name/Organization:_______________________________________________________________________
Address: _________________________________________________________________________________
City: __________________________________________ State: ___________Zip:______________________
Home /Cell Phone: _____________________________ Work Phone: ______________________________
Occupation: _____________________________ Employer: _______________________________________
Email: ____________________________________________________Fax:____________________________

To Contribute by Check:
Please make checks payable to “Gustavo Rivera for State Senate” and mail to:
Gustavo Rivera for State Senate
220 Lafayette Street, 3rd Floor
New York, NY 10012
To Contribute by Credit Card
Please charge my: Visa MC Discover Amex / In the amount of: $______________
Name as it appears on card: _____________________________________________________
Billing Address (if different than above):__________________________________________
Account Number: ______________________________________________________________
Exp. Date: _________ Card Verification No.: _____ (last 3 digits on back of card; 4 on front of amex)

Individuals and all non-corporate entities may contribute up to $6,000 for the Primary Election and up to $9,500 for the General
Election. Corporations may contribute up to $5,000 per calendar year (subject to NYS aggregate limits for corporate contributions).
Contributions and gifts to Gustavo Rivera for State Senate are not tax deductible.

If you have any questions, please contact Jennie Berger at Jennie@gustavoforstatesenate.com


P: (347) 346-2395 / F: (646) 417-7315
Printed in House • Labor Donated

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