HomeMy WebLinkAboutCitizens for Schin - 2016 Annual Report `l` Commonwealth of Pennsylvania
PAGE 1 OF
CAMPAIGN FINANCE REPORT (COVER PAGE)
(NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification 14132_5103Report CANDIDATE 1
COMMITTEE V LOBBYIST 3
Number: 7 Filed By: 0.
Name ofFiling Committee, Candidate or Lobbyist:
Ct 1 isens for Sckin ,
Street Addreds:
AO 5. .3(04 .{reed
City: �� State: Zip Code:
Camp Will
PR 1701 —
-
TYPE OF 8TH TUESDAY 1. 2ND FRIDAY 2. 30 DAY 3 / 'AMENDMENT YES NO
REPORT PRE-PRIMARY PRE-PRIMARY POST PRIMARY REPORT?
8TH TUESDAY 4. 2ND FRIDAY 5• 30 DAY 6. TERMINATION
PRE-ELECTION PRE-ELECTION POST ELECTION REPORT? YES NO
(place X to
the right of ANNUAL 7. YEAR FILING METHODPAPS ✓ DISKETTE
report type) REPORT X ,Z�p f 6 ( ) CHECK ONE P
Name of Office Sought by Candidate: DATE OF ELECTION District Office Party County
Number Code Code Code
MO. DAY YEAR
(SEE INSTRUCTIONS FOR CODES)
FOR OFFICE USE ONLY
Summary of Receipts MO. DAY YEAR MO. DAY YEAR
and Expenditures from: 110, II 1 010110 To 12. 31 020!49
A. Amount Brought Forward From Last Report $ t ` '7 58 = o
B. Total Monetary Contributions and Receipts (From Schedule I) S 0 CD
ITt
C. Total Funds Available (Sum of Lines A and B) $ ,,,p
�
J r.: )
D. Total Expenditures (From Schedule III) $ 0 O
0 >s
E. Ending Cash Balance (Subtract Line D from Line C) $ 21 1 7 0 { Si n =
F. Value of In—Kind Contributions Received (From Schedule II) $ z.
YD
G. Unpaid Debts and Obligations (From Schedule IV) S 0 "< En
/ AFFIDAVIT SECTION
PART I — if this is a Committee report, treasurer sign here. If this is a Candidate report candidate sign here.
I swear (or affirm) that this report, including the attached schedules, on paper or computer diskette, are to the best of my knowledge and belief true,
correct and complete.
Sworn to and subscribed before me this
4
day of _ 20/ .Signat`>1-4--
, of Person Submitting Report
i./ .,%1.�:: .f... r�:�tr., r� r �-��Ir118 S�IIih
� '"^
Cr �. .yi Printed Name
My • -ussion exIMOURIALSE'AL 717 7 61-4271
BETHANY SAU:A0540 DA YR. Area Code Daytime Telephone Number
.........VN
PA- II ctjoltiisiion ':' a 4%4M1.! ='s Authorized Committee, candidate shall sign here.
I swe• m tat to the best of my knowledge and belief this political committee has not violated any provisions of the Act of June 3, 1937
(P.L. 1333, No. 320) as amended.
Sworn to and subscribed before me this day of Jit - 20 /( .//./ --ilf°'
, . / '
l � ...igna�of candidate
/ , .. F. �c. l'
mai/. iL `L , f ";1 • ICA sir. 1
Si�n"a't r Printed Name
My corn
CI r V • TH Of pENBRIINANIIA ,, �t
NOTAR1y�1�ySEAL F 17 76/-417/
octue�1v f111RULO DAY YR. Area Code Daytime Telephone Number
Notary Public
CARLISLE B0R0,',CUMBERLANQ CNTY
My„C.omnlissiotftritelrE •407State • Bureau of Commissions, Elections and Legislation
3uS North uttrce Building • Harrisburg, PA 17120-0029 • (717) 787-5280
DSEB-502 (7-99)