HomeMy WebLinkAboutFreed, David - 2016 Annual Report COMMONWEALTH OF PENNSYLVANIA
CAMPAIGN FINANCE STATEMENT
• File this in lieu of a full report only if aggregate receipts, expenditures, or
liabilities incurred each did not exceed $250.00 during the reporting period.
FILER IDENTIFICATION -- REPORT FILED �'—J ?�--I
CANDIDATE I I I/ COMMITTEE I I LOBBYIST 3. 1- 1
NUMBER 'I ON BEHALF OF I/\
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST•
___ ., _. ___ ..._. ...... ._..-.-.._._ -_,.__
�C,-�
STREET ADDRESS _ .
CITY. ._- .- _ --. ___ - _ .. ._ _-._-. __— - _ - STATEZIP CODE ., __
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1
NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
TYPE OF REPORT • .. -
(CHECK ONE) ..__ : ._._.- _ _. -_. --- -- MO. DAY YEAR
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CAN
6TH TUESDAY 1., I-- V.1_S� �� tti _._ (2,1% - _i,. ?>
. PRE-PRIMARY •FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR
2ND FRIDAY 2. DATES OF ---
PRE-PRIMARY REPORTING i - '7 I/'_ TO 1 2 31 - 1(,., .�'
. PERIOD I� V 1(.• tv
30 DAY 3. ..�
POST-PRIMARY -I, C."rri -c ..
CASH BALANCE AT END ;,ts- i V*
-_ 1
6TH-TUESDAY - a. OF REPORTING PERIOD: $'�-�---- � $"r'¢--^'t {0 .
PRE-ELECTION _ , 0. �''y-FI
TOTAL AMOUNT OF FILER'S "Bi __'
5. OUTSTANDING DEBTS OR LIABILITIES i T {
2ND FRIDAYCAT THE END OF REPORTING PERIOD: $ i O ! --4 PRE-ELECTION.'
• 6. - rn o
POST30 -ELECTION - AMENDMENT Y - 1 YES NO .)‹ •
REPORT?
7.
ANNUAL TERMINATION
REPORT - REPORT? YES NO X.
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! - AFFIDAVIT SECTION •
PARTI- •
If statement is filed on behalf of a Political Committee or Candidates's Committee,the Treasurer must sign here.
If statement is filed on behalf of a Candidate,the Candidate must sign here.
If statement is filed on behalf of a Contributing Lobbyist, the Lobbyist must sign here. .
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
3 DAY OF 100_A V • 20 l 7ATURE OF PERSON SUBMITTING REPOR
1/4'�'� PRINTED NAME
SIGNATURE G�7-7 f -5C:..)1
� '
. - MY COMMIs�ty I. ii ,.....i'--N- .,_:
a. . .
, . ¢j Q A U ' 1 1'? . C.(S -5C^ 11
NOTAR SEAL' . .YR. AREA CODE DAYTIME TELEPHONE NUMBER
Sonia E.Myers,Notary Public
PART!I C lisle B ro,� b�c 1aad •
If statement is=i. �iaRn te9b �lyd� n Authorized Committee, Candidate must sign here.
I SWEAR(OR AFFIRM)THAT 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
SIGNATURE OF CANDIDATE
DAY OF 20_
PRINTED NAME
SIGNATURE '
MY COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR.
Department of State • Bureau of Commissions, Elections and Legislation
DSEB-503(12-99) 303 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280
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