HomeMy WebLinkAboutFulham-Winston, Deb - 2017 2nd Friday Pre-Primary 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 ' I. 2. - 3
NUMBER ON BEHALF OF CANDIDATE c� .COMMITTEE:: rLOBBYIST :.
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
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STREET ADDRESS
.2-ACL U MrcJ S�
CITY STATE ZIP CODE
C isc¢ PA- 1747,3 -
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) eiN a'&/4\ &C 'U
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6T14 TUESDAY 1
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR::.. )MO. DAY.....YEAR
2ND FRIDAY ,:2. / DATES OF
REPORTI
PRE-PRIMARY V PERIOD NG ' r (1 TO S.-
1 r p
1 J 1 C
3O DAY
3. ? ..,,i
IV 3t
POST-PRIMARY
m v.
CASH BALANCE AT END 260 -<
a. OF REPORTING PERIOD:
6TH.TUESDAY
PRE-ELECTION N)
TOTAL AMOUNT OF FILER'S p
2ND FRIDAY 5. OUTSTANDING DEBTS OR LIABILITIES „ C n
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ p
C N
6.
30 DAY. AMENDMENT ...4POST-ELECTION. YES NO `/ ...<
REPORT?
ANNUAL TERMINATION ': YES NO
REPORT REPORT?
AFFIDAVIT SECTION
PART I-
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($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
/��J (1.(1� �'1
, r-id DAY OF /Y 1 20 /7 \ SIGNATURE OF PERSON SUBING REPORT
IG R�/fi b (v\lAn• - k OC
• / V �`�� 1�' PRINTED NAME
MY COMMISSION EXPIRE NOTvA�4t1AL' EM. it? 2,,,-r, i(cFc/
MO. meoww E AREA CODE DAYTIME TELEPHONE NUMBER
PART II- ` CA*LI$tI MMO umuno D GOUN71r
My Glemissits Eakss Jan 14,2019
If statement is filed on b .elf..f,.OtAkI.AA Autlitriintreetry mittee,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.
DSEB-503(12-99) 0