HomeMy WebLinkAboutFulham-Winston for Council - 2017 2nd Friday Pre-Primary I!_a '' Reset Form .Print Form
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Commonwealth of Pennsylvania-Campaign Finance Report
(Note:This report must be clear and legible.It should be typed)
Filer Identification a Report Filed By Candidate Committee Lobbyist —
Number O Z��Z3 , 15j 94 (Mark X)
Name of Filing Committee,Candidate or `*� �a y �/� 061(),X‘
Lobbyist Pf'�,INptH1- W '4)fj}{�,Pc W GL
Street Address 242-- Wa t - J-f S+
City C 4 Y` V>s l-e State p A Zip Code (-7 o f.3
Type of Report(Place x under report type)
1-6th Tuesday 2- 2nd Friday 3-30 Day Post 4-6th Tuesday 5-2"d Friday 6-30 Day Post 7-Annual Special 2"Friday Special 30 Day
Pre-Primary. Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election
x
Date Of Electionr_ Year Amendment Termination
(MM/DD/YYYY) 6-I'/ 2-o I 1 Report Report
Summary of Receipts and From Date To Date For Office Use Only
Expenditures
1-1. - Ic—i7 4. -30 ^ I7
A.Amount Brought Forward From Last Report $
B.Total Monetary Contributions and Receipts $
(From Schedule I) 5'00 . a 0 C c
C.Total Funds Available $ r
(Sum of Lines A and B) J V o b 0 CO mit
m 1,.
D.Total Expenditures $
(From Schedule III) -6 - r' c
E.Ending Cash Balance $ Z N
(Subtract Line D from line C) S00.400 C7
F.Value of In-Kind Contributions Received $ ^ C3 3
(From Schedule II) - 0 C N
G.Unpaid Debts and Obligations $ Z
(From Schedule IV) -0 ,-
Affidavit Section
Part 1-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,is to the best of my knowledge and belief true,correct and complete.
Swore, nd: subscrib-d before me this 11 _�,��
4► dayof 1 r� 201"1 )
et
`(�' . 4r Signature of Person Submit g report
W. '` .. )'. ' `_of Is V Printed Name
Z�
M Commission Nfl7AAIALSEAL -- 7/ ' S—y6L
OEWi�kM LORUL
Notary'F!ubliC �AY YR. Area Code Daytime Telephone Number
CARI_ISt�F Nna UV ffized
yy
P rt II-If�isG Ff � ..mmittee,candidate shall sign here.I s ..-. - . ' -- •• . .1., ed:e a d 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
(),1 el day of A —7 20 � / Q� '461A..ts--kkrAme-'
` Signature of Candidate
4.C.f d—' �.Q b Ftk(�taPW• b..t^'e
SignaaLL..,1
Printed Name
My Commission expl s ?CV 2 S tY—(i yec-)
MO. DAY YR. Area Code Daytime Telephone Number
COMMONWEALTH OFPENNSYUTAMA
INOTARIAL SEAL.
MEGAN.E ORRiS'
'Notary Pubc ..
CARLISLE BORA CUM iltANQ'MINTY
My Commission Expires Jan 14,2019
i
SCHEDULE I
Contributions and Receipts
Detailed Summary Page
•
IFiler Identification Number II Q 2 12,3 ( I S. 9
1.Unitemized Contributions and Receipts-$50.00 or Less per Contributor
Total for the reporting period (1) $
TO -
2.Contributions of$50.01 to $250.00(From I
Part A and Part B)
Contributions Received from Political Committees(Part A) $
All Other Contributions(Part B) $
COO too
Total for the reporting period (2) $
3.Contributions Over$250.00(From Part C and Part D)
Contributions Received from Political Committees(Part C) $ D
- All Other Contributions(Part D) $ _ b
Total for the reporting period (3) $ D ^
4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E)
Total for the reporting period (4) $
–
O
Total Monetary Contributions and Receipts during this reporting period(Add and $
enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report SD Q . OD
Cover Page,Item BJ
PART B
All Other Contributions
$50.01 TO$250
Use this Part to itemize all other contributions with an aggregate value from
$50.01 TO$250 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
I Filer Identification Number:
I
Full Name of Contributor Date(MM/DD/YYYY) $
I)ek, FuIharn — Wl45+0 ,n oaf /zo (?..9r7 2co ,00
House# Street Address Date[MM/DD/YYYY) $
2 42 Vocttou 4- S.- .
City ���� �� State Zip Code Date[MM/DD/YYVY) $
L QA 11013
Full Name of Contributor Date[MM/DD/YYYY) $
ebb irk.ca,d 1(0-u kw►ayi �S0,o0
O �Izo (2�ry
House# 3Street Address Date[MM/DD/YYYYj $
9191C) i
Low
City �� t State P d Zip Code Date(MM/DD/YYYYJ $
�s f 1 1l
Full Name of Contributor Date[MM/DD/YYYY) $
House# Street Address Date[MM/DD/YYYY) $
City State Zip Code Date(MM/DD/YYYY) $
Full Name of Contributor Date IMM/DD/YYYYJ $
House# Street Address Date(MM/DD/YYYY) $
City State Zip Code Date[MM/DD/YYYY] $
Full Name of Contributor Date[MM/DD/YYYY] $
House# Street Address Date[MM/DD/YYYY) $
City State Zip Code Date[MM/DD/YYYY] $
Full Name of Contributor Date[MM/DD/YYYY) $
House# Street Address Date[MM/DO/YYYY] $
City State Zip Code Date[MM/DD/YYYY] $