HomeMy WebLinkAboutBirbeck, Jonathan - 2017 2nd Friday Pre-Primary II II Reset Form 1 Print Form
Commonwealth of Pennsylvania-Campaign Finance Report
(Note:This report must be clear and legible.It should be typed)
Filer Identification I Report Filed By Candidate i, ` 1 Committee Lobbyist —
Number (Mark X) ,
Name of Filing Committee,Candidate or
Lobbyist JOAATh f% /tr LelL
t
Street Address. gig $• ,PI/ SfrLeIy
City /-4 r f JS k State y� ; Zip Code J /70/3
Type of Report(Place x under report type) r/7
1-6th Tuesday 2. 2nd Friday 3-30 Day Post 4-6th Tuesday 5-2"d Friday 6-30 Day Post k 7-Annual Special2"d Friday, Special 30 Day
Pre-Primary Pre-Primary Primary Pre-Election ; Pre-Election Election Pre-Election_ Post-Election.
X
Date Of Election S I Year ^ Amendment• Termination
.(MM/DD/YYYY) P017 Report Report
ISummary of Receipts and From Date To Date For Office Use Only
Expenditures
A.Amount Brought Forward From Last Report $
C) N
B.Total Monetary Contributions and Receipts $ _Co
(From Schedule I) 0 '-''
C.Total Funds Available $ I j b
(Sum of Lines A and B) —<
D.Total Expenditures $ �^ I
(From Schedule III) ..HCl/Cr),t�c�
♦ cC.....)CD
E.Ending Cash Balance $ _a
(Subtract Line D from Line C) '-:50(000.oe af000' j nr
F.Value of In-Kind Contributions Received ` $ = ce?
(From Schedule II) b - `...I O
G.Unpaid Debts and Obligations $ Cn
(From Schedule IV) `---I ---
Affidavit
--- —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•.•compl• •.
(\
Sworn to and subscribed before me this
3 day of 4 20 /7 ,
COMMONWEALTH OEPENNSYLVAN • Si; ature ers Sei•ingrek
rt
i .
♦ ,-0`� r� NOTARIl.LSEAL 1
4 Signature
Joseph K.Lahr,Notary Public Printed Name
My Commission expires /0 /.' -,•,, City of Harrisburg,Dauphin County 717 =C.,—jog 3
O iIl�i►'irami -fission Expires Oct.18,2b --Code Daytime Telephone Number
- ,P. ` YLVA IAA S•CIA ION OFN'TAMES
Part II-If this is a report of a Candidate's Authorized Committee,candidate shall 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•
day of 20 •
Signature of Candidate
Signature Printed Name
My Commission expires
MO. DAY YR. Area Code Daytime Telephone Number
a
SCHEDULE III
Statement of Expenditures
I.Filer Identification Number. J o^G r' 0.". ICa rfc._
To Whom Paid '- :'Date(MMJDD/YYYJ $:/C4 ianQ 24EeCtio"ScT1ce
Atili7 /OO .00
House# � Street Address !N.1 I I 'Description of Expenditure
f
of 1 sTn� riwy, st.41e_ 20
CityState . Zip.
I,.s(� rA-- code 17c)13 Fuer,, Fe
To Whom Paid ,_Date(MM/DD/YYYYJ •$:
Fe:::erect S cF 1/43 ons Rr c I/3 ii? Sa,°CO.'''''
House# Street Address `/ :Desciiption of Expenditure
)01 $. tic :00uer S'(''. f
City Cy./' r r,S(� Stale (�i"t code. (7o r 3 L-00.n
To Whom Paid Date(MM/DDJYYYYJ, $
House# Street Address Description of Expenditure:.
City State Zip:
Code
To Whom Paid. Date(MM/DD/YYYYJ -$.
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid 1 Date(Mint/DD/YYYY) $
House# Street Address Description of Expenditure
City :. State `Zip
Code
To Whom Paid Date.(MM/DD/YYYYJ $
House#- Street Address Description of Expenditure
City State Zip.
Code ,
•
To Whom Paid Date:(MM/DD/YYYYJ $
House# Street Address Description of Expenditure
City State- Zip.
Code
A
To Whom Paid Date[MM/DD/YYYYJ 5-
House# Street Address Description of Expenditure
City State Tip.
Code