HomeMy WebLinkAboutBorder, Zachary - 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 duringithe reporting period.3t
FILER IDENTIFICATION REPORT FILED I CANDIDATE I ✓ COMM)2E LOBBYIST 3
NUMBER ON BEHALF OF '
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST �or ex'22 ,hc rq
STREET ADDRESS Y a6 60S t o A\i'e
CITY• ` RL STATE
PA ZIP CODE
� 1'1043 -
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) 1. i' yco h Co u nci( a qgP 5 t Co -2017
6TH TUESDAY
PRE-PRIMARY FOR OFFICE USE ONLY
/ MO. DAY YEAR MO. DAY YEAR
2NDOF
FRIDAY zV DEPORTING �, 1.7� TO 7 ..PRE-PRIMARY
30 DAY . .3. C73 =
POST-PRIMARY:. M
CASH BALANCE AT END :0 —<
6TH TUESDAY
4. OF REPORTING PERIOD: S.-0.--m >.
PRE-ELECTION
TOTAL AMOUNT OF FILER'S '0
2ND FRIDAY 15. OUTSTANDING DEBTS OR LIABILITIES 0 C) =
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ C (V
6. --I
X'
30 DAYAMEND ( +
POST-ELECTION
REPORT?
Ili
NOIII •-•<RT?
7.
ANNUAL TERMINATION
I REPORT ` y
j REPORT? YES NO
1
AFFIDAVIT SECTION
S. g
li ot6- atement is filed on behalf of a Political Committee or Candidates's Committee, the Treasurer must sign here.
NzvI atement is filed on behalf of a Candidate,the Candidate must sign here.
z —I o atement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
w ZV. V'
n- rn 11'2321 I WEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
LL --I Y4 E NzI'CEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLED E ANO BELIEF,TRUE CORRECT AND COMPLETE.
rtCa•`
I=. Q 0 -x: SWORN TO AND SUBSCRIBED BEFORE ME.THIS
3 Z ,,N DAY OF I t- ' 2017GNGURE OF PERSON SUBM�I[�,G REPORT
ci
_ E. _'� "_ PRINTED NAME ```��9
0 (� V SIGNATURE Zci 6 e / /-(o y
U Z MY COMMISSION EXPIRES �( (S [��( ` ( To. ' V` a
MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
PART II-
If statement is filed on behalf of a Candidate's 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) 210 North Office Building • Harrisburg,PA 17120-0029 * (717)787-5280