HomeMy WebLinkAboutKlamerus, Justin - 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 - 2. 3.
' CANDIDATE..:. COMMITTEE::: LOBBYIST
NUMBER ON BEHALF OF
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
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STREET ADDRESS
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CCckI(\qo\-& STATE p A ZIiPCODE --
TYPE OF REPORT ME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) \ \ ..
MO. "..DAY YEAR
CPC C, s- CCk, \\ \''C) 'S--
6TH TUESDAY
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PRE-PRIMARY FOR OFFICE USE ONLY
MO. :.DAY- YEAR MO. DAY YEAR
2ND FRIDAY 2. DATES OF
PRE-PRIMARY ptN PERIOD REPORTING I \ ^ TO
30 DAY. 3. t C) O
POST-PRIMARY
CASH BALANCE AT END Q pyo _
6TH TUESDAY 4' OF REPORTING PERIOD: $ rT1 a
PRE-ELECTION . . r--
TOTAL AMOUNT OF FILER'S a C7I
2ND FRIDAY5• OUTSTANDING DEBTS OR LIABILITIESD a
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ -0
6. 0
30 DAY - C w
AMENDMENT
POST-ELECTION REPORT? YES NO .,..1 CD
7. ...<
ANNUAL TERMINATION
REPORT REPORT? YES rNO
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 _ign h-, z.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED D - G THE R.PO-TING PERIOD INDI••TED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BE • MY 0 EDGE AND = LIEF,TRUE, •RR'•T AND COMPLETE.
SWOR TO AND SUBSCRIBED BEFORE ME THIS &/..A
I. `l I
ii1
DAY OF Ma. 20.0 IG-URE OF •E--O -UBMITTING REPORT
PRINTED NAME
A-c_Afb I(
tr
COMMONWEALTH a 1 �l ck 0—
BETHANY SAUARUt DAY. YR. AREA CODE DAYTIME TELEPHONE NUMBER
wary Putttit.
PART I- CARLISLE BOR0:.CUM$ERLAND.CNTY
If stat: merfA t MPE '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.
DSEB-503(12-99) (fin