HomeMy WebLinkAboutMorrow, Douglas - 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 00. REPORT FILEDCANDIDATE:- L COMMBTEE 2. LOBBYIST'' 3.
NUMBER ON BEHALF OF , ...
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
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00 q L� 5 M o itkou/
STREET ADDRESS
CITY E
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New Wavv‘.L...2r (key V
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO. DAY YEAR
6TH TUESDAY
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR... ..
2ND FRIDAY 2.‘ DATES OF C") ,V
PRE-PRIMARY PERIODREPOR
/ 1 TO (� f O
30 DAY 3• ( (J J ( /7 rn 3}
POST-PRIMARY: 33 '-<
CASH BALANCE AT ENDr— I
6TH TUESDAY 4. OF REPORTING PERIOD: $ D
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PRE-ELECTION . CD
TOTAL AMOUNT OF FILER'S C)
2ND FRIDAY 5' OUTSTANDING DEBTS OR LIABILITIES ID ---•--•
_
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ G
--.I 1V
6. N
30 DAY AMENDMENT
POST-ELECTION YES NO
REPORT?
ANNUAL TERMINATION;`
REPORT REPORT?^ YES NO
AFFIDAVIT SECTION
PART t-
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 BES • I s KNOWL G BE IEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
%9411 DAY OF lit��J 20�I "I'T E F ERSON SUBMITTING REPORT
SIGNATURE-11//117/''' --od 'e.4-7- 4 DpIM✓I ICS J PRINTED NAME
MY COMMISSION EXPIRES COMMONWEALTH OF PENNSYLVANIA �t r-i a-
‘ '' I $ t
MO.NOTARIR6i6EAL YR' t AREA CODE DAYTIME TELEPHONE NUMBER
MEGAN E GAMS
PART II- Notary Public
et t,I$i 8ntit Elet1$ C UR't
If statement is filed m be1�I�� a>�#Lu�orized 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)