HomeMy WebLinkAboutFulham-Winston, Deb - 2017 30-Day Post-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 lloo, REPORT FILED CANDIDATE:-' I/I I COMMI TEE.`. 2. .LOBBYIST 2.
NUMBER ON BEHALF OF , -
NAME OF RUNG COMMITTEE,CANDIDATE OR LOBBYIST
STREET ADDRESS
` yam Atv\UW c
CITY STATE ZIP CODE
Q1anf 7 D )3 —
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
L �^
(CHECK ONE) L'�`tY 1 6CIC Ot U U f\t-� ' 1 MO. DAY:' YEAR..,
I-i
6TH TUESDAY
PRE-PRIMARY FOR OFFICE'.USE ONLY
. .MO. ':DAY YEAR... `MO.- DAY:' : YEAR:.',
2ND FRIDAY: 2. DATES OF
PRE-PRIMARY REPREPORTING 6 2 f . TO to 5 11 n V
e
C
3.
30:DAY / CV C.-.
POST-PRIMARY.- ✓ m C
CASH BALANCE AT END P7
6TH TUESDAY ::::':'4. OF REPORTING PERIOD: $
PRE-ELECTION.
TOTAL AMOUNT OF FILER'S t�
OUTSTANDING DEBTS OR LIABILITIES
2ND FRIDAY. n
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ d
..
6. 2!, W
30 DAY
POST-ELECTION :. AMENDMENT NO
REPORT' "
7.
ANNUAL : TERMINATION
REPORT, REPORT? YES NO
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 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 BEST OF MY KNOWLED AND BELIEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THISGki
�I'�,`
----DAY OF 20 SiNNATU F PERSON SUBMITTI RT
SL• ,�� 4IKi - t>J .'n<
• PRINTED NAME
,TARI' 3l�
MY OMMISSION AI:a<A. LO ( '/ tyOci
Setuy.Pop111D. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
CARLU€EE BOf10;,OUMBERLANO CNTY
PART II ihy Caniillssion Expires Oct 7,2017
If statement is Iles on •ehalf of a Crandidatefs 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) V