HomeMy WebLinkAboutBorder, Zachary - 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 IDENTIFICATIONREPORT FILED CANDIDATE 2. 3.
NUMBER Illi ON BEHALF OF ' I.
COMMITTEE LOBBYIST
NAME OF FILING COMMITTE/E�fayJ yE OR LOBBYIST 8 dor
STREET ADDRESS ��� M94-1h *r-
CODEit-
CITY /�- STATE 0 V /
TYPE OF REPORT // �NAME OFHT BY CANDIDATE !DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) '
e?()-/lmk (ow (
I p6TH TUESDAY // EP11
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. OAY I YEAR
DATES OF
2ND FRIDAY
PRE-PRIMARY REPORr 7, PERIOD 5 /1 I ` TO U' I `n r
30 DAY 3' / ...-tPOST-PRIMARY v Q7
CASH BALANCE AT END rT1
6TH TUESDAY 4. OF REPORTING PERIOD: $ 0 PO
PRE-ELECTION
TOTAL AMOUNT OF FILER'S OOUTSTANDING DEBTS OR LIABILITIES 0 "O
2ND FRIDAY AT THE END OF REPORTING PERIOD: $ C)
PRE-ELECTION
CD t y
6.
30 DAY
POST-ELECTION REPORT? YES NO •�.-t "AMENDMENT N
7.
ANNUAL TERMINATION YES NO V
REPORT REPORT?
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AFFIDAVIT SECTION
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z J.g2t ement is filed on behalf of a Political Committee or Candidates's Committee, the Treasurer must sign here.
w wit#ement is filed on behalf of a Candidate,the Candidate must sign here.
o0
�.t terrlent is filed on behalf of a Contributing Lobbyist, the Lobbyist must sign here.
= Q E aR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
II- I¢- QXLD TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLE ..AND B : TRUE,CORR T AND COMPLETE.
LU Z I- O<WORN TO AND SUBSCRIBED BEFORE ME THIS
-_ C S) /q
oZ F- E 10 DAY11FF Oat- 2017 SIGNATURE OF PERSON UBMITTING R ORT
GO SIG A Q e7 t ///� PRINTED NAME // /�
MY COMMISSION EXPIRES 6 1 ) ( zo(tel G( (TOD S" 6
MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
PART 11-
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
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