HomeMy WebLinkAboutNguyen, Michael - 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 Illo. REPORT FILED I. 2. - - 3.
NUMBER
ON BEHALF OF 01' CANDIDATE COMMITTEES:' tOBBY15T
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
AA yc t__ /V&w( M)
STREET ADDRESS
`I 0 X S
CITY STATE ZIP CODE
6i&A,L,/- PA- ITO ZS — 051c
TYPE OF REPORT NAME OF OFFICE,FISOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) R E c( OG2 0 r E))5 Devoor,--1I M0. DAY ;. YEAR
1. S ii 701-+
6TH TUESDAY``_
PRE-PRIMARY FOR OFFICE USE ONLY
MO. - .DAY. ;>YEAR .iMO. DAY.,'. YEAR.:. n :...:.._r-•2
2• DATES OF
PRE-PRIMARY REPORTINGERIOOS� I t TO ( _ c 14.
O
3o DAY 3. l .z
POST-PRIMARY
CASH BALANCE AT END r— .......
'
OF REPORTING PERIOD: $ Z
Gm TUESDAY
PRE-ELECTION "p
TOTAL AMOUNT OF FILER'S C) Mc
2ND FRIDAY5. OUTSTANDING DEBTS OR LIABILITIES D C fi
PRE-ELECTION AT THE END OF REPORTING PERIOD: $
6. -< ON
30 DAY
AMENDMENT
POST-ELECTION. : REPORT? YES NO
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 KNOWLEDG AND BELIEF TRUE, CT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS J
DAY OF ...AI : SI T E OF PERSON SUBMITTI REPORT
glEMI I,;WEA r RR, ' Mil/oft_ niGuYEA)
VV(x �Y RIAL EAL PRINTED NAME
SIGNATUij lE GEISTWHITE
MY COMMISSION * 'IRES LUMNl to y Public 1-17 -IWO
CARLISLEVPORO.CUR ERLANnOUNTY AREA CODE DAYTIME TELEPHONE NUMBER
My ComITN331e,.Gp;.c,Petr Iv,Zan
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.
DSEB-503(12-99)