HomeMy WebLinkAboutPickford, Susan - 2017 30-Day Post-Primary COMMONWEALTH OF PENNSYLVANIA
CAMPAIGN FINANCE STATEMENT
File this in lieu of a fullreport only if aggregate receipts, expenditures, or
liabilities incurred each did not exceed $250.00 during the reporting period.
FILER IDENTIFICATIONREPORT FILED t. i 3.
NUMBER ' ON BEHALF OF CANOtDATE: ' COMAIRTEE:;' :L088YIS;-
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
SUS , ,;,tet 1)
STREET ADDRESS
CITY STATE ZIP CODE
CnNIP 4// �� /7f// -
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
D j- J �7 j�
(CHECK ONE) rI// 6/ - apt tin . :' .MO. i''-':'PAY.... ..' XEAR":'
;::.6i*TilFSDAY":::<
PREPRIMARY.:^:, FOR,OFFICE;USE;;ONLY::.:: :::':
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0
1;ZND'FRIDAY:' :'':` 2. DATES OF r C ......i::13040 MARY:'.::':' PERIOD G e)J d // l 7 TO jI/_ O S /7 (r
3.0 DAY v- :O
POST PRIMARY �•
CASH BALANCE AT END --e-1 Z .r" •
a. ClOF REPORTING PERIOD: $
STMTUESDAY:' ;: --0
"•PRE-ELECTION'. C) =
TOTAL AMOUNT OF FILER'S
5. OUTSTANDING DEBTS OR LIABILITIES —4"-- —'-
:.':FREELECTION:>::::. AT THE END OF REPORTING PERIOD: $ 1 Z-
-C An
30D!AY..,:Ci1:.':0N AMENDMENT;.::
POST-ELEYES NO .�
REPORT?.. :,':.
: :'ANNUAL :;'.:,:::. - TERMINATION Y
REPORT? LES NO ,
`:REPORT �
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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($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWL E AND BELIEF,TRUE, ECT AND COMPLETE.
SWON /�TO AND SUBSCRIBED BEFORE ME THIS
DAY OF I �--_ 20/7 SIGNATURE OF P SUBMRTt // EPPORT
. //i IIIAtkiil( P D NAME
MY COMMISSION EXPIRES Y010A$f D 7/7 'y-f 7 / ,
MO. '' y PssAl(e. AREA CODE DAYTIME TELEPHONE NUMBER
CARLISLE SORA;cuMs[RUNID Wort
PART II- My CommI'slot Expires Jan 14,2019
If statement is filed on behalf of a Candldale'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.
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DSEB-503(12-99) /