HomeMy WebLinkAboutStill, Jon - 2017 2nd Friday Pre-Election 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 110. REPORT FILED3_
NUMBER ON BEHALF OF 0, I. 2.CANDIDATE COMMITTEE.. LOBBYIST
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
STREET ADDRESS 1
413 W oo�'lw- c 1an
CITY STATE ZIP CODE
Cad j e FA 1.7 015 —
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) t p� MO. DAY YEAR
1. �ccloo l aJc r�Aor 11 8 r 2017
6TH TUESDAY
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR. . MO. DAY YEAR
2ND FRIDAY 2. DATES OF
PRE-PRIMARY PER ODTING ! r 1 7 TO 1 O n L 3 1 N
1
(� (� r 1 C .
30.:DAY 3' J
POST-PRIMARY CO C
CASH BALANCE AT END M. I
OF REPORTING PERIOD: $ N *;
6TH TUESDAY
PRE-ELECTION . >'
TOTAL AMOUNT OF FILER'S
2ND FRIDAY OUTSTANDING DEBTS OR LIABILITIES 0 -V !
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ 0
30 DAY ..AMENDMENT / ---I
POST-ELECTION /Y`
REPORT? YES NO. 4
7.
ANNUAL TERMINATION., YES NO
REPORT REPORT?
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 REPORT! E ,QED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNO GE AND BE R rCT AND COMPLETE.
swo�TO AND SUBSCRIBED BEFORE ME THIS _.
DAY OF w' `�laa20� / IGNATUR OF P - /SUB ITTING REPORT
- r
c
A_ n�t)4TH44 L1 /L.L
_ii r .I+,+.-+:a',I�a..,.LL'♦',1 :.Y .II' AN ' PRINTED NAME
IGN TOREu AL SEAL
MY COMMISSION EXPIRES M NE ORRIS 7i 7 748752-7
.ALIBLE '.CII PUMP AREA CODE DAYTIME TELEPHONE NUMBER
BLE 81' 1,CUMBERLAND COUNTY
My Commission Expires Jan 14,2019
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
PRINTEDNAME
SIGNATURE
MY COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR.
DSEB-503(12-99) (4)