HomeMy WebLinkAboutMiller, Nicole - 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 00, REPORT FILED I•
NUMBER ON BEHALF OF 110, 2.CANDIDATE COMMITTEE. LOBBYIST J.
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
I\J C? c. M i.l l c/
STREET ADDRESS
313 Chesuf-
s�-
CITY STATE ZIP CODE
Carne ) 70 ) J -
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO. DAY YEAR.-
I. Cu (rnbea 1 VOIley School Direr D � 1�
6TH TUESDAY 11 '-7
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR --
2ND FRIDAY. 2. DATES OF
PRE-PRIMARY PEROD NG co j nTO )ID 23 i-i
30 DAY 3.
POST-PRIMARYCO
CASH BALANCE AT END MC)
6TH TUESDAY 4. OF REPORTING PERIOD: $ ' (V
r-`
PRE-ELECTION ►-J
TOTAL AMOUNT OF FILER'S
s. OUTSTANDING DEBTS OR LIABILITIES
2ND FRIDAY X AT THE END OF REPORTING PERIOD: $ n
PRE-ELECTION6.
1, C�
30 DAY
AMENDMENT cn
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(5250.00)AND THIS REPORT IS,TO THE BEST O MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
SWOR TO AND SUBSCRIBED BEFORE ME THIS -7
1;1? DAY OF VAI SIGNATOR OF PERSON SUBMITTING REPORT
w(-r C k 11c
/ / �is�' i!%` E. L�
N1! j L PRINTED NAME
SIGMA R a -Notary
Pu;; 2I W
SB
MY COMMISSION EXP RES P g CUMBERLAND COUNTY
My C�tAmiasion Mites Janrirl,2019 AREA CODE DAYTIME TELEPHONE NUMBER
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.
Department of State • Bureau of Commissions,Elections and Legislation
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120.0029 • (717)787-5280