HomeMy WebLinkAboutFriends of Jim Hertzler - 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 10, r. REPORT FILED O• CANDIDATE I COMMITTEE — LOBBYIST J
NUMBER ON BEHALF OF
NAME r�Y NG COMMITTEE,OCAS ATE ORLOBSLLOBBYIST 1"' '
N l ke-R V LE��i
STR ET ADDRESS �f�. ,`J/
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CITY ZIP CODE�J.OL STATEfyk 190.Q5- ^ 00 3
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE (DISTRICT NO. PARTY DATE
DATE OF ELECTION
(CHECK ONE) co 00 e 6 M`M�-SS JEk_ 2_' -De-v.\
TY N,0. DAY 10011/YEAR
�JI
67H TUESDAY t✓J L \ /,r• 0`�1 1(
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAYYEAR MO. DAY I YEAR
DATES OF
PRE-PRIMARY 2 PER OD NG 06 OG 2:11 TO o a3 20)2ND FRIDAY co
M
30 DAY 3. CO
POST-PRIMARY ('Tl n
CASH BALANCE AT END $ 11661V. � Pa N4. OF REPORTING PERIOD: v �'
6TH TUESDAY Z
PRE-ELECTION
TOTAL AMOUNT OF FILER'S Zs
2ND FRIDAY OUTSTANDING DEBTS OR LIABILITIES 3
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ 0 C vD
27
6. --i Ca
30 DAY AMENDMENT
POST-ELECTION REPORT? YES NO
7.
ANNUAL TERMINATION
REPORT REPORT? YES NO
AFFIDAVIT SECTION
PART!- < W
If statement is filed on behalf of a Political Committee or Candidates's Committee, the Treasurer sign here.s 4
If statement is filed on behalf of a Candidate,the Candidate must sign here. = > 2";
If statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here. >., 0 o
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOZ 3 C
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE. d I
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SWORN TO AND SUBSCRIBED BEFORE ME THIS ^� '�I�,K./Y�- (
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.0 �� (� I
�JV' h DAY OF 0 J�1 20 S NATURE •F PERSON EMITTING REPORT F 4.- '2 1`"
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PRINTED NAME /�j T' 3/1i
MY COMMISSION EXPIRES SIGNATURE\( O. • \% 1 9. . O2_D�� may`/ 0 X_ '
IMO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER a m
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PART Il -
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. ISWORN TSA AND SUBSCRIBED BEFORE ME THIS /' ,/f '..1 /211 ( 10
1 \\ j SIGNATURE OF CANDIDATE
iliDAY OF _ , y 2O
17
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♦A ', ..1 l.IXEIARIIIITATISTLIUMF N'', PRINTED NAME \
11110' SIGNOME GEIS ?
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MY COMMISSION1XPIRES NOtary rUGIIC AREA CODE r
+:ARLISLE 8 80,CUMBRLAND RUNTY DAYTIME TELEPHONE NUMBER
My f:nmmicSinn FIpire$'PM>14 2021
Department of State • Bureau of Commissions,Elections and Legislation
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280