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HomeMy WebLinkAboutPickford, Susan - 2017 2nd Friday Pre-Election III) II Reset Form Print Form Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Filer Identification Report Filed By Candidate Committee Lobbyist Number (Mark X) Name of Filing Committee,Candidate or Lobbyist 5(ISAidA< /Cp,Qj Street Address 67 OZ e -�/fit/�J CityP /�1/ State n� Zip Code. /7O// Type of Report(Place x under report type) !" 1-6th Tuesday 2- 2"d Friday 3-30 Day Post 4-6th Tuesday 5.2nd Friday 6-30 Day Post 7-Annual Special 2""Friday Special 30 Day Pre-Primary Pre-Primary PrimaryPre-Election Pre-Election Election Pre-Election Post-Election IR Date Of Election Year Amendment Termination (MM/00/YYYY) r:7.ffi/7 Report Report • Summary of Receipts and From Date To Date For Office Use Only Expenditures W6/�/7 �d/ 31��JA.Amount Brought Forward From Laport $ B.Total Monetary Contributions and Receipts $ _ (From Schedule I) , `_ C.Total Funds Available $ —' n N (Sum of Lines A and B) -4?"-- t=_ D.Total Expenditures $ DOO t� (From Schedule III) O�/ m n E.Ending Cash Balance $ r (Subtract Line D from Line C) D Lam) F.Value of In-Kind Contributions Received $ p -1)(From Schedule II) CD or G.Unpaid Debts and Obligations $ . - -,_ (_) . (From Schedule IV) • _ '. / I^ - IN Affidavit Section p Part 1-If this is a Committee rt,treasurer sign here.If this is a Candidate report,candidate sign here. I swear(or affirm)that this report,inc TUdxi:the attached schedules on paper,is to the best of my knowledge and belief true,correct and complete. Sworn to and subscribed before me this day of 20 Signature of Person Submitting report Signature r Printed Name My Commission expires MO. DAY YR. Area Code Daytime Telephone Number Part II-If this is a report of a Candidate's Authorized Committee,candidate shall 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 J��ttoand subscribed before me this 3/ da ofQC/►t 20 17 L ,t 0 4il ‘41/1447aLL ��y} Signator Can. .: c_S Signature COMMONWEALTH WA!JIA Printed Name NMy Commission expir s MEGANRI L SEAL ,/7 fQ��9V MO. D MEGAN ub is Area Code Daytime Telephone Number _ �otar��uDlic CARLISLE BORE,CUMBERLAND COUNTY My Commission Expires Jan 14,201'9 a SCHEDULE III Statement of Expenditures filer Identification Number: To Whom Paid ' ga_Pord Coy / Date[M15�YYYYJ $ d , 000 J 3o/� House# itak_ Street AddressMarke± 0446 166 ) Description of Expenditure City 62 ��� State PA Code /70L/3 C f a-cr tae-vi To Whom Paid Date[MM/DD/YYYY] $ House# Street Address Description of Expenditure City State ' Zip Code To Whom Paid Date[MM/DD/YYYY] $ House# Street Address ; Description of Expenditure City State " Zip _Code-_ To Whom Paid Date[MM/DD/YYYY] $ House#: Street Address Description of Expenditure City State Zip Code so Whom Paid,. ,Date.[MM/DD/YYYY].,.. .$ House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/YYYY] $ House# Street Address Description of Expenditure City State" Zip Code To Whom Paid Date[MM/DD/YYYY] $ House,# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/Y.YYY] $ House# Street Address Description of Expenditure 3 City State Zip - - • -Code-