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-