HomeMy WebLinkAboutKnutelsky, Debra - 2017 30-Day Post 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 ' REPORT FILED ' I. 2. 3.
NUMBER ON BEHALF OF CANDIDATE. COMMITTEE. LOBBYIST
NAME OF FIUNlbro-
OMMITTEE,CANDIDATE OR LOBBYIST
lam►u /.Sk /
STREET ADDRESS
X/ 111 Prince S-L
CITY STATE ZIP CODE
% Shu ppbash PA 1.7 -) -
TYPE OF REPORT NAME OF OFFI SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) Attoti
MO. DAY YEAR
6TH TUESDAY // 7 i -7
PRE-PRIMARY FOR OFFICE USE.ONLY
MO. DAY YEAR.. MO. DAY 'YEARDATES OF
..
PRD FRIDAY 2
PRE-PRIMARY (/RERIODTING /U ?f /7 TO. // (/1,n7 /
C7 N
30 DAY 3. C o
...J
POST-PRIMARY _.
03 CASH BALANCE AT END
6TH TUESDAY OF REPORTING PERIOD: $ O m
PRE-ELECTION . CO
TOTAL AMOUNT OF FILER'S C)
2ND FRIDAY
5. OUTSTANDING DEBTS OR LIABILITIES d
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ <J C) MC
MC
B c ry
30 DAY27.
AMENDMENT
POST-ELECTION YES NO X CT1
REPORT? . CA)
7.
ANNUAL - TERMINATION. YES NO \/
REPORT REPORT? Jl
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($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE�� � AND�BELIEF,TRUE,CORRECT AND COMPLETE.
2SW�ORNN�TO AND SUBSCRIBED BEFORE ME THIS r.litut`-6L
J v . r, DAY OF O 20 /7
11 3SIGNATURE OF PERSON SUBM G REPORT
A / / i�iiiilinu1, .i..' A .iii: ANIA 0Q-3151 f( k)1 I ulc l5
SI ;NA RE ' / ' ' F PRINTED NAME
MY COMMISSION EXPIRES MEGAN E ORRIS 7 /l j _ ] /�C 1_
MEARUS�E X13 u,cu Efl4AN0 COUNTY AREA CODE DAYTIME TELEPHONE NUMBER
My COORI33IO11 Expire=Jan 14,-?079
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.
DSEB-503(12-99) 197