HomeMy WebLinkAboutDeMartyn, George - 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 REPORT FILED CANDIDATE �/ COMMrI-TEE LOBBYIST '
NUMBER ® ON BEHALF OF ` I X 2 t.
NAME OF FILING
COMMITTEE,CANDIDATE 0 LOBBYIST
620 r y._ air (�v
STREET ADDRESS J
095' 4//C-4 S� ed
CITYSTATE ZIP CODE
,Ola.. PA- »o, 5
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE \ DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) rr� MO. DAY YEAR
1.
EP/ 5t1 SaWv 1 /\
6TH TUESDAY
/�\/
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR - -
2ND FRIDAY 2. DATES OF
PRE-PRIMARY PERIOD REPORTING / / / (J TO /" �(3 C O
30 DAY eV
3. (0 (0 n ,:d
POSTPRIMARY cco
CASH BALANCE AT END �r
6TH TUESDAY 4. OF REPORTING PERIOD: $ xi ---'I
PRE-ELECTION w
TOTAL AMOUNT OF FILER'S Z
2ND FRIDAY S_` OUTSTANDING DEBTS OR LIABILITIES y, 3
PRE-ELECTION ,X AT THE END OF REPORTING PERIOD: $ Z ,
6.
30 DAY
AMENDMENT
POST-ELECTION REPORT? YES NO K. -I
7,
ANNUAL TERMINATION
YES NO
le
REPORT - REPORT?
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 •=OVE DID NO
EXCEED TWO HUNDRED AND FIFTY DOLLARS(5250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWL-> E AND BELIEF,T/-UE,CO-?-CT A •MPLE�
SWORN TO AND SUBSCRIBED BEFORE ME THIS / /
DAY OF r.231.E 20 17E f•`ER ON SUBMITTING REPORT --•--.............._6 PRINTED NAME
Si
TH OF NNSYLVANIA y/
MY CO MISSION EXPIR''S /y/7 / -5 < 27
MO. MEOW E ORRIS AREA CODE ff DAYTIME TELEPHONE NUMBER
-Notary Public
PART II- , CARLISLE'BORO,CUMBERLAND COUNTY
If statement is filed on h21t1 £°a 0M-R Pec tlffn,20f9
t ",�„"nmittee,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(RL. 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 0 Bureau of Commissions,Elections and Legislation
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280