HomeMy WebLinkAboutGilbert, Patti - 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 IDENTIFlCATtoN -
REPORT REP C)lerDATE
1. 3.NUMBER O• ON BEHALF OF COMMITTEE.: 2 LOBBYIST
NAME OF FLUNG COMMITTEE,CANDIDATE OR LOBBYIST
P0+“ 1) , 611 fa2/-t---
STREET ADDRESS _
l3 PQ¢-i 'ct DnA2
CITY
ZIP COM
A01O MAPA 1'7ol5 — 113 3
NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY
TYPE OF REPORT • 'TE-CSF In`ECTIptd
(CHECK ONE) mo. .DAY YEAR
• ,. 061691 G(\�Cf-or - 1i 07 07017
6TH TUESDAY ' ';
PRE-P•RIMARY. _ FOR'OFFICE)USE ONLY
•
No.' ..DAY. YEAR:.. 'Mo. DAY ' .'YEAR.
2NaTaiDAY '. 2 DATES OF
PRE?P.RIINARY::::• REPORTING O(O D _ 2.0 Y7 TO I ^2 dor7
PERIOD l(' d !!�
20 DAY 3.
•POSTPRIMARY.
CASH BALANCE AT END
`.. ..
• OF REPORTING PERIOD: $
6TH.TuEsclAy : N
PRE-ELECTION. O
TOTAL AMOUNT OF FILER'S 4
5. OUTSTANDING DEBTS OR LIABILITIES W
2ND FRIDAY
PRE-ELTciiOR A AT THE END OF REPORTING PERIOD: $ p
6. D 1
-30 DAT: ...
.
'POST-ELEG770H. • . `/.• AMENDMENTYES NEPORTI NO X
ANNUAL .: TERMINATION.'• YES NO )( a
REPORT: REFiDRT ::
C CO
AFF1 iVn-sE-crrsaN
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.
L I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABIUTIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED ANb FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWL AND BELIEF TRUE, T AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
YPDA WEALTH OFAE NSYLVANIA SIGNATURE/ OF PE 8UBM GpREPO
c DAyQ�TGRIAI� 21}� Pa-11-11
�ICT�o l
•dIt •!isjel '�+I"�� d County PRIED NAME
My Co s,tssion Expir ay 0,2021 z 0 I 71 7 4 0 - aa L
O. YR. AREA CODE DAYTIME TELEPHONE NUMB R
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)