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HomeMy WebLinkAboutMiller, Nicole - 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 110, REPORT FILED ' If ?. 7 NUMBER ON BEHALF OF OP' CANDIDATE COMMITTEE: LOBBYIST NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST kJ1 Cale C. 14i11rf STREET ADDRESS 3C6 \2 Crlf S- n u-* SI- CITY STATE ZIP CODE fla- p 4i 1 I na. OD 1 - -_ TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIIDATE DISTRICT NO. PARTY DATE OF ELECTION (CHECK ONE) C1.1..ry)b C i(l\('k Val Ipp�� �� ma. :'DAY YEAR 6TH TUESDAY T SC 1-1001 Dir Pi R I 1-1 PRE-PRIMARY FOR OFFICE USE ONLY MD. I.DAY: YEAR . .MO. DAY -.YEAR... ... 2ND.FRIDAY:- - 2' DATES OF PRE-PRIMARY REPORTING ,1 TO + PERIOD I 0 24' i i i I - 1 17 30 DAY 3' C)POST-PRIMARY C CASH BALANCE AT END ,-;,� 6TH TUESDAY OF REPORTING PERIOD: $ co = PRE-ELECTION M O TOTAL AMOUNT OF FILER'S 73 'C OUTSTANDING DEBTS OR LIABILITIES r 2ND FRIDAY` CT PRE-ELECTION AT THE END OF REPORTING PERIOD: $ `C/ CD aa• s C) Z 30 DAY AMENDMEPOST-ELECTION REPORT? YES NO 4:97 X Z N ANNUALTERMINATION YES REPORT / NO -< 1.C,�'� REPORT? /X� 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 A D BELIEF,TRUE,CORRECT AND COMPLETE. n SWORN TO AND SUBSSCEEJ�/IBED BEFORE ME THIS 7 U:.i`l /t l l�; 0/ /i / /i /6 /I/I DAY OF /V t'V� 20/ !! 1 SIGNATURE OF/PE`RSON SUBMITTING REPORT ®Q� 0 0:.? I,' ,rl,l i SY,96NJt j G NI Co le C 'Mille ✓ ���/�%�-�f PRINTED NAME ` NOTARIAL SE � l MY COMMISSION EXPI'i S NOTARIAL E ORRIS (71�7 / 42-1 -3 --P)' MO. .Nctavy+PUbIIc YR. AREA CODE DAYTIME TELEPHONE NUMBER . I . . : . I •UN PART Il- My Commission Expires Jan 14.2015 — If statement is filed on •e a o 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. Department of State • Bureau of Commissions,Elections and Legislation DSEi3-503(12-99) 21.0 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280