HomeMy WebLinkAboutPickford, Susan - 2017 30-Day Post Election IIll I Reset Form r 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 X Committee Lobbyist
Number (Mark X) •
Name of Filing Committee,Candidate or
• Lobbyist L__ a54-7() J /G/td _.
Street Address ,J
a6. /a c2 srNvr ‘.77--City n fr/n, ///GG Stat •
e �� Zip Code O
ii
Type of Report(Place x under report type)
1-6th Tuesday 2- 2"d Friday 3-30 Day Post 4-6th Tuesday 5-2"d Friday 6-30 Day Post 7-Annual Special 2"tl Friday Special 30 Day
Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election
Date Of Election YearAmendment Termination
(MM/DD/YYYY) (9^/7 Report Report
Summary of Receipts and From Date To Date / For Office Use Only
Expenditures
/:/.2//7 /a/7/ /7
A.Amount Brought Forward FrostReport $
B.Total Monetary Contributions and Receipts $ _ C") o
(From Schedule I) 4 •- C_ _
C.Total Funds Available $ .' "' •
(Sum of Lines A and 8) —e--- rZ-i r
rn `
D.Total Expenditures $ r—
(From
c-)
(From Schedule III) 6 a 00 z -r-
E.Ending Cash Balance $ Q
(Subtract Line D from Line C)
I
C--) Z
F.Value of In-Kind Contributions Received $ C„)
(From Schedule II) f5.3N
G.Unpaid Debts and Obligations $ C.)(From Schedule IV) -0`
Affidavit Section
Part 1-If this is a Committee report,treasurer sign here.If this is a Candidate report,candidate sign here.
I swear(or affirm)that this report,including 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 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 togd subscribed before me this .»m ..,..
Ai day of� (Pm bei 20 / . ,"1: 11""
ect �rSi u e. C. dicta C
�� C`Signature Printed Name
•
My Commission expires — I J of 7/ 7 4 75-
- 3 al y
MO. DAY YR. Area Code Daytime Telephone Number
Cuiriuionweaitn of Pennsylvania
•
Notarial Seal
LECRETIA HARING-Notary Public
CAMP HILL @ORO,CUMBERLAND COUNTY
My Commltglen Expires dun 7,2021 • 6.2)
SCHEDULE III
Statement of Expenditures
Filer Identification Number:
To Whom Paid Date[MM/DD/WW] $
46/cr 4g7 /i _T /6 ///m7 I aha —
House# Street Address Descri ion.bf Expenditure '
A250 arhet" Si- 6P/P16)-5-6)
City State Zip
,�,f�rto/iu p/9- Code /70 Y3 ryi/az CLQ i�
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 It 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/YYYYJ $
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid Date[IVIM/DD/YYYY] $
House# Street Address Description of Expenditure
City State Zip
• Code...