HomeMy WebLinkAboutSimpson, Mark - 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 IDENTIFICATIONREPORT FILED CANDIDATE. I.
NUMBER , ON BEHALF OF 0, Y COMMITTEE.. Z 3
LOBBYIST
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST - /� -
�!_1-k I 1/16.‘e)1"...
STREET ADDRESS
3 73 Al. zg-1-t,
CITY /! // STATE M2/COD // -
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO. DAY YEAR
6TH TUESDAY 1 iI
7 ZV F
PRE-PRIMARY F OFFICEn' SE ONLY
MO.' -DAY YEAR MO. DAY YEAR
2ND FRIDAY 2 REPORTING f� /� TO p p
PRE-PRIMARY PERIOD �/ Z L ( ` �� rn m i
30,DAY 3.
r
POST-PRIMARY -.J
CASH BALANCE AT END . -
6rri TUESDAY.'' 4. OF REPORTING PERIOD: $ D 3::r+
PRE-ELECTION . C
TOTAL AMOUNT OF FILER'S t
5. OUTSTANDING DEBTS OR LIABILITIES ,� .7-
P1RDE FRIDAY I AT THE END OF REPORTING PERIOD: $ — a . -.
PRE-ELECTION � �"
6.
30 DAYAMENDMENT
POST-ELECTION x YES NO
REPORT?
7.
ANNUAL TERMINATION.. J
REPORT REPORT? YES NO /}[_
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($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
SWORN� TO AND SUB CCRIIBED BEFORE ME THIS '�-
T1 'n, DAY OF / Y.��G� -7 20) ( SIG OF P RSE ON SUBMITTING REPORT
IL .11..Ih '!'
.L 'i .', ll; r 1 C . "14..1-k... 4..PRINTENO'A Y
I "t.ARI SEAL.+ i t�
MY COMMISSION EXPIRES MEGAN E 010115 I 717 gy3 z$�
1 MOj4OIefy POW YR. AREA CODE DAYTIME TELEPHONE NUMBER
I CARPS!EBOK Gtl1RERLANDCOUNTY
PART II- I My Commission Wes Jan 14,2019 t
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) 0