HomeMy WebLinkAboutMakam, Asha - 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. COMMITTEE' I. LOBBYIST 3.
NUMBER 00. ON BEHALF OF 1111,
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
AS Mc,t cum
SIREA,ADDRESS
CITY STATE ZIP CODE
E.,,a)c-\ PA I -70 —asgc0
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) 1 MO. DAY YEAR
,. C Jrs )( o Co LA-t-t- Darc.Di_re. - t1 -1 -7
6m TUESDAY - - - - i !
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR - MO. DAY YEAR -- --
2ND FRIDAY 2. DATES OF
PRE-PRIMARY PERIOD REPORTING
ERODTING I il 23 1-7 TO (1 .2� 1 .--77
30 DAY 3.
POST-PRIMARY
CASH BALANCE AT END 0% C) r
6TH TUESDAY 4. OF REPORTING PERIOD:
PRE-ELECTION 'Ta l
TOTAL AMOUNT OF FILER'S' Co p
2ND5. OUTSTANDING DEBTS OR LIABILITIES Q mfri
PRE FRIDAY '' AT THE END OF REPORTING PERIOD: $
PRE-ELECTION r--
9
6. -��y --J
30 DAY
POST-ELECTION X AMENDMENT YES NO 3S
REPORT? C)
7. c)
ANNUAL TERMINATION .r
YES NO
REPORT" REPORT?
' - C,.)
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,t ' must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR ABIL;ES INC RED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,T c-=I;EST OF %KNOWLEDGE ANND BELIEF,TRUE,CORRECT AND COMPLETE.
SWORN O AND SUBSCRIBED BEFORE ME THIS 3 IS m 3 _,,h0,,,,.- ,\,,,,,L,,,,,„_______
/ yy�-� ) 3•Gly = SIGNATURE OF PERSON SUBMITTING REPORT
VJ DAY OF !✓P�' {� 4Lt' 20 1
K . mZ f
SIGNATURE' /� U C I sL O� PRINTED/' NAME
MY COMMISSION EXPIRES t7 -P 74 ' 2' N / "1-1-� 0 1 g i
MO. DAY YR. z S A- ,.CODE DAYTIME TELEPHONE NUMBER
N Z ,<
V.V e <
PART II- No ^ 2.
If statement is filed on behalf of a Candidate's Authorize Cb tmitt:If must sign here.
I SWEAR(OR AFFIRM)THAT TO THE BEST OF MY KNOWLEDGE AND BEUEF THIS POLITICAL COMMITTEE HAS NOT VIOLATED ANY PROVISIONS OF THE ACT OF
JUNE 3, 1937(Pl. 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
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280
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