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HomeMy WebLinkAboutPacker, Alissa - 2017 30-Day Post Election r' illL Reset Form b 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 V Committee Lobbyist Number (Mark X) Name of Filing Committee,Candidate or Lobbyist Ji 1'-S a Pa-a.e.- Street Address 5o!I n i,� -tA t -/� City C / 1+7/1 'jJ Stj to 14,_ Zip Code / I Type of Report(Place x under report type) 1 1-6`h Tuesday 2- 2nd Friday 3-30 Day Post 4-6th Tuesday 5-td Friday 6-30 Day Post 7-Annual Special 2"d Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election i Date Of Election Year Amendment Termination (MM/DD/YYYY) 11/7/17 201 7 Report Report Isonsrmississaarstisimmisr Summary of Receipts and From Date To Date For Office Use Only Expenditures /db-7//7 1/ h /1-7—. A.Amount Brought Forward From Last Report $ ten/ �(ry <a �+ B.Total Monetary Contributions and Receipts $ ,C� cD (From Schedule I) „2...4-D , (Th rT i r rl C-.3 C.Total Funds Available $ Z�3 I (Sum of Lines A and B) ,2 9i/ f _J D.Total Expenditures $ CD (From Schedule HI) — O --- ra E.Ending Cash Balance $ �,j /� <D " ' (Subtract Line D from Line C) oZ 9-I ,,-{ 2 F.Value of In-Kind Contributions Received $ a '--i O (From Schedule II) -� <9 G.Unpaid Debts and Obligations $ (From Schedule IV) rn fidavit Section Part 1-If this is a Committee report,treasurer sign here.If trig:1a Candidaereport,candidate sign here. I swear(or affirm)that this report,including the attached sc,'c )goon pap ,is to the best of my knowledge and belief true,correct and complete. .C)!.> Sworn to and subscribed before me this z O c Z TT z3Ha /'/� day of 1.1-erevVI. 1x20 17 Z 4. '• z n' i '6{- � mon QC F.F. 3 m t _ /' Hato/re �r�^son uj„pittin r p rt S nature y It Z-g 0 Printed Name cA 1'4 lig 4 My Commission expires 9- ,P—a,b 1 5- s w g-Q p m 57° JTZ �c� ('/.-�S MO. DAY YR. z c)c = Area Code Daytime Telephone Number O N C O' u) Part II-If this is a report of a Candidate's Authorized Commi W 6indidate shall sign here. I swear(or affirm)that to the best of my knowledge and bel - is political kommittee has not violated any provisions of the Act of June 3,1937(P.L.1333,NO.320)as amended. z' 'a a.. Sworn to and subscribed before me this day of 20 Signature of Candidate Signature Printed Name My Commission expires MO. DAY YR. Area Code Daytime Telephone Number 4 PART A Contributions Received From Political Committees $50.01 TO$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value from$50.01 TO$250.00 in the reporting period. Filer Identification Number I Amount Full Name of Contributing be-01OC..1-- J Date[MM//DSD//YYYY] $ j Committee C%_ 1 r n iee_ �� S�i�y2eGUa /0 1,2-6017-! 017- W 0 House# Street Address `('IC(/v/ Date[MM/DD/YYYY] $ p A 6a 513 City State Zip Code Date[MM/DD/YYYY] $ 7lD Full Name of Contributing Date[MM/DD/YYYYJ $ Committee House# Street Address Date[MM/DD/YYYY] $ City ' State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date[MM/DD/YYYY] $ City ' ' State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $