HomeMy WebLinkAboutBorder, Zachary - 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 REPORT FILED 10,
CANDIDATE /C/ COMMITTEE'• 2 LOBBYIST 3
NUMBER ON BEHALF OF /
NAME FILING COMMITTEE,CANDID OR LOBBYIST
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STRCI EET Y, Y ADDRESSvV 4'! �/ 5 !
CITY /I6 ,f 0)Pr
STATE j/��{ ZIP CODE 21
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) ,,ry / /` �,�/.r�"/ il MO. DAY .YEAR• •
itp
6TH TUESDAY
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR
DATES OF
2ND FRIMAYR:' ` Z PE OD /0NG 23 /727 /
TO J
PRE=PRIMARY
30 DAY 3' C> ry
POST-PRIMARYQ C O
CASH BALANCE AT END -
4. OF REPORTING PERIOD: $ LO O
• .6TH.TUESDAY
PRE-ELECTION ` ! X r n
TOTAL AMOUNT OF FILER'S I- C'�
• 5. OUTSTANDING DEBTS OR LIABILITIES 0 A i
PRE-EL DAYCTI AT THE END OF REPORTING PERIOD: $ " '�
ARE-ELECTION CD
s C) "'U
� CD
30 DAY AMENDMENT
POST-ELECTION, YES NO CD (�,)
REPORT?
7.
ANNUAL •TERMINATION YES NO N
,/ -G
REPORT " REPORT? 7,K.
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. a c W
If statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here. a ,2 w o
C N O
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT} Z
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE. U) U ~ 0
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SWORN TO AND SUBSCRIBED BEFORE ME THIS (..--2------- W W CL a
11- N U
DAY OF Oettm b l 20 i_J ,�SIGNATURE OF PERSONS BMRTING RENLL -I GI`• N
I i2
Intim"
AMS PRINTED NAME Q .O C a
�/ ^ O N ?
SI NA E / ///� �^ Q
MY COMMISSION EXPIRES 0 I i L 2.0 ZO ` 0 dv & W Y
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MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER Z I E
O 5 E OO a
2. m V
PART II- 2v ''m
If statement is filed on behalf of a Candidate's Authorized Committee,Candidate must sign here. _o w
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
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280
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