HomeMy WebLinkAboutNguyen, Michael - 2017 Annual Report 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 CANDIDATE I� COMMITTEE 2. LOBBYIST 3.
NUMBER ON BEHALF OF 110
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
MI-clIP,L PC-01? J
STREET ADDRESS
(o 3OX s9c,
CRY STATE ZIP CODE
tio�/ (19 f70z s - t)sq‘„
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) (�7� MO. DAY YEAR
T r•L(..04-06a-- J,r P D Gi yfNV tri-A% 1/ Q- Zb!7-
6m TUESDAY
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR
2ND FRIDAY 2. DATES OF
PRE-PRIMARY PER OD NG i 7 ZoI TO IZ '2 I `"I 2 N...
30 DAY.
3.
POST-PRIMARY
CASH BALANCE AT END
6TH TUESDAY 4. OF REPORTING PERIOD: $ 1— ry
PRE-ELECTION
TOTAL AMOUNT OF FILER'S E 3
ABI
OUTSTANDING DEBTS OR LILITIES
5. C? 3.
2ND FRIDAY
PRE-ELECTIONAT THE END OF REPORTING PERIOD: $ (]
8.
30 DAY AMENDMENT
-a
POST-ELECTION REPORT T YES NO –<
ANNUAL )6 YES YES X I NO
REPORT REPORT? �1
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(S250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOO -t'E A •;100000r,CORRECT AND COMPLETE.
SWORN TO SUBSCRIBED BEFORE ME THIS Commonwealth of Pen `°"e/
0 DAY OF 7a h V ALV 2� Notarial Seal SIGNAT RE OF PER 'SUBMITTING REPORT
R E FRY—Notary : • W�u k�
SILVER SPRING TWP CLIMB ---Pie-4
tIATURER, 0. My Co,,,mission Expires Jun 25,2021 PRINTED NAME
MY COMMISSION EXPIRES - ^ wy - V
MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
PARTII-
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 BEUEF 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
O.-,