HomeMy WebLinkAboutCamp Hill Rep. Committee - 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 110, REPORT FILED I
NUMBER ON BEHALF OF
CANDIDATE COMMITTEE j1 LOBBYIST 3.
1110'
NAME OF RUNG COMM It LOBBYIST /
CvAti/i/p -i/1 ei›ti..„0 1 cif-A
STREET ADDRESS,
"13 .1 t-1/4‘.0(k5-1-y-fa2-
CRY STATE A ZIP CODE
C44,E) 14 (7 ,./T 170 — (:), 1
TYPE OF REPOIrRT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. 'PARTY DATE OF ELECTION
(CHECK ONE) MO. DAY YEAR
6-n4 TUESDAY KeP if 7 0(7
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DA IIEZMI MO. DA 1=11
i
2ND FRIDAY 2. DATES OF
PREPRIMARY , REPORTING IITh
PERIOD r R Ef 0
c.--)
30 DAY 3' C: c=)
_
POST-PRIMARY -,*
CASH BALANCE AT END $ 3'17/7 -63 C xx
6TH ruEsDAy
rri .
OF REPORTING PERIOD:
-...-r)
PRE-ELECTION
TOTAL AMOUNT OF FILER'S ..-x.
--- CTN
5. OUTSTANDING DEBTS OR LIABILITIES ------ 0 --- ..-....
2ND FRRIAY C..")
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ z:a.
C.) ---
6. —
30 DAY AMENDMENT 2r
POST-ELECTIONYES NO
REPORT? .< .......I
ANNUAL TERMINATION YES
NO
REPORT REPORT?
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.
s I S R(DR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
IED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE,
v iga SWORN TO AND SUBSCRIBED BEFORE ME THIS /3- '''31--Ift..,•!`"' —
‘,
1 g fit 405 DAY OF 3(..1,..Y\t,)cz,..rki 2011 SIGNATURE PERSON SUBMITTING REPORT
i ..-"...,IglePAT.I.'Veil"—k. DID k P, PRINTED NAME
11,- TURE
* r MY COMMISSION EXPIRES VIVA.4 i 0 0 c r a c:;. 7 I 7 737— g- 8 V
...., i_i
r . MO. I DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
i —11-
§ —tement is filed on behalf of a Candidate's Authorized Committee, Candidate must sign here.
I I SWEAR OR AFFIRM)THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS POLITICAL COMMI I ItE 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.
DSES-503(12-99)