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Home My WebLink AboutFriends of Dawn Wetzel Keefer - 2017 Annual Report 111 f I IR RINE! Reset Form 1 Print Form Commonwealth of Pennsylvania-Campaign Finance Report I (Note:This report must be clear and legible.It should be typed) Filer Identification Report Filed By Candidate Committee / Lobbyist Number 20160003 • (Mark X) n Name of Filing Committee,Candidate or Lobbyist KEEFER WETZEL,DAWN COMMITTEE FRIENDS OF Street Address 150 ORE BANK ROAD City DILLSBURG State PA Zip Code 17019-9334 Type of Report(Place x under report type) 1-6u'Tuesday 2- 2nd Friday 3-30 Day Post 4-6th Tuesday 5..2""Friday 6-30 Day Post 7-Annual Special 2""Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election X i Date Of Election Year Amendment Termination a (MM/DD/YYYY) Report Report 4 Summary of Receipts and From Date To Date For Office Use Only ---- Expenditures Expenditures LTA 01/01/2017 12/31/2017 M f7. I A.Amount Brought Forward From Last Report $ 4012.34 GJ C B.Total Monetary Contributions and Receipts $ 15,300 C 3 (From Schedule I) C) C.Total Funds Available $ 1931234 C) _... (Sum of Lines A and B) C__• -. D.Total Expenditures $ •`– ' r ,(From Schedule Ill) 5631.01 -•C Wv al e= E.Ending Cash Balance $ 1 i'7 ca 13,681.33 - 9' (Subtract Line D from Line C) .—t•1 C,... f'a l F.Value of In-Kind Contributions Received $ I ,,_{ : , (From Schedule II) 456.75 ,C1 G.Unpaid Debts and Obligations $ _.--,I C...) k :3 10947.79 ..• (From Schedule IV) 7--.' ,,. Affidavit Section –• Part 1-If this is a • mittee report,treasurer sign here.If this is a Candidate report •.dida — ..... + I swear(or affirm)t•at this report,incl ing the attached schedules on paper,is .the best: owledge and belie, nd comp _ ; .. 3 Aorntto and s.bscr.ed before •this /rs.) L'ffay.f Janua 20 2,018 ��.•+..� //c..(� . / / 7 COMMO' . •�ua•:A�..S 11 �ti �:�u1�ii�n Submitting report Signature 4C.WAYNE KEECH,Notary" r•rinse Name Camp Hill. n?Cumberland a my 5745032 My Commission expires My'COMffil SiOn�k ;}(( ber,25,2020 MO. DAY YR. rca o ^ Daytime Telephone Number 1 Part II-If this is a report of a Candidate's Authorized Committee,candidate shall sign here. 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 ubscribed before m his / : .‘4 January \ 8 1 ,– y o 20 R Ill •�9_Dw.`►.Y�11 ig re o Candid. - CC MONWEALT - Signa NOTARIAL SEAL d Name • -C.WAYNE KEEch Notary Public 6as-o159 My Commission expires Camp Hill 13oro.,�betCounty Daytime Telephone Number ` MO. DAY YR. My Commission Expires rt�ovvem]pber 25,2020 fI ' SCHEDULE I Contributions and Receipts Detailed Summary Page 2 Filer Identification Number 1.Unitemized Contributions and Receipts-$50.00 or Less per Contributor Total for the reporting period (1) $ 0 2.Contributions of$50.01 to $250.00(From Part A and Part B) Contributions Received from Political Committees(Part A) $ 1,000 All Other Contributions(Part B) $ 0 Total for the reporting period (2) $ 1,000 3.Contributions Over$250.00(From Part C and Part D) • Contributions Received from Political Committees(Part C) $ 11,750 All Other Contributions(Part D) $ 2,550 Total for the reporting period (3) $ 14,300 4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) Total for the reporting period (4) $ 0 Total Monetary Contributions and Receipts during this reporting period(Add and $ enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report 15,300 Cover Page,Item B) 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. 3 Filer Identification Number 20160003 Amount Full Name of Contributing Date[MM/DD/YYYY] $ Committee Pa Optometric PAC 250 10/21/2017 House# Street Address Date[MM/DD/YYYY] $ 218 North St. City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17101 Full Name of Contributing Date[MM/DD/YYYY] $ Committee Pennsylvania Coalition of Nurse Practitioners 10/21/2017 250 House# Street Address Date[MM/DD/YYYY] $ 2400 Ardmore Blvd,Suite 302 City State Zip Code Date[MM/DD/YYYY] $ Pittsburgh PA 15221 Full Name of Contributing Date[MM/DD/YYYY] $ Committee Pa Physical Therapy Association PAC 11/01/2017 250 House# Street Address Date[MM/DD/YYYY] $ 1500 One PPG Place City State Zip Code Date[MM/DD/YYYY] $ Pittsburg PA 15222 Full Name of Contributing Date[MM/DD/YYYY] $ Committee High-Tech PAC 11/4/2017 250 House# Street Address Date[MM/DD/YYYY] $ 200 S.Broad St. City State Zip Code Date[MM/DD/YYYY] $ Philadelphia PA 19102 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] $ PART C Contributions Received From Political Committees Over$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value over$250.00 in the reporting period. Filer Identification Number: 20160003 Full Name of Date[MM/DD/VYYY] $ Contributing Committee Pennsylvania Video Gaming Assoc PAC 300 09/17/2017 House# Street Address Date[MM/DD/YYYY] $ 200 N.3rd St.Suite 1500 City State Zip Code Date[MM/DD/YYYIn S Harrisburg PA 17101 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Pennsylvania Association of Milk Dealers 300 10/09/2017 House# Street Address Date[MM/DD/YYYY] $ 240 N.3rd St.Suite 406 City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17101 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Bike PAC 10/14/2017 300 House# Street Address Date[MM/DD/YYYY] $ P.O.Box 564 10/17/2017 300 City State Zip Code Date[MM/DD/YYYY] $ Mechanicsburg PA 17055 Full Name of Date[MM/DD/YYYYj $ Contributing Committee Pennsylvania Bankers PAC 300 10/14/2017 House# Street Address Date[MM/DD/YYYY] $ 3897 North Front St. City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17110 Full Name of Date[MM/DD/YYYY] $ Contributing Committee PPL People For Good Govt.PAC 10/13/2017 300 House# Street Address Date[MM/DD/YYYY] $ 2 North 9th St. City State Zip Code Date[MM/DD/YYYY] $ Allentown PA 18101 Full Name of Date[MM/DD/YYYY] $ Contributing Committee PA Assoc of Private School Administrators 10/17/2017 300 House# Street Address Date[MM/DD/YYYY] $ 224 Pine St. City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17101-1350 f PART C Contributions Received From Political Committees Over$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value over$250.00 in the reporting period. Filer Identification Number: I 20160003 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Bravo PAC10/17/2017 300 House# Street Address Date[MM/DD/YYYY] $ 20 North Market Square Suite 800 City State Zip Code Date[MM/DD/YYYY) $ Harrisburg PA 17101-1350 , Full Name of Date[MM/DD/YYYYI $ Contributing Committee Geisinger Health PAC 10/17/2017 300 House It Street Address Date[MM/DD/YYYY] $ 409 North Second St.Suite 500 City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17101 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Range Resources Energy Independence PAC 10/17/2017 300 House It Street Address Date[MM/DD/YYYY] $ • P.O.Box 545 City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17108-0545 Full Name of ' Date[MM/DD/YYYY] $ Contributing Committee Pennsylvania Automotive Assoc PAC 300 10/17/2017 House# Street Address Date[MM/DD/YYYYj $ 1925 North Front St. City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17105 Full Name of Date[MM/DD/YYYY] $ Contributing Committee CUPAC300 10/17/2017 House# Street Address Date[MM/DD/YYYY] $ 4309 North Front St. City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17110-161 Full Name of Date[MM/DD/YYYY] $ Contributing Committee McNees PAC 10/17/2017 300 House# Street Address Date[MM/DD/YYYY] $ P.O.Box 1166 City State Zip Code Date[MM/DD/YYYYj $ Harrisburg PA 17108-1166 PART C Contributions Received From Political Committees Over$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value over$250.00 in the reporting period. Filer Identification Number: 20160003 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Troopers Association PAC 09/17/2017 750 House# Street Address Date[MM/DD/YYYY} $ 3625 Vartan Way City State Zip Code Date[MM/DD/MY] $ Harrisburg PA 17110 Full Name of Date[MM/DD/YYYY] $ Contributing Committee NiSource PAC Columbia Gas of PA 300 10/17/2017 House# Street Address Date[MM/DD/YYYY] $ 290 W.Nationwide Blvd City State Zip Code Date[MM/DD/YYYY] $ Columbus Oh 43215 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Food PAC of Pennsylvania 10/19/2017 300 House# Street Address Date[MM/DD/YYYY] $ 1029 Mumma Road P.O.Box 870 City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17011 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Political Labor Actio-Now 10/19/2017 500 House# Street Address Date[MM/DD/YYYY] $ 904 North 2nd Street City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17102 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Pennsylvania Manufactures Assoc PAC 10/21/2017 300 House# Street Address Date[MM/DD/YYYY] $ 225 State St. City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17101-1129 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Highmark PAC 10/21/2017 300 House# Street Address Date[MM/DD/YYYY] $ 1800 Center Street City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17089-0089 PART C Contributions Received From Political Committees Over$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value over$250.00 in the reporting period. Filer Identification Number: I 20160003 Full Name of Date[MM/DD/YYYY) $ Contributing Committee Lewis Eckert Robb&Co. 10/21/2017 500 House# Street Address D• ate[MM/DD/YYYY] $ P.O.Box 311 City State Zip Code Date[MM/OD/YYYY) $ Plymouth Meeting PA 19462 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Robert 5.Tayhlor Esq. 10/28/2017 300 House# Street Address D• ate[MM/DD/YYYY] $ P.O.Box 220 City State Zip Code D• ate[MM/DD/YYYY] $ Solebury PA 18963-0220 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Aqua America,INC.H2O PAC 10/28/2017- 300 House# Street Address Date[MM/DD/YYYY] $ 762 West Lancaster Ave City State Zip Code D• ate[MM/DD/YYYY] $ Bryn Mawr PA 19010 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Energy Transfer PAC 10/28/2017 500 House# Street Address Date[MM/DD/YYYY] $ 400 W.15th St.Sjuite 720 City State Zip Code Date[MM/DD/YYYY] $ Austin Tx 78701 Full Name of Date[MM/DD/YYYY] $ Contributing Committee PAW-PAC 10/28/2017 300 House# Street Address Date[MM/DD/YYYY] $ B00 West Hershey Park Drive City State Zip Code Date[MM/DD/YYYY] $ Hershey PA 17033 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Agent PAC of PA 10/28/2017 300 House# Street Address Date[MM/DD/YYYY] $ 5050 Ritter Road City T State Zip Code Date[MM/DD/YYYY] $ Mechanicsburg PA 17055 r PART C Contributions Received From Political Committees Over$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value over$250.00 in the reporting period. 1 Filer Identification Number: I 20160003 Full Name of Date[MM/DD/YYYY] $ Contributing Committee First Energy PAC 10/28/2017 300 House# Street Address Date[MM/DD/YYYY] $ 76 S.Main St. City State Zip Code Date[MM/DD/YYYY] $ Akron OH 4308-1890 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Chamber PAC300 10/28/2017 House 8 Street Address Date[MM/DD/YYYY] $ 417 Walnut St City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17101-1902 Full Name of Date[MM/DD/YYYY] $ Contributing Committee National Fuel Gas PA PAC 300 10/30/2017 House# Street Address Date[MM/DD/YYYY] $ 1100 State St. City State Zip Code Date[MM/DD/YYYY] $ Erie PA 16501 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Exelon,PAC 11/2/2017 500 House# Street Address Date[MM/DD/YYYY] $ 300 Exelon Way City State Zip Code Date[MM/DD/YYYY] $ Kennett Square PA 19348 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Eli Lilly&Co. 11/10/2017 300 House# Street Address Date[MM/DD/YYYY] $ DC 4925 City State Zip Code Date[MM/DD/YYYY] $ Indianapolis, IN 46285 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Independent Blue Cross PAC 11/15/2017 300 House# Street Address Date[MM/DD/YYYY] $ 1901 Market St. City State Zip Code Date[MM/DD/YYYY] $ Philadelphia PA 19103 I ' f PART C Contributions Received From Political Committees Over$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value over$250.00 in the reporting period. I Filer Identification Number: 20160003 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Pennsylvania Truck PAC 300 11115/2017 House# Street Address Date[MM/DD/YYYY] $ 910 Linda Lane City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17011 Full Name of Date[MM/DD/YYYY) $ Contributing Committee Duane Morris LLP 11/24/2017 300 House# Street Address Date[MM/DD/YYYY] $ 300 North 2nd Street Penthouse City State Zip Code Date[MM/DD/YYYY) $ Harrisburg PA 17101 Full Name of Date[MM/DD/YYYY] $ Contributing Committee At&T PAC 11/25/2017 300 House# Street Address Date[MM/DD/YYYY] 5 351 Stanley Drive City State Zip Code Date[MM/DD/YYYY] $ Palmyra PA 17078-9152 Full Name of Date[MM/DD/YYYY) $ Contributing Committee Pennsylvania Fraternal Order of Police 12/13/2017 300 House# Street Address Date[MM/DD/YYYY] $ 2949 North Front St. City State Zip Code ' Date[MM/DD/YYYY] $ Harrisburg PA 17110-1250 Full Name of Date(MM/DD/YYYYJ $ Contributing Committee House# Street Address Date[MM/DD/YYYY] $ City 1 I State Zip Code Date[MM/DD/YYYY) $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee House# Street Address Date[MM/DD/YYYY) $ -�CitY1 State Zip Code Date MM DD $ PART D All Other Contributions Over$250.00 Use this Part to itemize all other contributions with an aggregate value over$250.00 in the reporting period. 10 (Exclude contributions from political committees reported in Part C) Filer Identification Number: 20160003 Full Name of Contributor Date[MM/DD/YYYY] $ Dawn Keefer 1,550 01/30/2017 House# Street Address Date[MM/DD/YYYY] $ 430 Franklin Church Road City State Zip Code Date[MM/DD/YYYY] $ Dillsburg PA 17019 Employer Name Occupation House of Representatives State Representative Employer Mailing Address/ Principal Place of Business Harrisburg,PA Full Name of Contributor Date[MM/DD/YYYY] $ James D.Robinson 11/10/2017 1,000 • House# Street Address Date[MM/DD/YYYY] $ 1040 Red Rock Road City State Zip Code Date[MM/DD/YYYY] $ Gettysburg PA 17325 Employer Name Occupation Utica National Insurance Group Chairman of the Board Employer Mailing Address/ Principal Place of Business 180 Genesee Street New Hartford,NY 13413 Full Name of Contributor Date[MM/OD/YY/VI $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/ Principal Place of Business Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer NameOccupation Employer Mailing Address/ Principal Place of Business IC l SCHEDULE II IN-KIND CONTRIBUTIONS AND VALUABLE THINGS RECIEVED n. USE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS DURING THE REPORTING PERIOD DETAILED SUMMARY PAGE Filer Identification Number: 1 20160003 1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR I TOTAL for the reporting period (1) $ 2. IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F) TOTAL for the reporting period (2) $ 3. IN-KIND CONTRIBUTION RECEIVED-VALUE OVER$250.00(FROM PART G) TOTAL for the reporting period (3) $ 456.75 TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING $ PERIOD(Add and enter amount totals from boxes 1,2,and 3;also enter on Page 1,Report Cover Page,Item F) 456.75 • ti • SCHEDULE II Part G In-Kind Contributions Received 12 VALUE OVER$250 Filer Identification Number: 20160003 Full Name of Contributor Date[MM/DD/YYYYJ $ Pennsylvania Rural Electric 10/17/2017 456.75 House# Street Address Date[MM/DD/YYYY] $ P.O.Box 1266 City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17108 Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Fund Raiser Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYYJ $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution Full Name of Contributor Date[MM/DD/YYYYJ $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution SCHEDULE III Statement of Expenditures 13 Filer Identification Number: 20160003 To Whom Paid Date[MM/DD/YYYY] $ Dawn Keefer 23.95 02/20/2017 House# Street Address Description of Expenditure 430 Franklin Church Road City State Zip Dillsburg PA 17019 Postage Code To Whom Paid Date[MM/DD/YYYY] $ Northern York County Republican Club 115 02/24/2017 House# Street Address Description of Expenditure North Baltimore St. City Zip Dillsburg State PA Code 17019 Annual dinner Ad To Whom Paid Date[MM/DD/YYYYI $ Chase Bank 49.91 03/18/2017 House# Street Address Description of Expenditure P.O>Box 15298 City State Zip Interest Wilmington DE Code 19850 To Whom Paid Date[MM/DD/YYYYI $ Hot Frog Media 317.25 10/09/2017 House# Street Address Description of Expenditure 118 west Allen St. City Mechanicsburg State PA Copde 17055 Mailing for Fundraiser To Whom Paid Date[MM/DD/YYYY] $ Dillsburg Farmers Fair Ad 65 10/25/2017 House# Street Address Description of Expenditure 202 S.Chestnut St. City Zip Dillsburg State PA Code 17019 Ad in Dill Pickle To Whom Paid Date[MM/DD/YYYY] $ Dawn Keefer 3,000 04/16/2017 House# Street Address Description of Expenditure 430 Franklin Church Road City State Zip Partial Repayment of loan Dillsburg PA Code 17019 To Whom Paid Date[MM/DD/YYYYI $ Cumberland County Republican Committee 125 10/30/2017 House# Street Address Description of Expenditure P.O.Box 1495 • City State Zip Camp Hill PA 17011 Ad Annual Bankquet Code To Whom Paid Date[MM/DD/YYYY] $ York County Republican Club 100 11/02/2017 • House# Street Address Description of Expenditure 2453 Kingston Court City State Zip Annual Dinner York PA Code 17402 SCHEDULE III 14 Statement of Expenditures Filer Identification Number: 20160003 To Whom Paid Date[MM/DD/YYYY] I $ Adams County National Bank 12.05 11/08/2017 House# Street Address Description of Expenditure 3 Tristan Drive City State Zip Dillsburg PA Code17019 printed deposit slips To Whom Paid Date[MM/DD YYY] $ Sophie's On Market 1 792.72 01/06/2017 House Street Address Description of Expenditure 3700 Market St City State Zip Camp Hill PA Code 17011 Swearing in party To Whom Paid Date[MM/DD/YYYYJ $ Dawn Keefer 12/31/2017 1 400 House# Street Address Description of Expenditure 430 Franklin Church Road City Dillsburg State PA Zip 17019 School Football Ads Code To Whom Paid a Date[MM/DD/YYYY] $ Dawn Keefer 178.8 12/31/2017 I House# Street Address Description of Expenditure I 430 Franklin Church Road City - - State Zip Dillsburg PA Code 17019 Website hold&Phone To Whom Paid Date[MM/DD/YYYYJ $ Chase Bank 451.33 12/31/2017 House# Street Address Description of Expenditure I P.O.Box 15298 City State Zip Interest on Loan Wilmington DE Code 19850 To Whom Paid Date[MM/DD/YYYY] $ ' House it Street Address Description of Expenditure City • State Zip Code To WhomiiimmPaid ~ Date[MM/DD/YYYYJ $ House# Street Address Description of Expenditure City State Zip Code To Whom Paid - Date[MM/DD/YYYY] $ IHouse# Street Address Description of Expenditure City State Code SCHEDULE IV i5 Statement of Unpaid Debts Use this Section to itemize all unpaid debts and obligations which are outstanding at the end of the reporting period. Filer Identification Number: 201600490 Name of Creditor Dawn Keefer Outstanding Balance of Debt House it Street Address DATE DEBT INCURRED $ 430 Franklin Church Road [MM/DD/YYYY] 12/31/2017 , City State Zip 10947.79 Dillsburg PA Code 17019 Description of Debt Loan to Committee Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip Code Description of Debt Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip Code Description of Debt Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip Code Description of Debt Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip Code Description of Debt Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip Code Description of Debt