HomeMy WebLinkAboutBorder, Zachary - 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$250„00 during the reporting period.
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FILER IDENTIFICATIONN
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NIEMEN ON tlENALF OF 1 I CA1D10111E. _1>r;COYYt[T�: _• •LOBBYIST I7.
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NAME OF FILMO commis,GpATE OR LOBBYIST ,
STREET ADDRESS
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CITY i STATE ZIP CODE /�
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NAME FOFFICESOUGHTBYCANDIDATE DI NO. PARTY rIA.rE Or ELECTION
TYPE OF REPORT ,
CHECK ONE) - MO •DAYYESAR*.
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PREPRIMARY • FOR$ICE 1BEi0NLY_
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` 'FRIDAr.: .:. 4 DATES OF _ rrn 3:06
• REPORTING G TO y 2 3' 17
PERIOD 1/
• -3o:n - ' ' ,. 3.
'POSTPREIARY. .': t J
CASH BALANCE AT END
5711 T finic.R�'" 4. OF REPORTING PERIOD: $ 0 ,,3
PRE^elECtioN
TOTAL AMOUNT OF FILER'S
.
OUTSTANDING DEBTS OR UABILmES0
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PRE-EtecnDR AT THE END OF REPORTING PERIOD: COMMONWEALTH OF PENNSYLVANIA
s, _ NOTARIAL SEAL
A-e dcstaN '•.i►luaioiulwrr' No
Megan Champagne,Notary Pablic
City of Harrisburg,Dauphin County
• . MAL AT. My Commission Expires Jan.12,2020
7ERutu1ATloK YES NO MEMBER,PENNSYLVANIAASSOCIATIAN OF NOTARIES
AFFIDAVIT SECTION
PART I-
If statement Is flied 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 behatf of a Coqtributina Lobbyist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES E CURREO DURING THE REPORTING PEka00 INDICATED ABOVE CAD NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE.CORRECT AND COMPLETE.
SWORNrTO AND SUBSCRIBED BEFORE ME THIS
I 0 ,DAY OP J & U Di.I^ 20-d SIGNATURE OF PERSON SUBMITTING REPORT
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kyr . 0/`Lec
/t' l 8II PRINTED NAME
MY COMMISSION EXPIRES 0 1 12 2 0 L0 6(6 (e'& 3-(a
MO. DAY YR. AREA CODE DAYTIME TE7.EP NUMBER
PART II-
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 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 i
PRINTED NAME.
SIGNATURE
MY COMMISSION EXPIRES - AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR.
DSEB-503(12-99) /�