HomeMy WebLinkAboutDelozier, Sheryl - 2018 2nd Friday Pre-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 110 REPORT FILED CANDIDATE. COMMITTEE 1 .LOBBYIST 3
NUMBER ON BEHALF OP
NAME OF FILING COMMITTEE CANDIDATE OR LOBBYIST
STREET ADDRESS
(.2)9)( 54g-carl 06-1
CITY STATE ZIP CODE
"W
ki
TYPE OF REPORT
NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) eMO.. DAY YEAR
t t ate It
6TH TUESDAY.. .....
PRE-PRIMARY FOR OFFICE USE,ONLY
MO, DAY YEAR MO. DAY YEAR
2ND FRIDAY 2. DATES OF
-PRE-PRIMAriV PERIOD ING Ot IA (S7 TO Lo 9 t% t
30 DAY..
POST-PRIMARY
CASH BALANCE AT END /� it)
l
4. OF REPORTING PERIOD: $ t/" "
- 6THIUESDAY:.
PRE-ELECTION
TOTAL AMOUNT OF FILER'S
OUTSTANDING DEBTS OR LIABILITIES 0 . n
2ND FRIDAY AT THE END OF REPORTING PERIOD:
PRE-ELECTION rT 3O DAYAMENDf1ENT CPOST=ECEG710N REPORT? YES NOCANNUAL' TERMINATION YESNO ` /
0144k-:
REPORT REPORT? �[-
AFFIDAVIT SECTION
PART I-
If statement is filed on behalf of a Political Committee or Candidates's Committee,the Treasurer must sign hgrle.
If statement is filed on behalf of a Candidate,the Candidate must s'.1 here. 1---..)If statement is filed on behalf of a Contributing Lobbyist,the Lo.= st sign here. ...< k
•
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR a1LT0� R: D' RING THE REPORTING ROD INDICATED ABOVE DID NOT `
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT i" BOE 3E" T OF MY .4 EDGE A?' B I7\'
TRUE .O:"ECT D COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS ��,a��.�! �1,_�/ I A I
21 _}\}- (6 S" Q.j ,. SIGNATURE OF PERSON SUBMITTING REPOR W
�1\ DAY OF ,:.. O��_��'E� ��..DOV,Q`reO`->
SIGNATURE GT¢0�,<605 rJ(\\J�; ^�^ „!
PRINTED�2,(A� NAME
MY COMMISSION EXPIRES `.2- 2 1 11 '0241/ S'6J
MO. DA ��YI�O AREA CODE DAYTIME TELEPHONE 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 POUT€CAL COMMITTEE HAS NOT VIOLATED ANY PROVISIONS OF TOE 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