HomeMy WebLinkAboutFriends of Jim Hertzler - 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 ► REPORT FILED , CANDIDATE I COMMITTEE OPLOBBYIST }
NUMBER ON BEHALF OF
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
FriCn/5 o-F JIA t Her+Jle.r
STREET ADDRESS
P. o. Box 1-3
CITY STATE ZIP CODE
(4,
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) rC COirnm(SSlone-�`�w Z-' DE i ' OC ,201/�
V
6TH TUESDAY 1 "'0��
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY I YEAR - -
2ND FRIDAY 2. DATES OF
PRE-PRIMARY REPORTING I�r O5 sot TO JO /7 n
PERIOD VKJ iU f/'. ..00''f/ ,-- O
30 DAY 3. COO
POST-PRIMARY -' C
CASH BALANCE AT END 3Q. •mn
4. OF REPORTING PERIOD: $ VV '�
6TH TUESDAY f""'
N)
PRE-ELECTION ". Cj"t
TOTAL AMOUNT OF FILER'S C:t
2ND FRIDAY OUTSTANDING DEBTS OR LIABILITIES
PRE-ELECTION / n AT THE END OF REPORTING PERIOD: $ �,-,/ a~,
6. O
30 DAY
POST-ELECTION REPORT?AMENDMENT
YES NO N)
7.
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.
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 KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS T__,
0(5 DAYOF Q tr 2Q.( SIGNATURE OF PERSON SUBMI ING REPORT
,si1.c• c. CTcv- ct_ �1N -raAel.Ckak
SIGNATURE
PRINTED NAME
MY COMMISSON EXPIRES O'p2 7 � y�0-aA � ` ,9 (ZV a^lJ6g6
MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
Commonwealth o.Pennsylvania-Notury Seal
PART it - Jessica C.Smith,Notary Public
If statement is filed on 9108 i' ': t.!...- ._ uthorized Committee, Candidate must sign here.
My commission expires Se. : .e ,-•
I SWEA-.r MILI ' _ ' • •- • •WLEDGE AND BELIEF THIS POLITICAL C 4.4MITTEE HAS NOT VIOLATED ANY PROVISIONS OF THE ACT OF
JUNE 3, 1937(P.L. 1333,No.320)AS AMENDED.
SWORN O AND SUBSCRIBED BEFORE ME THIS Tria.44.4, /4 liforitb..........
_ t/y��� / SIGNATURE OF CANDI'A E
DAX • ��� ���. ZO l `J ' ' /
ii
ll
I' //^/ �^�P/RINTEED�^N(A�ME ? `,]�/
CO ONA' ' P- °AO ' al f.. is URE \)� 2I / / „/.:/` — / ( l ,
T Jd� EEXPIREs [CI J• 1 ` (3D(31 AREA CODE DAYTIME TELEPHONE NUMBER
LLLLLL(((((�11111 R� [[[ I� pry. DAY YR.
Notary Public
CARLISLE BORO,CUMBERLAND COUNTY
My Commission Expires Feb 14.2021 Department of State • Bureau of Commissions,Elections and Legislation
._....DSEi3-503(i2-99) 0 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280