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HomeMy WebLinkAboutPA Assoc. of Ambulatory Surgical Centers - 2018 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. RLEa�ENREPORT FILED IDTIFICAGON 10, 2007017 ON o+ruF 0, cANDIDnTE '' coi irrse 'X warm '. NUMNAME OF FILING COMMITTEE,CANDIDATE OR LOaaYIST Pennsylvania Association of Ambulatory Surgical Centers STREET ADOREii 423 North 21st Street, Suite 104, American Office Center CITY STATE OF COOS Camp Hill PA 17011 — TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DARE OF ELECTION (CHECK ONE) MO." OAT TEAR 1. 6TH'TUESDAY PRE-PRIMARY FOR OFFICE USE ONLY MO. I OAT YEAR MO. OAT ) TEAR 2ND FRIDAY PZ. DATES OF PRPRIMARY PERIOc NG E01 101 2018 TO 12 31 2018 c N 30'DAY 3' C r POST-PRIMARY %C . • CASH BALANCE AT END 203.50 '*1 firm TUESDAY A. OF REPORTING PERIOD: $ rn n PREELECTIONt ' TOTAL AMOUNT OF FILER'S S• OUTSTANDING DEBTS OR LIABIUTIES )' --I PRE-ELECTION AT THE END OF REPORTING PERIOD: $ 0•0 0 Q e. C _ 30 OAT X C POST-ELECTION N REPORT? YES NO 2 ANNUAL T TERMINATION "-1 3 REPORT X REPORT? YES NO X AFFIDAVIT SECTION PARTI- 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 UABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE. SWORN _;TTO AND SUBSCRIBED BEFORE ME THIS r'') I/t. o(J DAY OF /I NA f 20 ICI '� ITTING REPORTo F. Wilson Jackson, M.D. iC e / (C /�,,4 - ATU' .1! ' ' ^^�ll nn PRINTED NAME M l• frt.©T. N EXPIRES ads �� �wC 717 761-0930 ,,147, 'Pee MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER �e k C� �ofe� • 4A,. PA- 4,.F%4 ?• 4 If state -• ' ..e .:half of a Candidate's Authorized Committee,Candidate must sign here. I SWEAR(0• '.t THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS POLITICAL COMMITTEE HAS NOT VIOLATED ANY PROVISIONS OF THE ACT OF ' JUNE 3,1937 - .1333,No.320)As ALIENDEO. 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 DSLB-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280