HomeMy WebLinkAboutFish, David - 2019 2nd Friday Pre-Primary 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 FILEDCANDIDATE COMMITTEE 2 LOBBYIST 9.
I
NUMBER ON BEHALF OF
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
3 0.),Ju) Q, _ i 'N-
STREET ADDRESS
i
L L(kMe 300-- LN,
CITY STATE ZIP CODE
CC&Mp l 1 \ /11 ?o 1 1 — ryqs----
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) c MO. DAY YEAR
I�-1�- P Ain l v/t , k L� a�; ,.
T. �� CdrnNt1Sa v • aj c�dly
6TH TUESDAY -
PRE-PRIMARY FOROFFICE USE ONLY
MO. DAY YEAR MO. 1 DAY 1 YEAR ZZ �� ~�
2ND FRIDAY
2,,k/...„ DATES OF i = Q
PRE-PRIMARY PERIOD POR ING ('e i 0 1 'tat 9 TO 0^t 0& ?g,9 '43
30 DAY 3. �+..
POST-PRIMARY r' t
CASH BALANCE AT END t
6TH TUESDAY 4. OF REPORTING PERIOD: $ �/ n
PRE-ELECTION
a
TOTAL AMOUNT OF FILER'S C) =_
5. OUTSTANDING DEBTS OR LIABILITIES
2ND FRIDAY C r-°`',,
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ .-jp.:
6, - - '"< '. j
30 DAY
POST-ELECTION AMENDMENT YES NO
REPORT?
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 IN URING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNO/LEDGE AND ELIEF, RUE,CORRECT AND COMPLETE.
SWORN1TO AND SUBSCRIBED BEFORE ME THIS I
I O^ DAY OF �� 20 ICI SIGNATURE OF PE NI:SUB TTING REPORT
CJI! `�1.= �1f1Z !,
'Gi COI 1 '.1 - 511
�`I"'-'I t ,!� ��' ''y' �• , PRINTED NAME
MY COMMISSION EX- :ES NOTARIAL SEAL / 1 / 3 7 —6‘3j
3'�
MO. LORIE f��II$TW11I1 AREA(CODE DAYTIME TELEPHONE NUMBER
Notary Public
CARLISLE KORO, CUMBERLAND COUNTY
PART II- My Commission Expires Feb 14,2021
If statement is filed on-laehalf-of-aCei ete' mmittee, 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
PRINTED NAME
SIGNATURE
MY COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR.
Department of State • Bureau of Commissions,Elections and Legislation
USER-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280