HomeMy WebLinkAboutMiller, Nicole - 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 REPO"FILED , CANDIDATE EX COMMITTEE. 2. LOBBYIST 3. ,
NUMBER 101, ON BEHALF OF
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
/Nicole MI.1ler
STREET ADDRESS
3S 3a. Cavirfc 3e, N DLuSe Dr
CITY STATE ZIP CODE
Cams 14t)I P4 i'7011 —
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) ^ MO. DAY YEAR.
Ci.t bevland valley 5c6001 Drvec+br L R
5 a1 19
6TH TUESDAY.
PRE-PRIMARY FORODFICE Llat ONLY
MO. DAY YEAR MO. DAY YEAR -=
2ND FRIDAY 2. DATES OF (�
PERIOD
PRE-PRIMARY ' REPORTING 3 1 19 TO 5 I )9 rIT 7g'
Y3 73
30 DAY 3' r-
1
POST-PRIMARY _/' = ..3
CASH BALANCE AT END ,`rJJS
6TH TUESDAY 4. OF REPORTING PERIOD: $ 3
PRE-ELECTION
TOTAL AMOUNT OF FILER'S
5• OUTSTANDING DEBTS OR LIABILITIES =
PREtio-gitELECTION iDAY AT THE END OF REPORTING PERIOD: $ ry
PRE-ELECTION
8. 1.b
30 DAY
POST-ELECTION AMENDMENT YES NO )(
REPORT?
7.
ANNUAL TERMINATION
REPORT REPORT? YES NO X
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 RRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST Off t ---------:----- -
MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSC IBED BEFORE ME THIS t~ DAY OF �v, 20 a fin\ SIGNATURE OF PERSON SUBMITTING REPORT
LMA
to,
41/ thnvania-NoySl N c o\ f ` 1 .i1''-' MI ,_.y ,�bhcCumberlPRINTED NAME
SI NATURE hsion Expi County 9_I 30S7 E PIRE ( �Commission Expires Jan t4,2023 � ' � � �' JLVJ�
MO. nit......"'....lictre' I!60066 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 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
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 0 (717)787.5290