HomeMy WebLinkAboutShultz, Sean - 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 FRED , I. 2. 3
NUMBER
•
ON BEHALF OF CANDIDATE IX COMMITTEE LOBBYIST -
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
S'e-AVI
5 A 0 I/---e_
STREET ADDRESS
.5-5 F Sf'res-
CITY STATE ?I ' ZIP CJDE
O i 3 —
Cy'(LSI.
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO. DAY • YEAR
1. Carlisle Soroid54 CoL i c / D pS Z. t Lot
'6TH TUESDAY
PRE-PRIMARY FOR OFFICE USE ONLY '
MO. DAY YEAR MO. DAY YEAR - -
2ND FRIDAY 2. DATES OF
PRE-PRIMARY PERIOD REPORTING
EODTING t// OI 'Cj 70 d� 17 nN�-.
30 DAY 3. I 1 - _
POST-PRIMARY
CASH BALANCE AT END r
Oa
a. OF REPORTING PERIOD: $ 73 —c
6TH TUESDAY I
PRE-ELECTION ›*
TOTAL AMOUNT OF FILER'S ^�
2ND FRIDAY s' OUTSTANDING DEBTS OR LIABILITIES /(�/'I a
PRE-ELECTIONAT THE END OF REPORTING PERIOD: $ C"3 MC
6. - fV
30 DAY AMENDMENT .""'a- (a
POST-ELECTION REPORT? YES NO ...,,A, W
-7.
ANNUAL TERMINATION' YES NO t��
REPORT - REPORT? JC
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($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SU CRIBED BEFORE ME THIS
•4
DAY OF � 2U�
SIGNATURE OF PERSON SUBMITTING REPORT
mom; _
Common AILJ� L,1I_�'u'L•'1 IIMi�_T / 1 . 4_ ; >_4 4✓ 5 G % ' `,PRINTED NAME
DOLLY M.''0 IENBE'l, - . .ry '' 'u r �+`
MY 6 i 151 I RYES -i 2 7 1 717 .5-114 y,J 1
My Commission Expires Sep 24,2022 MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
Commission Numhar 1143,341
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 BEUEF 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 • (717)787-5280