HomeMy WebLinkAboutScott, Fred - 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 10 REPORT FILEDI, `
NUMBER ON BEHALF OF lo, CANDIDATE: X COMMITTEE.: LOBBYIST:.
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
FR I-0 4 Sco.-17-
STREET ADDRESS _
76 4( iogin <.S 2'2‘. 's/
CITY
SA'/r�M /J S ,6 u 124 STATE P/- / .7..?‘ —
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) �!1 CC-4-6
/ // MO. DAY. y YEARc
6TH TUESDAY �• SCR 0 D L .� f l�L. - i� A / 9/ Q . / aL t7 /
PRE-PRIMARY:. FOR OFFICE USE ONLY
. - MO. DAY YEAR ':MO. ..DAY YEAR:.
2ND FRIDAY Z" DATES OF
PRE-PRIMARY V REPORTING a// n� TO n Oc /
/9 V �
30 DAY 3• ` Jv
POST-PRIMARY CI tv
CASH BALANCE AT END /Q , a O
6TH TUESDAY 4. OF REPORTING PERIOD: $
PRE-ELECTION rn
TOTAL AMOUNT OF FILER'S -mac
2ND FRro... 5. OUTSTANDING DEBTS OR LIABILITIES —
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ .7"" O
s. -0
30 DAY AMENDMENT ✓ L -
POST-ELECTION YES NO
REPORT?
7. ..
ANNUAL TERMINATION. // -.-1 CA)
REPORT REPORT? YES NO if .,{
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 DU ING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KN EDGE AND BELIEF,TR E,TR AND COMPLETE.
SWORN,TO AND SUBSCRIBED BEFORE ME THIS p A p_L) (
ICDAY OF 44(,(,,� ?n t? /SIIGNNAATTURE OF PERSON SUBMITTING REPORT
a.44..a ommon alth of Pennsylvania.Notary Seal fj2 1'O 4 S C O
MEGAN ORRIS-NotaryPublic PRINTED NAME
L4/111
ilC�-MATURE Cumberland County
MY COMM N/ R I -- My Commission Expires Jan 14,2023 ? �� Cj �! 'Y
MO. Comrrly�s}on Nurn9 r 1LbUUli6 REA 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.
DSEB-503(12-99) 1 1""Y 1