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Home My WebLink AboutHerbert, Sam - 2019 30-Day Post-Primary Commonwealth of Pennsylvania 3 PAGE 1 OF CAMPAIGN FINANCE REPORT (COVER PAGE) (NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.) Filer Identification ► Report , 1. 2. 3. Number: Filed By. CANDIDATE COMMITTEE ! LOBBYIST Name of Filing Committee, Candidate or Lobbyist: S mm 14S01.1 l\E R RT Street Address: "I ffu1•►T ?l._ City: State: Zip Code: WE- cKr `c.S3u�G PPs . 11a5"D — 2112 TYPE OF 6TH TUESDAY 1. 2ND FRIDAY 2. 30;'DAY 3• AMENDMENT YES NO REPORT PRE-PRIMARY PRE-PRIMARY POST PRIMARY ✓ REPORT? 6TH TUESDAY 4• 2ND FRIDAY 5• 30 DAY 6• TERMINATION / PRE-ELECTION PRE-ELECTION POST ELECTION + REPORT? YES NO �/ (place X to the right of ANNUAL 7. YEAR FILING METHOD report type) REPORT ( ) CHECK ONE . PAPER' DISKETTE Name of Office Sought by Candidate: DATE OF ELECTION District Office Party County ate( v•� MO. DAY YEAR Number Code Code Code Ott)V1Sk 1 0C ZI 2A9 (SEE INSTRUCTIONS FOR CODES) FOR OFFICE USE ONLY MO. DAY YEAR MO. DAY YEAR Summary of Receipts , 05 01 Zof1 To 06 l0 2Olr.., and Expenditures from: q C) p A. Amount Brought Forward From Last Report $ 0 .,.... . "' B. Total Monetary Contributions and Receipts (From Schedule I) S 0 23= 1— C. Total Funds Available (Sum of Lines A and B) $ 0 --, — ..cw CD D. Total Expenditures (From Schedule III) $ O ; -a E. Ending Cash Balance (Subtract Line D from Line C) $ 0 C. f' F. Value of In–Kind Contributions Received (From Schedule II) S 5D')D , O I, G. Unpaid Debts and Obligations (From Schedule IV) $ 0 - AFFIDAVIT SECTION PART I – Ifthis is a Committee:report, treasurer sign here. If this is a Candidate report candidate sign here. . I swear (or affirm) that this report, includingrt`^ -••-rhn,4 s.'hpAules. on paper or computer diskette, are to the best of my knowledge and belief true, correct and complete. Commonwealth of Pennsylvania-Notary Seal Sworn to and subscribed efore me this MEGAN ORRIS-Notary Public S5 Cumberla2ia ndn. ounty u,i, day of My Commissionn 14, 023 V7 f1, • Commission Number 12600 Signature of Perso,pubmitting Report %.44a-4../L__a2-1„. . 5/.061‘ `) 6/ Signature Printed Name My commission expires �l - /'/r €2. 3 11-1 325--4-546- MO. DAY YR. Area Code Daytime Telephone Number PART II If this is a report of a Candidate's Authorized Committee, candidate shall 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.1. 1333, No. 320) as amended. Sworn to and subscribed before me this day of 20 Signature of Candidate Signature Printed Name My commission expires MO. DAY YR. Area Code Daytime Telephone Number Department of State • Bureau of Commissions, Elections and Legislation 303 North Office Building • Harrisburg, PA 17120-0029 • (717) 787-5280 DSEB-502 (7-99) SCHEDULE II PAGE OF 3 IN-KIND CONTRIBUTIONS AND VALUABLE THINGS RECEIVED USE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS DURING THE REPORTING PERIOD. • Detailed Summary Page Name of Filing Committeeor CIC R�ER 1 or Candidate ,�^ Reporting Period S M OSFrom 0510/1100 To 06/10/1°19 1. 'UN ITEM IZED.IN-KIND CONTRIBUTIONS RECEIVED - VALUE OF $50.00 OR LESS PER CONTRIBUTOR TOTAL for the Reporting Period (1) $ 2. IN-KIND CONTRIBUTIONS RECEIVED - VALUE OF $50.01 TO $250.00 (FROM PART F} • TOTAL for the Reporting Period (2) I $ O • 3. , IN-KIND CONTRIBUTION RECEIVED - VALUE OVER $250.00 (FROM PART G) TOTAL for the Reporting Period (3) $ S$1 V., Ot TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING PERIOD (Add and enter amount totals from Boxes 1, 2, $ and 3; also enter on Page 1, Report Cover Page. Item F.) • • DSEB-502 (7-99) SCHEDULE II PAGE 3 OF 3 - PART G IN-KIND CONTRIBUTIONS RECEIVED VALUE OVER $250.00 Name of Filings 1Committee ori Candidate Reporting Period // p Sk ct 5)%1 !-I.CP fC1 From 05101(1-01,4 To _l7 "..Qfl DATE AMOUNT Full Name of ContributorSMO . DAY ' YEAR t. - C-U.V4e AA.r a cou.ht- Rip lA.bli(Aw - ,t e 05 15 7,a19 $ ”1 %•o t Mailing Address !MO. `. DAY,'. YEAR 225'0 KA I L Yo i u w. (Ata. - $ City State Zip Code (Plus 4) -11/10, DAY =`' YEAR $ C-holct. VA 1'1025 - t Employer of Contributor Occupation Employer Mailing Address/Principal Place of Business Description of Contribution tAM%(.thg `fard S'Afts,Poo4 or--Ay-Ys)e ce400t ./ Full Name of Contributor ,`'"MO. �DAY`" " YEAR:. $ Mailing Address .. ' MO a DAY;<> YEAR''' $ City State Zip Code (Plus 4) "MO ,MAY . ' YEARS Employer of Contributor Occupation Employer Mailing Address/Principal Place of Business Description of Contribution Full Name of Contributor "MO..l• DAY " YEAR:, $ Mailing Address 11/10.:,,a = DAY' YEAR `: $ City State Zip Code (Plus 4) <'MO : ,:•DAY .' YEAR,' $ Employer of Contributor Occupation Employer Mailing Address/Principal Place of Business Description of Contribution Full Name of Contributor "'wMO. DAY,'= YEAR-'' $ Mailing Address "'MO -,,DAY,", :'YEAR'`` $ City State Zip Code (Plus 4) „MO. ` DAY. '.i ;YEAR r'; $ Employer of Contributor Occupation Employer Mailing Address/Principal Place of Business Description of Contribution Full Name of Contributor : -MO. .. DAY"-' ;YEAR,i $ Mailing Address `r''MO.,, DAY.. YEAR-' $ - CityState Zip Code (Plus 4) MQ. "i ":"DAY :YEAR `s $ Employer of Contributor Occupation Employer Mailing Address/Principal Place of Business Description of Contribution PAGE TOTAL Enter Grand Total of Part G on Schedule II, In-Kind Contributions Detailed $ Summary Page, Section 3. DSEB-502 (7-99)