HomeMy WebLinkAboutPacker, Alissa - 2019 2nd Friday Pre-Election 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 FILED CANDIDATE I COMMITTEE 2, LOBBYIST
NUMBER ON BEHALF OF ' 3.
NAME OF FILING COMMITTEE,CANDIDAT OR LOBBYIST
iic o. Gaek
STREET ADDRESS
CITY STATE ZIP CODE
H-)Jl rn- !tel / --
TYPE OF REPORTNAME OF OFE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) 1. /) �' % ,j ,/` MO. DAY YEAR
6TH TUESDAY l/�' 1 /O��N/ - / D / GI
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR
2ND FRIDAY 2. DATES OF
PRE-PRIMARY REPORTING TO
PERIOD
('.) Rl
30 DAY 3. = C
CO to
POST-PRIMARY
CO CASH BALANCE AT END (9 -tea
Gm TUESDAY 4. OF REPORTING PERIOD: $ t'—
PRE-ELECTION N
TOTAL AMOUNT OF FILER'S 2
2ND FRIDAY 5, / OUTSTANDING DEBTS OR LIABILITIES / 3-, g c) .•p
PRE-ELECTION 1V AT THE END OF REPORTING PERIOD: $ =
6. 7.7
30 DAY Z,
POST-ELECTION REPORT?AMENDMENT
YES NO
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 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 SUBSCRIBED BEFORE ME THISComm nwealth of Pennsylvania-Notary Sig/
/� Jessica C.Smith.Not - ! !�,
c21"/DAY OF v * /- 209lberland County- SIS R 0 P RSON SUBM . ING REPORT
, �� �y / My Commission a xPlm: September 27,2021,1 /( S--<-, f d_e/
I- Commission number 1320098 PRINTED NAME
SIGNATURE
MY MMISSION EXPIRES O/ 27 ,2007/ �?"0 - a,: -c-C1 .-(/Q 5
MO. DAY YR. AREA CODE DAYTIME TEL HONE 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 • (717)787-5280