HomeMy WebLinkAboutShultz, Sean - 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 FILEDI. 2. 3.
NUMBER
ON BEHALF OF ' CAN�IUATE COMMITTEE_ LOBBYIST
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
S.0..\ 5Lca1-Fz
STREET ADDRESS c�
5-D F Si-rQ-e-i—
CITY
r 1 1.5.
SIC STATE ZIP CODE
�� 17o (3 -
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) T MO. DAY YEAR
1. CArIISIe 3�roc�,t1 a✓nc.l , .P1 t os zot9
6TH TUESDAY
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR _-- - -
2ND FRIDAY 2' DATES OF
PRE-PRIMARY PERIOD NG 66/ It / lQ (
TO 1 O iI 1?
! C), ry
30 DAY 3' C O
POST-PRIMARY +
CASH BALANCE AT ENDCO
6TH.TUESDAY 4. 171 C-1
OF REPORTING PERIOD: $ _.
PRE-ELECTION TOTAL AMOUNT OF FILER'S ›''
2ND FRIDAY 5. .2(
OUTSTANDING DEBTS OR LIABILITIES
PRE-ELECTION ( AT THE END OF REPORTING PERIOD: $ 0rs'
B. 0
30 DAY C w
AMENDMENT
POST-ELECTION REPORT T YES NO x p
7. -, '.` CO
ANNUAL - TERMINATION
REPORT REPORT? YES NO x
•
AFFIDAVIT SECTION
PART 1-
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 UABIUTIES 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 BEUEF,TRUE CORRECT AND COMPLETE.
SWOR TO AND SU: RI.ED BEFORE ME THIS
✓�.. ���,�,i' 204 SIGNATURE OF PERSON_SUBMITTING REPORT
Comm,Dnweatth jig e i 15R e I QA1,1 �. Jv`J +'r_
. :f •c tie i IF of A
DO.LY M1.1" F. SI E -v ( PRINTED NAME
Cumberland Co 1. I �J i --7 1 �^
Md Comml�5ili K 108611x igH 24 (✓ / / ;5-2--1=I
Commission Number 1193342 MO. DAY YR. 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 1
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
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