HomeMy WebLinkAboutMiller, Nicole - 2019 30-Day Post 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.
FILERIDENTIFICATION 101, REPORTREPORT FILED ' CANDIDATE I X COMMITTEE z LOBBYIST 3.
NUMB
NUMBER ON BEHALF OF /�
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
1\) o \. . MiI)rx
STREET ADDRESS
- .=6 3a Car r la T }�-o u s e Qt rSTATECITY ZIP CODE
Ccz m .1-1;I 1 Po 11011 —
TYPE OF PORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) cuArt N I C/'e� \ I D I J ' A '
YEAR
6.n4 TUESDAY
,' SGhpp1 1)1 yr%yIri(`
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR
2ND FRIDAY 2. REPORTIDATES OF
PRE-PRIMARY PERIOD NG /0 eXt )1 TO
30 DAY
3. a5 iq
POST-PRIMARY q
CASH BALANCE AT END r�
6TH TUESDAY 4. OF REPORTING PERIOD: $ ,
rri
PRE-ELECTION m
TOTAL AMOUNT OF FILER'S 3D
2ND PRIORY 5. OUTSTANDING DEBTS OR LIABILITIES
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ kr a
30 DAY
6. 0 _=
AMENDMENT REPORT? YES NO '7"
T -
ANNUAL TERMINATION YES NO ,�
REPORT REPORT?
x
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 _.bbyist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR D•BURSk S OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS(5250.00)A, THIS R ,TO THE BEST OF KNOWLEDGE AND BELIEF,TRUE CORRECT AND COMPLETE.
p /h
SWORN TO AND SUBSCRIBED BEFORE ME THIS �Iy`o C~O 10
c,•0 N
DAY OF C ,3 .. "yid SIGNATURE OF PERSON SUB ITTWG REPORT
/aC�yA ~ 60 t I I�l( ( 1 ,-,
LIj d/
ATURE G/ a 0a3 64p661p13
MY COMMISSION EXPIRES 11 PLi 2ED I NAME
SIG 3 0 ST)
'�T N-� `` /
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
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