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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 lb, Report1. 2. 3.
Number: Q4PR99926 Filed By: . CANDIDATE COMMITTEE ` x LOBBYIST
Name of Filing Committee,Candidate or Lobbyist:Reelect D.A. Skip Ebert
Street Address:
P.O.Box 1584
City: Camp Hill State: PA Zip Code: 17001-
TYPE OF 6TH TUESDAY 1. 2ND FRIDAY . 2. `30 DAY . 3. AMENDMENT `
REPORT PRE-PRIMARY PRE-PRIMARY . , POST PRIMARY REPORT? YES NO x
6TH TUESDAY ` 4. . 2ND FRIDAY.' 5, 30 DAY 6. TERMINATION
(place X to PRE-ELECTION PREELECTION POST ELECTION x REPORT? YE$; NO X
the right of ,
report type) ANNUAL 7. YEAR FILING METHOD
REPORT 2019 �� ( b/ )CHECK ONE , PAPER X DISKETTE
Name of Office Sought by Candidate:" DATE OF ELECTION District Office Party County
'? MO. DAY' YEAR Number Code Code Code
11 05 2019 21 REP 21
(SEE INSTRUCTIONS FOR CODES)
• MO. DAY YEAR MO. DAY YEAR FOR OFF!ICE USE ONLY
Summary of Receipts 10, 10 22 2019 11 25 2019 C) a
and Expenditures from: To ;c�
ET; c i
A. Amount Brought Forward From Last Report $ 25,677.13
B. Total Monetary Contributions and Receipts(From Schedule I) $ 0.00 ?>• 1
C71
C. Total Funds Available(Sum of Lines A and B) $ 25,677.13
D. Total Expenditures(From Schedule III) $ 12 527.19 C) =
E. Ending Cash Balance(Subtract Line D from Line C) $ 13,149.94N
?. O
F. Value of In-Kind Contributions Received(From Schedule II) $ 10,703.79 —< to
G. Unpaid Debts and Obligations(From Schedule IV) $ 81,000.00
I AFFIDAVIT SECTION
PART I —If this is a Committee report,treasurer sign here. If this is a' Candidate report,candidate sign here.
I swear(or affirm)that this report,including th'e attached schedules,on paper or computer diskette,are to the best of my knowledge and belief true,correct and complete.
Sworn to and subscribed before me this t
3 day of )eet4Yt.,.LA1 !Cnmmnnwaalfh of Pen .}'fl:- .otaryi.eal Signature of Person Submitting Report
Lisa M.Tosheff,Notary Public _
17Yi Dauphin County _c�c/./.....ie T Qr
Signature M)-cumnriaEiofrt,tpires May 1,20 / printed Na �
Cor�;i�,1fission number 1290393
My commission expires ember,PRI ania Association of No :ries 7/, 7/2_"f' i'77
MO. DAY YR. Area Code Daytime Telephone Number
PART II —If this is a report of a Candidate's Authorized Comthittee,'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.L.1333.No.320)as
amended. 4kL
Sworn to and subscribed before me this I
lot
Z day of �L,....+•..4.4..✓' 20 /7 Signature Candidate
`7� tea! K L E b�.rr 1"
Signature la..•.-,:t
9 ;g- Printed Name !! 1 ,1�
�I ,r :a 'of pant ' ry PLOW `7 1 '.1 d �P W 1 6
My commission expires t/g *:%„ . _ .� l J
MO. DAbpug:- Da•ion Coun' 06 „ Area Code Daytime Telephone Number
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DSEB-502(7-99) De l .• g- t..: e•Bureau of Commissions,Elections and Legislation
• h Office Building • Harrisburg,PA 17120-0029 • (717)787-5280
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SCHEDULE I Page 2 of `✓
CONTRIBUTIONS AND RECEIPTS
Detailed Summary Page
Name of Filing Committee or Candidate Reporting Period
Reelect D.A. Skip Ebert
From 10/22/2019 To 11/25/2019
1. UNITEMIZED CONTRIBUTIONS AND RECEIPTS—$50.00 OR LESS PER CONTRIBUTOR
TOTAL for the Reporting Period 1100 (1) $ 0.00
2. CONTRIBUTIONS $50.01 TO $250.00 (FROM PART A AND PART B)
Contributions Received from Political Committees(Part A) $ 0.00
All Other Contributions (Part B) $ 0.00
TOTAL for the Reporting Period ► (2) $ 0.00
3. CONTRIBUTIONS OVER$250.00 (FROM PART C AND PART D)
Contributions Received from P-olitical Committees (Part C) $ 0.00
All Other Contributions (Part D), $ 0.00
TOTAL for the Reporting Period II10, (3) $ 0.00
4. OTHER RECEIPTS—REFUNDS, INTEREST EARNED, RETURNED CHECKS, ETC. (FROM PART E)
TOTAL for the Reporting Period O. (4) $ 0.00
TOTAL MONETARY CONTRIBUTIONS AND RECEIPTS DURING
THIS REPORTING PERIOD :Odd and enter amount totals from Boxes $ 0.00
1, 2, 3 and 4;also enter this amount on Page 1, Report Cover Page, Item B.)
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•DSEB-502(7-99) •
PART A Page 3 of 11--
CONTRIBUTIONS
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CONTRIBUTIONS RECEIVED FROM POLITICAL COMMITTEES
• $50.01 TO $250.00
Use this Part to itemize only contributions received from political committees
with an aggregate value from $50.01 to $250.00 in the reporting period.
Name of Filing Committee or Candidate Reporting Period
Reelect D.A. Skip Ebert
From 10/22/2019 To 11/25/2019
DATE AMOUNT
PAGE TOTAL
Enter Grand Total of Part A on Schedule I, Detailed Summary Page, Section 2. $ 0.00
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DSEB-502(7-99)
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PART B Page 21 of
ALL OTHER CONTRIBUTIONS
$50.01 TO$250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to$250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Name of Filing Committee or Candidate Reporting Period
Reelect D.A. Skip Ebert
From 10/22/2019 To 11/25/2019
DATE AMOUNT
PAGE TOTAL
Enter Grand Total of Part B on Schedule I, Detailed Summary Page, Section 2. $ 0.00
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PART C Page 5 of lit
CONTRIBUTIONS RECEIVED FROM POLITICAL COMMITTEES
OVER$250.00
Use this Part to itemize only contributions received from political committees
with an aggregate value over$250.00 in the reporting period.
Name of Filing Committee or Candidate Reporting Period
Reelect D.A. Skip Ebert
From 10/22/2019 To 11/25/2019
DATE AMOUNT
i
PAGE TOTAL
Enter Grand Total of Part C on Schedule I, Detailed Summary Page, Section 3. $ 0.00
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PART D Page 4- of
ALL OTHER CONTRIBUTIONS
OVER$250.00
Use this Part to itemize all other contributions with an aggregate value of
over$250.00 in the reporting period.
(Exclude contributions from political committees reported in Part C.)
Name of Filing Committee or Candidate Reporting Period
Reelect D.A. Skip Ebert
From 10/22/2019 To 11/25/2019
DATE AMOUNT
PAGE TOTAL
Enter Grand Total of Part D on Schedule I, Detailed Summary Page, Section 3. $ 0.00
DSEB-502(7-99)
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OTHER RECEIPTS
REFUNDS, INTEREST INCOME, RETURNED CHECKS, ETC.
Use this Part to report refunds received, interest earned, returned checks and
prior expenditures that were returned to the filer.
Name of Filing Committee or Candidate Reporting Period
Reelect D.A. Skip Ebert
From 10/22/2019 To 11/25/2019
PAGE TOTAL
Enter Grand Total of Part E on Schedule I, Detailed Summary Page, Section 4. $ 0.00
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DSEB-502(7-99)
• SCHEDULE II Page of II-
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 Committee or Candidate Reporting Period
Reelect D.A. Skip Ebert
From 10/22/2019 To 11/25/2019
1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED—VALUE OF$50.00 OR LESS PER CONTRIBUTOR
TOTAL for the Reporting Period 1010. (1) $ 0.00
2. IN-KIND CONTRIBUTIONS RECEIVED—VALUE OF $50.01 TO $250.00 (FROM PART F)
TOTAL for the Reporting Period Opp. (2) $ 0.00
3. IN-KIND CONTRIBUTIONSRECEIVED—VALUE OVER$250.00 (FROM PART G)
TOTAL for the Reporting Period 1000 (3) $ 10,703.79
TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS
REPORTING PERIOD (Add and enter amount totals from Boxes 1, 2, 110' $ 10,703.79
and 3;also enter on Page 1, Report Cover Page, Item F.)
DSEB-502(7-99)
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• SCHEDULE II Page 9 of v
PART F
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OF $50.01 TO$250.00
Name of Filing Committee or Candidate Reporting Period
Reelect D.A. Skip Ebert
From 10/22/2019 To 11/25/2019
DATE AMOUNT
Enter Grand Total of Part F on Schedule II, In-Kind Contributions Detailed PAGE TOTAL
Summary Page, Section 2. $ 0.00
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SCHEDULE II Page )G of 12
PART G
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OVER$250.00
Name of Filing Committee or Candidate Reporting Period
Reelect D.A. Skip Ebert
From 10/22/2019 To 11/25/2019
DATE AMOUNT
Full Name of Contributor MO:DAY YEAR $ 3, 517 .21
Republican Party of Pennsylvania 11 04 2019
Mailing Address MO7TAY—YEArr $ 5,530.28
112 State Street 11 04 2019
City State Zip Code(Plus 4) 'MO. DAY` YEAR-
. $ 1, 656.30
Harrisburg PA 17101- 11 04 2019
Employer Name of Contributor Occupation
Employer Mailing Address/Principal Place of Business Description of Contribution
Printing
Enter Grand Total of Part G on Schedule II, In-Kind Contributions Detailed PAGE TOTAL
Summary Page, Section 3. $ 10,703.79
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SCHEDULE III Page d of 1^
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
Reelect D.A. Skip Ebert
From 10/22/2019 To 11/25/2019
To Whom Paid IM01I IIDAV7 L EAR1 Amount
Quantum Communications 10 23 2019 347. 41
Mailing Address Description of Expenditure
123 State St Printing
City State Zip Code(Plus 4)
Harrisburg PA 17101-
To Whom Paid IMO1I IDAI?]I EAR1 Amount
Cumberland County Republican Committee 10 24 2019 7, 000.00
Mailing Address Description of Expenditure
P.O. Box 1495 _ Contribution
City State Zip Code(Plus 4)
Camp Hill PA 17001-
To Whom Paid I001 IEEAR1 Amount
Quantum Communications 10 24 2019 5, 179.78
Mailing Address - Description of Expenditure
123 State St Printing and postage
City - State Zip Code(Plus 4)
Harrisburg PA 17101-
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D. PAGE TOTAL
'REFER TO INSTRUCTIONS FOR EXPENDITURE CODE NUMBERS. $ 12,527.19
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DSEB-502(7-99)
SCHEDULE IV Page Ph. of j-
STATEMENT OF UNPAID DEBTS
Use this Section to itemize all unpaid debts and obligations
: which are outstanding at the end of the reporting period.
Name of Filing Committee or Candidate Reporting Period
Reelect D.A. Skip Ebert
From 10/22/2019 To 11/25/2019
Name of Creditor Outstanding Balance of Debt
Skip Ebert $ $4, 000.00
Mailing Address DATE MO. DAY YEAR
1885 Lisburn Rd DEBT 02 26 2019
Cit INCU RED
Y State Zip Code(Plus 4)
Carlisle PA 17015-
Description of Debt
•
Loan
Name of Creditor Outstanding Balance of Debt
Skip Ebert $ $20, 000.00
Mailing Address DATEMO. DAY YEAR
1885 Lisburn Rd DEBT �' 04 29 2019
Cit INCU RED
Y State Zip Code(Plus 4)
Carlisle PA 17015-
Description of Debt
Loan
Name of Creditor • Outstanding Balance of Debt
Skip Ebert
$ $20,000.00
Mailing Address ... DATE MO. DAY YEAR
1885 Lisburn Rd DEBT `' 05 06 2019
CityINCU RED ,
State Zip Code(Plus 4)
Carlisle PA 17015-
Description of Debt
Loan
Name of Creditor Outstanding Balance of Debt
Skip Ebert $ $17, 000.00
Mailing Address DATE MO. DAY YEAR
1885 Lisburn Rd DEBT INCURED 05 23 2019 •
City State Zip Code(Plus 4)
Carlisle PA 17015-
Description of Debt
Loan
Name of Creditor .. Outstanding Balance of Debt
Skip Ebert $ $20,000.00
Mailing Address DATEMO. DAY YEAR
1885 Lisburn Rd DEBT INC ► 10 20 2019
U RED
City State Zip Code(Plus 4)
Carlisle PA 17015-
Description of Debt
Loan
PAGE TOTAL
Enter Grand Total of Unpaid-Debts on Page 1, Report Cover Page, Item G. $ 81,000.00
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DSEB-502(7-99)