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Commonwealthof Pennsylvania-Campaign Finance Report
(Note:This report must be clear and legible.It should be typed)
Filer Identification Report Filed By Candidate Committee gm 1 Lobbyist Ill
Number c: / (Mark X)
Name of Filing Committee,Candidate or ri
Lobbyist (...-e il 4r4 i Cukr, tteletaid Pe iti de-t-a 1 s
Street Address 4,.
-12
CP4) re• Di-.
, City -1' State Zip Code
Ad te-ilef II;es bur, — F',4
4,- 1 '7.0 g 5-
Type of Report(Place x under report type)
1-6th Tuesday 2- 2"d Friday 3-30 Day Post 4-6thTuesday 5-rd Friday 6-30 Day Post 7-Annual Special es Friday Special 30 Day
Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election
x —1
Date Of Election Year Amendment r— Termination
- (MWED/YYYY) / i/05 .3, 0 /5 Report I Report
Summary of Receipts and From Date To Date For Office Use Only
Expenditures
/o 1,3.611 f:2 3! ,9-011
ii
A.Amount Brought Forward From Last Report
3 2 Sr
B.Total Monetary Contributions and Receipts
(From Schedule I)
. C.Total Funds Available
(Sum of Lines A and B) S
Mt xx..
3.1
D.Total Expenditures k"--
—
(From Schedule III) . OID )›.
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E.Ending Cash Balance t=
(Subtract line 0 from Line C) 3 g.5.-/O il --0
C'D =
F.Value of In-Kind Contributions Received CD
c F3
-
(From Schedule II)
G.Unpaid Debts and Obligations --I —
(From Schedule IV) I 6 &ID ..< CD
Affidavit Section
Part 1-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 the attached schedules on paper,Is to the best of my knowledge and belief true,correct and complete.
Sworn to and subscribed before me this
, c r
/-7441 day oki/ ,, I '20...
• I Signature of Person Submitting report
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k co CQ*76 R/S•,s;4' d,
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Signature '''Irsio4,404j° 0,,titvic l'.see/ Printed Name
Q'44., 14, ,,
My Commission expireN114.-• /q, 1.,'2OP-3 4602066.23 - 7/7 4,q7- /1z.7/
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 1
/ Signature of Candidate
Signature Printed Name
My Commission expires —
MO. DAY YR. Area Code Daytime Telephone Number
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