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f 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 Report , 1. 2. 3.
Number: Filed By CANDIDATE COMMITTEE LOBBYIST
Name of Filing Committee, Candidate or 1 Lobbyisn � � C.,� � �` nneQ I_ lpfc?', ,.., ct'e S CG d A C
Street Address:
,P- 0- . ).7x I Y32_
City: , State: Zip Code:
(It cl,or,„(....s 60� 6',r- 1705 c -
TYPE OF 6TH TUESDAY 1. 2ND FRIDAY 2. 30 DAY 3. AMENDMENT YES NO
REPORT PRE-PRIMARY PRE-PRIMARY POST PRIMARY REPORT?
6TH TUESDAY 4• 2ND FRIDAY 5. 30 DAY 6. TERMINATION
PRE-ELECTION PRE-ELECTION POST ELECTION ' REPORT? YES NO
(place X to
the right of ANNUAL 7• Z c�
EAR G FILING METHOD 16,
report type) REPORT 2- � I ( ) CHECK ONE PAPER �/, DISKETTE
Name of Office Sought by Candidate: DATE OF ELECTION District Office Party County
14N MO. DAY YEAR
' eci j� J , Number Code Code Code
�f .
(SEE INSTRUCTIONS FOR CODES)
FOR OFFICE USE ONLY r
Summary of Receipts MO. DAY YEAR MO. DAY YEAR
and Expenditures from: ► 1( 2 4 20(ci To Z 3 ( 2011C1
Ds,"
A.
A. Amount Brought Forward From Last Report $ I Q 0 .3° co c_
rrI s,,.
B. Total Monetary Contributions and Receipts (From Schedule I) $ -a" X) ZE
>. tom)
C. Total Funds Available (Sum of Lines A and B) $ 1 C�® 30
D. Total Expenditures (From Schedule III) $ ..e-
0
E. Ending Cash Balance (Subtract Line D from Line C) $ i 01,0,30c: L-
--I
F. Value of In-Kind Contributions Received (From Schedule II) $ -e- -< VD
G. Unpaid Debts and Obligations (From Schedule IV) $ ,.0qoo,
d
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 attached schedules, on paper or computer diskette, are to the best of my knowledge and belief true,
correct and complete. C°
Sworn to and subscribed before me this mmO°wPelth
31 S't' MFc,NOR fes,,,, — ..
day of . C(. 4 Al C , R/S20�d.
(� • mis �idn racy° N°t Signature of Person� rS/,,milting Report
��� �� C0.47" a�n FkPi es°��ty ubii° 'Sp �G " 5 i 1 Gt/ -eciJe e�Y
Signature 'et.lj6°4,20IJ y Printed Name
My commission expires
of-an-. 111 .paw °66 -q--i. �- 3 J-- `�-
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.L. 1333, No. 320) as amended.
Sworn to and subscribed before me this
day of 20
Signature of Candidate
Signature Printed Name
My commission expires
MO. DAY YR. Area Code Daytime Telephone Number
Department of State • Bureau of Commissions, Elections and Legislation . a
303 North Office Building • Harrisburg, PA 17120-0029 • (717) 787-5280
DSEB-502 (7-99)