HomeMy WebLinkAboutMiller, Nicole - 2019 Annual Report 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 10. REPORT FILED 2.
10, CANDIDATE COMMRTEELOBBYIST
NUMBER ON BEHALF OF
NAMEF FILING COMMITTEE,CANDIDATE OR LOBBYIST
NIC°t-c KI It "C✓
STREET ADDRESS
1-4 1 e o CC Cr;?girl-+ D i'I\I LC, A.PT• 20 S'
CITY STATE ZIP CODE
I/rikvin i.(< L2 _ -P 11 n SID -_-._
TYPE OF REPORT NAME OF OFFIC OUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) \ .3 e MO.. ' ' DAY YEAR
-6.TUESOAv 1 17 D 0J b�-0
PRE-PRIMARY FOR OFFICE USE ONLY
.. .. ..MO. DAY YEAR MO. DAY YEAR
2. DATES OF
2ND'FRIDAY
REPORTIPRE-PRIMARY 1. PERIOD NG I 2 k I ci TO 1 I I ,
30 DAY 3. L
POST-PRIMARY',
CASH BALANCE AT END ---0--- C)
,e_i. ESDAY . 4' OF REPORTING PERIOD: $ C
D1T• PRE-ELECTION
TOTAL AMOUNT OF FILER'S rC77Tl
2No' iobY-
5• OUTSTANDING DEBTS OR LIABILITIES
AT THE END OF REPORTING PERIOD: $ t— N
'PRE-ELECTION• .I... >
i9 ,. ' 8. 1 / C
AMENDMENT YES NO I n
30 DAi /
Post ELECTION. ,
REPORt? .
7. C d
ANNUAL .J- TERMINATION REPORT • J� REPORT? YES NO
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 Lobbyist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES 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 A LIEF TRUE.CORRECT AND COMPLETE.
,Commonwealth of Pennsylvania•Notate Seal
SWORN TO AND SUBSCRIBED BEFORE ME THIS AU..4.9.- . vl...,TaryrrN191cG31Ten,Notary Public
�O SIGNA RE OF PERso V SUBMrTTINI�I� and county
�� 2 M lssion expiresAug ust 22,2023
'DAY OF C // 1 / A\ COit Q( (mission number 1355234
� SI/A UREr1 (� PRINTEO MMer,Pennsylvania Association of No aries
MY COMMISSION EXPIRES C./,Y c;: ::9- CT'�-�a3 1 ii �` -(DS
MO. DAY YR. AREA CODE DAYTIME TELEPHONE UMBER
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(Pl. 1333,No.320)AS AMENDED.
SWORN TO AND SUBSCRIBED BEFORE ME THIS •
SIGNATURE OF CANDIDATE
DAY OF 20
r
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