HomeMy WebLinkAboutShakespeare, Tara - 2020 2nd Friday Pre-Primary Pennsylvania Department of State
Bureau of Campaign Finance&Civic Engagement
210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4)
www.dos.pa.gov/campaignfinance • ra-stcampaignfinancePpa.gov
Unsworn Statement in Lieu of Sworn Statement for
Campaign Finance Statements
Note: Per the temporary waiver granted by the Governor on April 6, 2020, Campaign Finance
Reports (form DSEB-502), Campaign Finance Statements In lieu of full reports (form DSEB-503),
and Independent Expenditure Reports (form DSEB-505) need not be notarized. (See Temporary
Waiver of Notarization Requirement for Campaign Finance Reports and Statements). Instead, the
filer may file with each report or statement the corresponding version of this form signed by the
required individual(s). This particular form is to be used only for Campaign Finance Reports and
only so long as the waiver referenced above is in effect. This form must be signed by hand or by
typing your name where a signature is required. If you type your name, you understand that's
your electronic signature and will constitute the legal equivalent of your signature on this form.
Name of Filing Committee, Candidate, or Lobbyist
Mcg-f& S hCike-s
Reporting Cycle Name
El Cycle 1 m Cycle 2 ❑ Cycle 3 El Cycle 9
6th Tuesday Pre-Primary 2nd Friday Pre-Primary 30 Day Post Primary 30-Day Post Special
Election
Part I - If this form is submitted with a statement in lieu of full report by a political
committee, the treasurer must sign here. If this form is submitted with a statement in lieu
of full report by a candidate, the candidate must sign here. If this form is submitted with
a statement in lieu of full report by a contributing lobbyist, the lobbyist must sign here.
By signing or typing my name below, I hereby declare under the penalty of perjury,
pursuant to 18 Pa.C.S. § 4904, that the information contained in the accompanying
Campaign Finance Report is to the best of my knowledge and belief true, correct and
complete.
7.144A• 5/21/2020
Signature of Treasurer, Candidate, or Lobbyist Date
Tara Shakespeare
Printed Name
DSEB-503S
4/15/2020
Pennsylvania Department of State
Bureau of Campaign Finance&Civic Engagement
210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4)
www.dos.pa.gov/campaignfinance • ra-stcampaignfinance(Wpa.gov
Part II - If this is submitted with a statement in lieu of full report by a Candidate's
Authorized Committee, candidate sign here.
By signing or typing my name below, I hereby declare under the penalty of perjury,
pursuant to 18 Pa.C.S. § 4904, that the information contained in the accompanying
Campaign Finance Report is to the best of my knowledge and belief true, correct and
complete.
5/21/2020
Signature of Candidate Date
Printed Name
DSEB-503S
4/15/2020
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 202000440 REPORT FILED ' CANDIDATE x COMMITTEE LOBBYIST 3.
NUMBER ON BEHALF Of
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
Tara Shakespeare
STREET ADDRESS
1813 Letchworth Drive
CITY STATE ZIP CODE
Camp Hill PA 17011
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO. DAY YEAR
1.
6TH TUESDAY - - - 11 X3,/2020
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR - ------
2ND FRIDAY 2. DATES OF
PRE-PRIMARY X PERIOD REPORTING 01 01 20 TO 05, 18 20
30'DAY 3'
POST-PRIMARY
CASH BALANCE AT END
6TH TUESDAY 4' OF REPORTING PERIOD: $ 0 00
PRE-ELECTION
TOTAL AMOUNT OF FILER'S
5. OUTSTANDING DEBTS OR LIABILITIES
PD FRIDAY AT THE END OF REPORTING PERIOD: $ 0.00
PRE-ELECTION
6.
30 DAY
POST-ELECTION AMENDMENT YES NO
REPORT?
7.
ANNUAL TERMINATION v
REPORT 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 UABIUTIES 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 AND BE F,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS Tau
DAY OF 20 SIGNATURE OF PERSON SUBMITTING REPORT
Tarn ShakPceare
SIGNATURE PRINTED NAME
MY COMMISSION EXPIRES 717-877-0826
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