HomeMy WebLinkAboutFriends of Tara Shakespeare, 6/5/20 - 2020 24 Hour Report 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-stcamnalgnfinancelapaAny
Unsworn Statement in Lieu of Sworn Statement for
Independent Expenditure Reports
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 Independent Expenditure
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.
Nam'e';:ofPerson Filing Report
rric eV1.cLS oc 'Fara- S - Js pn..ctxe_,
arne ofyOrganization (if applicable)
• �r ` ,� cle Name
❑ Cycle 1 v Cycle 2 ❑ Cycle 3 0 Cycle 9
6th Tuesday Pre-Primary 2"d Friday Pre-Primary 30 Day Post Primary 30-Day Post Special
Election
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
Independent Expenditure Report is to the best of my knowledge and belief true,correct
and complete.
/5/0/19t
Signature of Filer Date
SSI ('Z 9222.
Printed Name
DSEB-5051
4/15/2020
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Name of Filing Committee or Candidate Filer Identification Number
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DATE RECEIVED
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Full Name of Contributor 01414140.036MOSIWatir
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Full Name of Contributor .i rN% ' '+E"'.5 ;''}
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Name of Person Submitting Report: SS Date of Report: 6/15/70n
Contact Phone Number: 70 6./ q aZ 1 a"7
Email Address: i INSCW1 77 te 9 , am