HomeMy WebLinkAboutBosha for State Senate - 2020 30-Day Post-Primary ley 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@pa.gov
Unsworn Statement in Lieu of Sworn Statement for
Campaign Finance Reports
Note: Per Act 2020-15, which was signed into law on April 20, 2020 and allows for unsworn
declarations, 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. 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. This form must be signed by hand where a signature is required.
Name of Filing Committee, Candidate, or Lobbyist
Bosha for State Senate
Reporting Cycle Name
❑ Cycle 1 ❑ Cycle 2 ❑✓ Cycle 3 ❑ Cycle 4 ❑ Cycle 5
6th Tuesday 2"d Friday 30 Day 6th Tuesday 2"d Friday
Pre-Election
Pre-Primary Pre-Primary Post Primary Pre-Election
❑ Cycle 6 ❑ Cycle 7 ❑ Cycle 8 ❑ Cycle 9
30 Day Post-Election
Annual Report 2"d Friday Pre-Special Election 30 Day Post-Special Election
Part I - If this form is submitted with a Committee report, the treasurer must sign here. If
this form is submitted with a Candidate report, the candidate must sign here. If this report
is submitted with a report by a contributing lobbyist, the lobbyist must sign here.
I declare under penalty of perjury under the law of the Commonwealth of Pennsylvania
that the foregoing is true and correct.
410;,,I4 06/22/2020
Signature o Treasurer, Candidate, or Lobbyist Date (DD/MM/YYYY)
Sarah Yerger Camp Hill, PA
Printed Name Location (City/State/Country)
DSEB-502R
Updated 6/24/2020
Ictilt3.7
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@pa.gov
Part II-If this form is submitted with a report by a Candidate's Authorized Committee, the
candidate must sign here.
$declare under penalty of perjury under the law of the Commonwealth of Pennsylvania
that the foregoing is true and correct.
fr4ii4PJvt ) C / 06 /a20) 0
Signature of Treasurer, Candidate,or Lobbyist Date(DD/MM/YYYY)
H,(( / /
Printed Name Location (City/State/Country)
DSEB-502R
Updated 6/23/2020
Commonwealth of Pennsylvania I111II011111 11 11111111II
Campaign Finance Report 327976
(NOTE:This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification 20200019 Report CANDIDATE COMMITTEELOBBYIST
Number: I Filed By:
Name of Filing Committee,Candidate or Lobbyist: BOSHA FOR STATE SENATE
Street Address: PO BOX 12
City: CAMP HILL 'State: PA (Zip Code: 17011
TYPE OF 6TH TUESDAY 1. 2ND FRIDAY PRE- 2. 30 DAY POST- 3.X AMENDMENT Yes No vi
REPORT PRE-PRIMARY PRIMARY PRIMARY REPORT?
(place X to 6TH TUESDAY 4. 2ND FRIDAY PRE- .5. 30 DAY POST- 6. TERMINATION Yes No
PRE-ELECTION ELECTION ELECTION REPORT?
the right of
report type) ANNUAL 7. Year 2020 FILING METHOD PAPER DISKETTE
REPORT ( )CHECK ONE
ict Office Cou
Name of Office Sought by Candidate: DATE OF ELECTION NNumber Code Code Code
MO DAY YEAR 31 STS DEM 21
SENATOR IN THE GENERAL ASSEMBLY
11 3 2020 (SEE INSTRUCTIONS FOR CODES)
Summary of Receipts and MO DAY YEAR MO DAY YEAR FOR OFFICE USE ONLY
Expenditures from: 5 19 2020 TO 6 22 2020
A.Amount Brought Forward From Last Report $ 150.79
B.Total Monetary Contributions And Receipts(From Schedule I) $ 50.00
C.Total Funds Available(Sum Of Lines A and B) $ 200.79
D.Total Expenditures(From Schedule III) $ 200.79
E.Ending Cash Balance(Subtract Line D From Line C) $ 0.00
F.Value Of In-Kind Contributions Received(From Schedule II) $ 0.00
G.Unpaid Debts And Obligations(From Schedule IV) $ 0.00
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 the attached schedules filed on paper or by el- the best of my knowledge and belief,true,
correct and complete. �, `
Sworn to and subscribed before me this Person Submitting Report
day of 20 Sarah Yerger
Printed Name
sarah.yerger@comcast.net
Signature Email
My Commission Expires 717.856.1388
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. D.01.02 P2.
Sworn to and subscribed before me this, U
Signature of Candidate
day of 20 .�v 11,1 J), Dose
{ Printed Name
_,i1)AAA �P.A-ti. a },c.(JG. CO•1
Signature
My Commission Expires ,S?(7 Email Li r( 3 4 87
MO DAY YR Area Code Daytime Telephone ne Number(
6/23/2020 12:56:50 PM
PAGE 1
Commonwealth of Pennsylvania MEI11111II111111111111I1111CI11111111I1111111111
Campaign Finance Report 327976
(NOTE:This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification 20200019 Report
CANDIDATE COMMITTEE LOBBYIST
Number: Filed By :
Name of Filing Committee,Candidate or Lobbyist: BOSHA FOR STATE SENATE
Street Address: PO BOX 12
City: CAMP HILL State: PA Zip Code: 17011
TYPE OF 6TH TUESDAY 1. 2ND FRIDAY PRE- 2. 30 DAY POST- 3.X AMENDMENT Yes No
REPORT PRE-PRIMARY PRIMARY PRIMARY REPORT?
6TH TUESDAY 4. 2ND FRIDAY PRE- 5. 30 DAY POST- 6. TERMINATION Yes No
(place X to PRE-ELECTION ELECTION ELECTION REPORT?
the right of ,
report type) ANNUAL REPORT 7. Year 2020 FILING METHOD PAPER V DISKETTE
( )CHECK ONE
Name of Office Sought byCandidate: DATE OF ELECTION District Office Party Code County
9 Number Code Code
MO DAY YEAR 31 STS DEM 21
SENATOR IN THE GENERAL ASSEMBLY
11 3 2020 (SEE INSTRUCTIONS FOR CODES)
Summary of Receipts and MO DAY YEAR MO DAY YEAR FOR OFFICE USE ONLY
Expenditures from: 5 19 2020 TO
6 22 2020
A.Amount Brought Forward From Last Report $ 150.79
B.Total Monetary Contributions And Receipts(From Schedule I) $ 50.00
C.Total Funds Available(Sum Of Lines A and B) $ 200.79
D.Total Expenditures(From Schedule III) $ 200.79
E.Ending Cash Balance(Subtract Line D From Line C) $ 0.00
F.Value Of In-Kind Contributions Received(From Schedule II) $ 0.00
G.Unpaid Debts And Obligations(From Schedule IV) $ 0.00
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 the attached schedules filed on paper or by electronic medium,are to the best of my knowledge and belief,true
correct and complete.
Sworn to and subscribed before me this Signature of Person Submitting Report
day of 20
Printed Name
Signature
My Commission Expires Email
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 3une 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 Email
MO DAY YR Area Code Daytime Telephone Number
6/23/2020 1:17:04 PM
PAGE 2
SCHEDULE I
CONTRIBUTIONS AND RECEIPTS
Detailed Summary Page
Name of Filing Committee or Candidate Reporting Period
BOSHA FOR STATE SENATE From: 5/19/2020 To: 6/22/2020
1.Unitemized Contributions Received-$50.00 or Less Per Contributor
TOTAL for the Reporting Period (1) $ 50.00
2.Contributions Received- $50.01 To$250.00(From Part A and Part B)
Contributions Received From Political Committees(Part A) $ 0.00
All Other Contributions (Part B) $ 0.00
TOTAL for the Reporting Period (2) $ 0.00
3.Contributions Received Over$250.00(From Part C and Part D)
Contributions Received From Political Committees(Part C) $ 0.00
All Other Contributions (Part D) $ 0.00
TOTAL for the Reporting Period (3) $ 0.00
4.Other Receipts,Refunds,Interest Earned,Returned Checks, Etc.(From Part E)
TOTAL for the Reporting Period (4) $ 0.00
Total Monetary Contributions and Receipts During this Reporting Period(Add and enter amount 50.00
totals from Boxes 1,2,3 and 4;also enter this amount on Pagel,Report Cover Page,Item B.)
6/23/2020 1:17:04 PM
PAGE 3
PART A
CONTRIBUTIONS RECEIVED FROM POLITICAL COMMITTEES
$50.01 TO $250.00
Use this Part to itemize only contributions received from political committees
with an aggregate value from $50.01 to $250.00 in the reporting period.
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributing Committee
MO DAY YEAR
Mailing Address
$ 0.00
City State Zip Code(Plus 4)
PAGE TOTAL
Enter Grand Total of Part A on Schedule I, Detailed Summary Page,Section 2. $ 0.00
6/23/2020 1:17:04 PM
PAGE 4
PART B
ALL OTHER CONTRIBUTIONS
$50.01 TO $250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to $250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A)
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributor
MO DAY YEAR
Mailing Address
$ 0.00
City State Zip Code(Plus 4)
PAGE TOTAL
Enter Grand Total of Part A on Schedule I, Detailed Summary Page, Section 2. $ 0.00
6/23/2020 1:17:04 PM
PAGE 5
PART C
Contributions Received From Political Committees
OVER $250.00
Use this Part to itemize only contributions received from Political committees
with an aggregate value from Over $250.00 in the reporting period.
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributing Committee
MO DAY YEAR
Mailing Address
$ 0.00
City State Zip Code(Plus 4)
PAGE TOTAL
Enter Grand Total of Part C on Schedule I, Detailed Summary Page, Section 3.
$ 0.00
6/23/2020 1:17:04 PM
PAGE 6
PART D
ALL OTHER CONTRIBUTIONS
OVER $250.00
Use this Part to itemize all other contributions with an aggregate value of
over $250.00 in the reporting period.
(Exclude contributions from political committees reported in Part C.)
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributor
MO DAY YEAR
Mailing
Address $ 0.00
City State Zip Code(Plus 4)
Employer Name Occupation
Employer Mailing Address/Principal Place of City State Zip Code(Plus 4)
Business
PAGE TOTAL
Enter Grand Total of Part C on Schedule I, Detailed Summary Page, Section 3.
$ 0.00
6/23/2020 1:17:04 PM
PAGE 7
PART E
OTHER RECEIPTS
REFUNDS, INTEREST INCOME, RETURNED CHECKS, ETC.
Use this Part to report refunds received, interest earned, returned checks and
prior expenditures that were returned to the filer.
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name
MO DAY YEAR
Mailing Address $ 0.00
City State Zip Code(Plus 4)
Receipt Description
PAGE TOTAL
Enter Grand Total of Part E on Schedule I, Detailed Summary Page, Section 4.
$ 0.00
6/23/2020 1:17:04 PM
PAGE 8
SCHEDULE II
IN-KIND CONTRIBUTIONS AND VALUABLE THINGS RECEIVED
USE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS
DURING THE REPORTING PERIOD.
Detailed Summary Page
Name of Filing Committee or Candidate Reporting Period
BOSHA FOR STATE SENATE From: 5/19/2020 To: 6/22/2020
1.UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR
TOTAL for the Reporting Period (1) $ 0.00
2.IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F)
TOTAL for the Reporting Period (2) $ 0.00
3.IN-KIND CONTRIBUTION RECIEVED-VALUE OVER$250.00(FROM PART G)
TOTAL for the Reporting Period (3) $ 0.00
TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING PERIOD(Add and enter $ 0.00
amount totals from Boxes 1,2,and 3;also enter on Page 1,Reports Cover Page,Item F.)
6/23/2020 1:17:04 PM
PAGE 9
SCHEDULE II
PART F
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OF $50.01 TO $250.00
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributor
MO DAY YEAR
Mailing Address $ 0.00
City State Zip Code(Plus 4)
Description of Contribution:
Enter Grand Total of Part F on Schedule II, In-Kind Contributions Detailed Summary Page, PAGE TOTAL
Section 2.
$ 0.00
6/23/2020 1:17:04 PM
PAGE 10
SCHEDULE II
PART G
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OVER $250.00
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributor
MO DAY YEAR
Mailing Address
$ 0.00
City State Zip Code(Plus 4)
Employer of Contributor Occupation
Employer Mailing Address/Principal Place of City State Zip Code(Plus Description of Contribution
Business 4)
Enter Grand Total of Part G on Schedule II,In-Kind Contributions Detailed PAGE TOTAL
Summary Page, Section 3. 0.00
6/23/2020 1:17:04 PM
PAGE 11
SCHEDULE III
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
BOSHA FOR STATE SENATE From 5/19/2020 To: 6/22/2020
DATE AMOUNT
To Whom Paid
ActBlue MO DAY YEAR
Mailing Address PO Box 441146 6 1 2020
$ 0.83
City Somerville State Zip Code(Plus 4) Description of Expenditure
MA 02144 Service Fee
To Whom Paid
ActBlue MO DAY YEAR
Mailing Address PO Box 441146 6 1 2020
$ 2.22
City Somerville State Zip Code(Plus 4) Description of Expenditure
MA 02144 Service Fee
To Whom Paid
MO DAY YEAR
East Pennsboro Democratic Club
Mailing Address 5 Gale Circle 6 12 2020
$ 197.74
City Camp Hill State Zip Code(Plus 4) Description of Expenditure
PA 17011 Contribution
PAGE TOTAL
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D.
$ 200.79
6/23/2020 1:17:04 PM