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Home My WebLink AboutCamp Hill Democrats - 2020 30-Day Post-Primary viPennsylvania Department of State Bureau of Campaign Finance&Civic Engagement 210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4) www.dos.pa.govJcampaignfinance • ra-stcampaignfinance@pa.gov Unsworn Statement in Lieu of Sworn Statement for Campaign Finance 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 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 f}/y) " H / ,) 4.106 c, 4-/ S Reporting Cycle Name ❑ Cycle 1 ❑ Cycle 2 (( Cycle 3 ❑ 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 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. 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. ' ZA) Wal-Les Signature of Treasurer, Candidate, or Lobbyist Date • G11,/6 yLo� Printed Name DSEB-502R 4/15/2020 it it it-- Z + Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Filer identification Report Filed By Candidate Committee y Lobbyist i Number (Mark X) ✓If Name of Filing Committee,Candidate or C 4In� II/LG. 4410/110 C'/ �S Street Address , 35 p iwc / &r City &4�' ila- StateV /0t- Zip Code /74// Type of Report(Place x under report type) 1-eh Tuesday 2- 2nd Friday 3-30 Day Post 4-6th Tuesday 5-2nd Friday 6-30 Day Post 7-Annual Special 2nd Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election .Pre-Election Election Pre-Election Post-Election Date Of Election Year Amendment Termination (MM/DD/YYYY) Report Report Summary of Receipts and From Date To Date For Office Use Only Expenditures • Os//1/ZO�0 P6/2Z/Z121 f A.Amount Brought Forward From Last Report $ a 5O 3.5- `-- B.Total Monetary Contributions and Receipts $ ` (From Schedule I) / '&, O D e :•1 C.Total Funds Available $ C::'. .-, (Sum of Lines A and B) 7 70 •.i S - , `-' D.Total Expenditures $ t Cr- (From Schedule III) 6'; /� , - rso E.Ending Cash Balance $ .1:, : OA (Subtract Line D from Line C) a /%J c., .-0 4. F.Value of In-Kind Contributions Received $ C"7 (From Schedule II) C.? 1::)C G.Unpaid Debts and Obligations $ (From Schedule IV) Q I —i Affidavit Section Part 1-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 on paper,is to the best of my knowledge and belief true,correct and complete. Swo n to and subscribed before me this l J,/ ,, /" ^�, day of 20 ( ® 7.f)41.,ik 9 ��.--- fft' 2.) Signature of Person Submitting report w�JJ / ( , J4-y/A/ -. Signature Printed Name My Commission expires 7/7 (p/a- -'yd / MO. DAY YR. Area Code Daytime Telephone Number r%artt 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 I Printed Name My Commission expires _ I MO. DAY YR. Area Code Daytime Telephone Number 45 r, SCHEDULE Contributions and Receipts Detailed Summary Page Filer Identification Number d41—fr) 1.Unitemized Contributions and Receipts-$50.00 or Less per Contributor l Total for the reporting period (1) $ 2.Contributions of$50.01 to $250.00(From Part A and Part B) Contributions Received from Political Committees(Part A) $ All Other Contributions(Part B) $ Total for the reporting period (2) $ 3.Contributions Over$250.00(From Part C and Part D) Contributions Received from Political Committees(Part C) $ All Other Contributions(Part D) $ Total for the reporting period (3) $ • 4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) 1 Total for the reporting period (4) $ Total Monetary Contributions and Receipts during this reporting period(Add and $ enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report / p r azf Cover Page,Item B) SCHEDULE III Statement of Expenditures I Filer Identification Number: d&me if ILL )f '1o1 y-✓`3- To Whom Paid Date[MM/DDMYY] $ House# _.._..__... Street Address f ije / Description of Expenditure 33 Ches �v f �S55d City rJQ 'a-iodpt State Tv" Zip Code 3.7/ `S_d Pid ez., /4J fees To Whom Paid I Date[MM/DD/YYYYJ $ House# Street Address Description of Expenditure City - State Zip `Code To Whom Paid Date[MM/ODJYYYY] $ House# Street Address Description of Expenditure City State I Zip i Code To Whom Paid Date[MM/DD/YYYYJ $ House# Street Address Description of Expenditure City State • Zip. Code • To Whom Paid ! Date[MM/DD/YYYYJ $ • House# Street Address Description of Expenditure City State , Zip Code_• To Whom Paid Date[MM/DDJYYYY] $ ' • House# IStreet Address •Description''of'Expenditure City State Zip Code To Whom Paid Date[MMJDO/YYYY] $ House# Street Address Description of Expenditure City State Zip Code 7o Whom Paid Date[MM/DD/YYYYJ $ House# -- .._._._.... .. Street Address Description of Expenditure City State : Zip Code ,