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HomeMy WebLinkAboutFriends of Tara Shakespeare - 2020 30-Day Post-Primary ififPennsylvania Department of State Bureau of Campaign Finance&Civic Engagement 210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4) www.dos.Aa,gov/campaignfinance • ra-stcampaignfinancegsna.gov Unsworn Statement in Lieu of Sworn Statement for Campaign Finance Reports Note: Per Act 2020-15, which was signed into low on April 20, 2020 and allows for unworn 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 Friends of Tara Shakespeare Reporting Cycle Name 0 Cycle 1 ❑ Cycle 2 0 Cycle 3 0 Cycle 4 0 Cycle 5 6th Tuesday 2"d Friday 30 Day 6th Tuesday 2"d Friday Pre-Primary Pre-Primary Post Primary Pre-Election Pre-Election ❑ Cycle 6 0 Cycle 7 ❑ Cycle 8 ❑ Cycle 9 30 Day Post-Election Annual Report 2' 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. 07/02/2020 Signature of Treasurer,Candidate, or Lobbyist Date (DD/MM/YYYY) Jessica Beamesderfer Camp Hill, PA USA Printed Name Location (City/State/Country) DSEB-502R Updated 6/24/2020 Pennsylvania Department of State ji Bureau of Campaign Finance&Civic Engagement irPF 210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4) www.dc s.pa.gov/carnoaianfinance • ra-stcarnpaienfinance@pa.gov Part II-If this form is submitted with a report by a Candidate's Authorized Committee, the candidate must sign here. I declare under penalty of perjury under the law of the Commonwealth of Pennsylvania that the foregoing is true and correct. yak. 07/02/2020 Signature of Treasurer, Candidate, or Lobbyist Date(DD/MM/YYYY) Tara Shakespeare Camp Hill, PA USA Printed Name Location (City/State/Country) • DSEB-502R Updated 6/24/2020 PAGE 1 Commonwealth of Pennsylvania iIHIIIIIllilli lailial111111111113 Campaign Finance Report 328015 (NOTE:This report must be dear and legible.It may be typed or printed In blue or black ink.) Filer Identificationu ,"i ; ?, ; l t Number: 20190382 Filed By: AI. gs1111' 1 ":P"`i's'I•txk rrii• ;","•; ..4--x-'='�: Name of Filing Committee,Candidate or Lobbyist: SHAKESPEARE,TARA FRIENDS OF Street Address: PO BOX 112 City: CAMP HILL State: pA Zip Code: 17001-0112 TYPE OF N' �ti:•:':i!I'; ! 1. '% i4i:,', , 2. y991r•-;t a�:..»7,: :•., 3.X 'MN.:'tri.}^,•'"ii;;Yes No ni, {- i s ••Je;2" n Hr•,�i'r,n i L Lief::"" —s =i -4, •r wil REPORT 2• r:l t _; N@ �i ; i'H. j�l�l @':"4lfif't"I1 l:t m.T7. i • .. i tl�7 �., , t,'= ...1 iN �,'j1...V y'i:�. o..�.;'�;rq 4.. 1': 9'd L•,fi"• 1 4. , 1/ T• .. +.•a is ,{. 11: :. )1. . ill ill itri (place X to -I0 t'it . , i,,y i::." 4� 1: 6. ..,.,: t the right of r'1!�.0•��' ��: .� .•-r.�s'.,,.�..:�,� :�,:i�i' .�,, .a;Y. K�Ih�,`. r :_a: report type) ri,71; +i 7. Year 2020 r=,";i`�:3�t"� '�r' ..•••• it..--•• -•.4'4' '' An t,•-: DISKETTE c:i_.i•',tii• .x� P sfi::_'•�... �#'•(t..;d.i L;.. • _ttkE �n.5.".. �p DATE OF ELECTION ri,-,. County Name of Office Sought by Candidate: f, mbar j 1 (Code TF�,rr n`';}I?iF rii- =p a'�j ftm yr'ir 1 -`.}:'' 21 r, 11 iv-: I'O ,:t,; pit IN9TRUCTIONs FOIL CODES) '1;"ii.. ii: ,. t.,.,., .a- ........1. ..N f:., N tt.:7:."+1 1:�,' 9t H N'{ttr'i(• •` z� 1 1;�t� .a:,y:{•'i it.. ±.- :q . i S F'."'�' Ytt _ ,k Summary of Receipts and ',@�' ' 1=W F•0, ;:' ib s t•k• ;.; :I'�1,idi`iif:;,:,:':;: it'Fts•,a 3._.: ;Al•ai At:: i i rJ, n`l (f1;,! Expenditures from: 5 19 2020 TO 6 I°' Y ,r • A.Amount Brought Forward From Last Report $ 1,iiil, 7,5.•-1• ,L.., B.Total Monetary Contributions And Receipts(From Schedule I) v. Ity.5.08 C.Total Funds Available(Sum Of Lines A and B) =>i $. 1•,`' 12,858.17 D.Total Expenditures(From Schedule III) u rt N 187.19 E.Ending Cash Balance(Subtract Line D From Line C) Y3 12,670.98 F.Value Of In-Kind Contributions Received(Fro:,a-1'•• „u r I" ✓f 0.00 G.Unpaid Debts And Obligations(From Schedule + "',' 7 $ 440.51 ,.tMri'.`•i,. AFFIDAVJ1 SLCTIOPJ I swear(or affirm)that this rep "'n • n•'- hedules filed on paper or by electronic medium,are to the best of my knowledge and belief,true correct and complete. e l :',:,v. , Sworn to and subscribed befo:':,I a this Signature of Person Submitting Report •;.vrr.�f 20 41, Printed Name tn.':1r. 0,1'. ignature My Corn •skin - Email •ifi'i' MO DAY YR Area Code Daytime Telephone Number f e r��.L .g:Ft: rt�.dl til�lyk a n• xu+ {y�,�grkl ��j gy �__E i5���pgg��!{Fai!•-„'`�e,i@i31?��'";;i� �•iE,Gi�»a'P1��Fsti:°�'�FI ..l �* A ...��;��� V:�.�-r•`c:i• }h �n3' "'��eii��r; �j3��aayi{c �F�F�•�'�i'��liT�+&k"F_ •�'Qiitn{n•,e:,fiLY3.+±?ti! F, tI?S I swear(or affi ) . at to the but of my knowledge and belief this political committee hes not violated any provisions of the act of June 3,1037(P.L.1333, No 320)as am 1-d. 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 7/2/2020 9:59:27 AM 6 PAGE 2 SCHEDULE I CONTRIBUTIONS AND RECEIPTS Detailed Summary Page Name of Filing Committee or Candidate Reporting Period SHAKESPEARE,TARA FRIENDS OF From: 5/19/2020 To: 2 2J2020 ,a. !..w r:•:` nE W- !.s::E'+; r rf4"h"i�`i, r`•uIt• { a•I'•-' :E E?. _ .. .ate q,ts 1 4... f : i r '#-. : 'tv ' • ',...,,f •4 �u'2��9:. I:if# i lii. ..E.., It ri i'•_ .iz: :},.i.�,.�j.?.-.�' ac:•22Gi'ti''•i`'ii,•NP�`:F�����€i •:i�!:'!.7° �f.^4i"-�• .. H ;'�.,.'�,"i�S ia:7 �,�'i�4#<t#�fi.;�iii'Stki.;..»q#� ':...«.,.,... E.l+i# TOTAL for the Reporting Period (1) $ 694.53 - J'.n.:>✓C'��:'R:t'��-2r: :r:�. r x�n -ti•e�4!att. 'cC:tSt �.y.�it,r t�r�.. f:q;st;..•i tG•'..�.I'�y� ��(^�;�ri�lr ;:r= ". t i;u_.• �-rt t�•�r; 0 �rl•`�.a; Y _ 3 Z';i WS t 11 5 d tit: t u•ir._ • ;E,? j r '... ,:t; tar!.>=��' iEr�",�; ': `i��';�o# � 1 �ti: ;a.,: # .i r; . Contributions Received From Political Committees(Part A) IiiP 100.00 All Other Contributions (Part B) r• `'t $ 600.00 TOTAL for the Reporting Period :t;'' ) $ 700.00 E . / u14«1744 N MPE wT NR 4 •7aBliV ';; g :?Y at: !.; 1 11 t^ .i}Contributions Received From Political Committees(Part C) $ 0.00 ,�tt • `t . All Other Contributions (Part D) -~'�'';`• / $ 3,800.00 TOTAL !Ciii, rt �` kr (3) $ 3,800.00 ,, •t n::.i1 .. ,f• ._!b/ ... f.• :-,�r ,a, � .;�tiiu:..t� �'i _ i• lard P _ ..i a3 . 1-•tv . ' , `P.". - ji7, 1:i- i M` I �F"E:3ii: # ��JJ��aa.. .J vt GFr ( y c:u .:t�y� •q�!�; �l� M,.,W );}�1s+p�i��3� ,{$ "'}Y.'Jii L!.«C.:�A•til 2:1 itgftlll��"��'i: - �'�.f, ..,F•. T •�T{--^ 'II'�tl•ri' � ...�l�t}Rt' I�t`�i{t'x••5ei0. •-... � � �.C�Y .23j�iN3•✓22•:.�:{".i�!it!i��:. 22.SIi • i� te.:, "`D:; ' ,i AL"4 I'% ± Reporting Period 4 $ 0.55 • xi;t Total Monetary Contributions ..}d ', •ts Durl • Is Reporting Period(Add and enter amount $ 5,195.08 totals from Boxes 1,2,3 and; ,r'll o :i., ':. is am;'nt on Pagel,Report Cover Page,Item B.) tiE„...J ,._. i�!J r; • y�R.t„ 7/2/2020 9:59:27 AM 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 SHAKESPEARE,TARA FRIENDS OF From: 5/19/2020 To: 5/22/2020 DATE AMOUNT Full Name of Contributing Committee , :tdr, :troll Friends of Diane Bowman .f !n Mailing Address 136 Linglestown Rd f'r. 100.00 City Harrisburg State Zip Code(Plus 4) 5 y; !' 2020 f L ? PA 17110 ;:at. 'f ii PAGE TOTAL Enter Grand Total of Part A on Schedule I,Detailed Summary Page,Section 2. S 100.00 V ,J irjlr' _ ,' If. 7/2/2020 9:59:27 AM 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 SHAKESPEARE,TARA FRIENDS OF From: 5/19/2020 To: 6/22/2020 DATE Ai, AMOUNT Full Name of Contributor MSFP'i i ': 1 a�"`,`::_ I Dorothy Aylward ){ 'e �' l �k "°Y� y F 'j{ as °_^.• . ''+Mailing Address 3296 Shelters Bend _• �' 1 - • 100.00 City State Zip Code(Pius 4) 5 % 2' :•,••r 20 State College i-'.;i . PA 16801 ;j s 1 E Full Name of Contributor i' °F `p Mel Heifetz •i ' Mailing Address 7 North Columbus Blvd .::.1 !:,••': $ 100.00 CityState :• p 0','` °us 4) 5 29 2020 Philadelphia PA �i.;�:., •106 'tc.; 4..f 1 i qt. ;: ,i 44 cs Full Name of Contributor q r=> .. }Eems• ; "�- , 7 Drew Lawrence ,i i`.k, r � ,'a,I'm _El ,g • Mailing Address 1009 Oak Lane ;E a f $ 100.00 li;. j Zip Code(Plus 4) 5 23 2020 city New Cumberland r,.e'°'' ' ,} �� 17070 rgl iia k Mirk 1 pt: prt' Full Name of Co ,'75., .r , :. gip. ..• _�4 6' r., I�;E `i'n �1; Susan Shue '� - "••=�•�-; r°y.aij:,.;. ;p}q�ps ' ;: �, '€1 += a i 'di; el Mailin•. ddro`° k 60 Street Apt 606 City i.urg Y'"7 State Zip Code(Plus 4) 5 23 2020 i'LLrr''' PA 17111 nn• w.r u�n.�iFf'�'��K i reli Full Name of Contributor i.•ii' ; 8[it i',�'. t•i: -`•_ Molly Frazier Ert;°�l {� -Aeifis � :�,� .ilviiii ;ifs; Mailing Address 304 Union Street Apt C $ 100.00 City Columbia State Zip Code(Plus 4) 5 23 2020 PA 17512 7/2/2020 9:59:27 AM PAGE 5 F. }�,uF TF. s iW Tc Full Name of Contributor 0 FBri;ui 1`•'r 7f4 Julie Shakespeare �E _.. :R'if ' Mailing Address 1424 Red Maple Ct $ 100.00 C�' New Cumberland State Zip Code(Plus 4) 5 23 2020 PA 17070 PAGE TOTAL Enter Grand Total of Part A on Schedule I, Detailed Summary Page,Section 2. $ 600.00 / ,F fin. 4; ;F'r , )1> r lFT.j. /> I *, . 1.,ire 'y . P i, 1;• i gill r{{ ' i4;.l'-:e . ;;' ,/ .i, / 7/2/2020 9:59:27 AM PAGE 6 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 l : :,.'' it:-,!,:•-;'.li,I qillii a,! Mailing Address State Zip Code(Pius 4) City it) / PAGE TOTAL Enter Grand Total of Part C on Schedule I,Detailed Summary Pa ,1 ction 3. `'K " $ OAO 41,44 f I% ,F q if 0', jor,, 7/2/2020 9:59:27 AM PAGE 7 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 SHAKESPEARE,TARA FRIENDS OF From: 5/19/2020 To: 6/22/2020 DATE AMOUNT Full Name of Contributor I o,r gam`'1.19A � 4''r 's_t;F � INI 'Y i` Sarah O'Neill S11!;I •i•• -1411 Mailing 79 Washington Place '�'. I'll- 4,'`' g 1^:. 500.00 Address -, „' r� State Zip Code(Plus 4) 6 .: ;!20 t� City New York ., ;:';` NY 10011 ,..,.44 .,,, , Employer Name Sarah O'Neill O lot Emploted :it--. Employer Mailing Address/Principal Place of City a_'''i to Zip Code(Plus 4) Business � 79 Washington Place i k i� •" / NY 10011 Full Name of Contributor 4 7 .r .^• ' 11J 5i' Karla Jurvetson ;4i , 't' r`+,a_,, + Mailing 5 ._,, `':c- Address 350 Second Street#4 fit ray;;;,,,.. s $ 2,500.00 City Los Altos I ip Code(Plus 4) ` 5 28 2020 rhnl CA 94022 r:..._' lit Employer Name Karla Ju :'"".,D' Occupation y=S,L_ Physician Employer Mailing Addres,„ ' ncipal Pia • of City State Zip Code(Plus 4) Business ,F 350 2nd Street#4 `;', ,I;; Los Altos CA 94022 Full Nat 'of r ; . .:'I;,°a}'• Z;' E y . ;'2�i7,( .t?. D N Ste-.'}-;"; ,. her � rfil. use �Imib ' r Mailing ;tr '. ,517 Winfield Street Address `y'_ >� State Zip Code(Plus 4) 6 17 2020 City Harrisburg PA 17109 Employer Name Stephen Fisher Occupation Not Emploted Employer Mailing Address/Principal Place of City State Zip Code(Plus 4) Business 4517 Winfield Street HARRISBURG PA 17109 7/2/2020 9:59:27 AM PAGE 8 ik G':n+:� '���,ice ����° Full Name of Contributor � S C t �� '� s Arl Nepon e�s� 1 •),; Ei.a.:—•4. c �.z -ii L • ii 1�.itt=.r;F::ea Ltd">�ici-1N.,�c:Y Mailing 45 Forest Drive Address $ 300.00 city Mechanicsburg State Zip Code(Plus 4) 5 25 2020 PA 17055 Employer Name Apple Occupation Manager Employer Mailing Address/Principal Place of 1 City State Zip Code(Plus 4) Business One Apple Park Way Cupertino CA 95014 0%li PAGE TOTAL Enter Grand Total of Part C on Schedule I,Detailed Summary Page,Section 3. ' /4,i 'a ,800.00 . : :r;:iiy ))'V e.`"t;l;Its. —• ` ,,i i 4 .r +'"!'fir-•.,,,' ' rYt ,r. .1:4a ', , , ,,1 �°lam 7/2/2020 9:59:27 AM PAGE 9 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 SHAKESPEARE,TARA FRIENDS OF From: 5/19/2020 To: 6/22/2020 DATE AMOUNT Full Name `• '1n'1 ':� :+�-`, �; `; raj; .- . a PSECU 11"..• ;'•`i ..`Ft . s ck • Mailing0.35 Address 1500 Elmerton Ave �` ''-.., f� I Ir.F 4 L I City State Zip Cods(Plus 4) 5 202 1 r � Harrisburg �"'•� • PA 17110 Receipt Description May 2020 Dividend Deposit -- Full Name #,fix. . 7' qui i PSECU ^V ,.: 4 s • ;• uhru• Mailing Address -fi''.. «;'• f,` 0.20 1500 Elmerton Ave • City State A \;;e(Plus 4 6 1 2020 Harrisburg ssy PA 171'.0 / qtr- Receipt Description { '• ' , May 2020 Debit Ca'%•°a- .• • PAGE TOTAL Enter Grand Total of Part E on S .:Y •ule I, .t`I Ile,€ummary Page,Section 4. .14 ei $ 0.55 7/2/2020 9:59:27 AM PAGE 10 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 SHAKESPEARE,TAM FRIENDS OF From: 5/19/2020 To: 6/22/2020 �+�{:,t►uV;1yi Egry�ii � pa " r - e. lil:� "R } A _.�'�`i�:4'.tp'�il�:�'r• inn. '�71.'kf R; SOR L ' � F N•..'•Ni:R' ''.�'.'�iN ar ��:p!»ii,'F a!u.?` j rr fVi ! i-xS�ti A....i !} F...•c h i}7 P .F+ iFi: Pu. 8 v�i} ar,�'d Pr..,..,.R.., »..2!�`�i 3 3 iRitii' ix � .i6.. •.�. !Sl• TOTAL for the Reporting Period (1) $ 0.00 'r TOTAL for the Reporting Period (2) AA. xo if.00 • . • 3 ..�� �xx5E3y ;��y � �� PAW- TOTAL for the Reporting Perio 3) 0.00 TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING PEA. ND(Add an }/ 0.00 amount totals from Boxes 1,2,and 3;also enter on Page 1,Reports Coy rrti:_,,•e,Item -0 _z ..:alb;?;• ,ii• x.. ixn G:tft 1. 7/2/2020 9:59:27 AM PAGE 11 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 it • ir �. s_ 11 fi y -r p kk c :� ilelt pr F FAO - Fat i fait' Mailing Address � $ 0.00 City 4- Y:› State Zip Coda(Plus 4) ;..u;;, ,j4Ti,14 `f f' f Description of Contribution: r,ir •,gr? r. 'g;e. Enter Grand Total of Part F on Schedule II,In-Kind Contributions D -lied Su ; A P4 a PAGE TOTAL Section 2. -�_.. ...e, al ;_. . ! ,1..; `)j $ 0.00 . a;`— _ tltr--,!1.,:::;':r air/ F„ r i'4 • ,, ' 7: ,.i, ,,,, n,. 7/2/2020 9:59:27 AM PAGE 12 SCHEDULE II PART G IN-KIND CONTRIBUTIONS RECEIVED VALUE OVER$250.00 Name of Filing Committee or Candidate Reporting Period From: To: DATE AMOUNT Full Name of Contributor i i Mailing Address State Zip Cade(Plus 4) city Employer of Contributor Occ,,• "' Employer Mailing Address/Principal Place of City State ''' '''` PI) Description of Contribution Business a•�11.: 1= i. n ^'. ,b,„ / PAGE TOTAL „ems Enter Grand Total of Part G on Schedule II,In-Kind Cont �'; :: D'- a- Summary Page,Section 3. .e�.;`;F ,'. 0.00 ttiff / J. /Ff��IR 2� 7/2/2020 9:59:27 AM PAGE 13 SCHEDULE III STATEMENT OF EXPENDITURES Name of Filing Committee or Candidate Reporting Period SHAKESPEARE,TARA FRIENDS OF From 5/19/2020 To: 6/22/2020 DATE AMOUNT To Whom Paid 1 1iit i I•Til�`iiR93411,1 i Maiichimp ,$ z._•,>. 19 mutat, Mailing Address 675 Ponce De Leon Ave NE ste 5000 5 29 201 41.'1 # 10.59 City State Zip Code(Plus 4) �'r, Atlanta Description of • to • 1 GA 94025 Email = 4. U"` til To Whom Paid li . :: # 'k., ,,,,+ :A,t f' Act Blue tt �.Y u. peth iyfi;q...' , Mailing Address ;..1: 2020 366 Summer Street # 59,37 iv City Somerville StateZip Cod De p, n of Expenditure MA 0 <"a�;;.. Ma, 020 Fees lllil q:d:f 'f^� -. w . Ana To Whom Paid = s;§' [ ;{� 1i''�:t - . r 'd Vantiv eCommerce hlf:,;;t`+. '":. .- '9 + ..,,,,.—,,FF„.k ,, Mailing Address 900 Chelmsford Street ,�,(;rah!;.,, !;'.i.�nS��. s 6 9 2020 ; # 117.23 _I City Lowell ,;,•1 ,;:.. `":':,Zip Code(Pius 4) Description of Expenditure j I-':. , , 01851 May 2020 Fees • PAGE TOTAL Enter Grand Total of Ex•:•="'• - .;; • - Report Cover Page,Item D. =t' 't4 $ 187.19 7!j: (vf.tk. r. A F ;ii . d: - f• eft j• f 7/2/2020 9:59:27 AM A SCHEDULE IV STATEMENT OF UNPAID DEBTS Use this Section to itemize all unpaid debts and obligations which are outstanding at the end of the reporting period Name of Filing Committee or Candidate Reporting Period SHAKESPEARE,TARA FRIENDS OF From: 5/19/2020 To: 6/22/2020 Outstanding DATE Balance of Debt Name of Creditor gri r< L:Gi42i iEi( ff. int Tara Shakespeare 44 g�`th si fl: ; ,TgEw, a •J ef.Gfli ,i,,, , Mailing Address 1813 Letchworth Drive 12 9 i l.i, .,. �' r s,,�1' 440.51 4-1 City Camp Hill State Zip Code(Pius 4) Descrlptlo l .+ PA 17011 Camp• snlipen' .; • PAGE TOTAL Enter Grand Total of Unpaid Debts on Page 1,Report Cover Page,Ite i., ,) 440.51 )1).f' fin. I�,: n i t 'riir 4 / • 7/2/2020 9:59:27 AM