HomeMy WebLinkAboutShakespeare, Tara - 2020 30-Day Post-Primary 4. }
lePennsylvania Department of State
Bureau of Campaign Finance&Civic Engagement
210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4)
www.dos.aa,aov/campaienfinance • ra-stcamuaienflnance@aa.eov
Unsworn Statement in Lieu of Sworn Statement for
Campaign Finance Statements
Note: Per Act 2020-15, which was signed Into law 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 Statements. This form must be signed by hand where a signature Is required.
Name of Filing Committee, Candidate, or Lobbyist
Tara Shakespeare
Reporting Cycle Name
❑ Cycle 1 ❑ Cycle 2 0 Cycle 3 ❑ Cycle 4 0 Cycle 5
6th Tuesday 2nd Friday 30 Day 6th Tuesday 2nd Friday
Pre-Primary Pre-Primary Post Primary Pre-Election Pre-Election
❑ Cycle 6 ❑ Cycle 7 0 Cycle 8 ❑ Cycle 9
30 Day Post-Election Annual Report 2"d Friday Pre-Special Election 30 Day Post-Special Election
Part 1 — 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 a 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.
I declare under penalty of perjury under the law of the Commonwealth of Pennsylvania
that the foregoing is true and correct.
'dam, 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-503S
Updated 6/24/2020
• Cow/tom/I/pt.-n-1 OF PENNSYLVAINEA
CAMPAIGN FINANCE STATEMENT
•
File this In lieu of a fuH report only*aggregate receipts, expenditures,or
liabilities incurred each did not exceed $250X0'during the'reporting period.
. .
• . . .
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ty0.E or Rti,oRy NAME Or.OFFIOE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
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ati-0.040#14-4'4 OF REPORTING PERIOD $ 0 , 0 6
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.k. - 140.101404, •
yki,:,...\....„,;:••:.4.7.;:!,..s, . TOTAL AMOUNT OF FILER'S
•
OUTSTANDING DEBTS.OR LIABILMES
AT THE END OF REPORTING PsaioIX. .$
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AFFIDAVIT SECTION •
• - . . . . .PARTI'- ' ' ' •:• . . ..
if statement is filed on behalf:•cife.POIltir,a1..Committee or Candidates's Committee,the Treasurer must sign tiere.
If statement Is filed oh behalf of a candidata;the Candidate must sign here
It statement is filed on behalf of a Contributing L.Obbvist,the Lobbyist must sign here.
..... . .. . .
I$YJEAR(oik AFFIRM)`1•NAT THE MORES:WE.RECEIPTS OR DISBURSEMENTS OR-.LiAanorTs INUVRRED OURIHB,THE REPORTING.PERIOD INDICATED.ABOVE OD.NOT •
OROEED TWO kuteneo 6NO'FIF-6'•bolvgR,s-,($2.50.(p)AND TN*REPORT IS,TO THE BEST OF DRY•KNOWLEDGE AND OAF,TRUE,CORRECT ANOCOMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS 'ram.
PAY OF • •• 20 SIGNATURE OF•PERSON SUBMITTING.REPORT i 1
......d. elvx
I a( oA fa-so...are- 712-170
•
PRINTED.NNW
•
SIGNATURE •
• •
• tun"com103846m.posiRes . _D.J.4— 01 •— 0 L2 (5,
• mo:. . .0.4. .^M. • AREA CO E DAYTIME TELEPHONE NUMBER
• ,.
'PART II-
If.statement is filed on behalf of 0 Candidate's Authorized Committee,Candidate must sign here.
• ••
I SWEAR(OR AFFIRM)THAT Tp•THEOE$T"OP MY.KNOWLECRIE AND BELIEF THIS POLTricAl....coMmriTEE HAS'NOT VIOLATED ANY PROVISIONS OF THE ACT OF
Juitts 3.;19_37(P.L.1333.,No..-329)A .AMENDEID:
SWORN TO AND SUBSCRIBED BEFORE ME THIS
SIGNATURE OF CANDIDATE
DAY OF . . 20 PRINTED'NAME
•
SIGNATURE
MY COMMISSION EXPIRES MO. DAV YR.
AREA CODE DAYTIME TELEPHONE NUMBER
-
Department of State • Bureau of Cornmissionsi.ElectIons and Legislation
..... • 2iti Mnrf hiltfira Rullefina a Narrlaharet.PA 17121MH1741 a Min TAT-R9RA
..._ ___ __ __.