HomeMy WebLinkAboutShakespeare, Tara - 2020 2nd Friday Pre-Election Pennsylvania Department of State
Bureau of Campaign Finance&Civic Engagement
210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4)
www.dos.oa,gov/camaaignfinance • ra-stcamoaianflnancetava,aov
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 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 Statements. This form must be signed by hand where a signature is required.
Name of Filing Committee, Candidate, or lobbyist
1 cu o` S Ina,k.2S p
Reporting Cycle Name
❑ Cycle 1 ❑ Cycle 2 0 Cycle 3 0 Cycle 4 !] Cycle 5
6th Tuesday 2"d Friday 30 Day 6u'Tuesday 2114 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 2nd Friday Pre-Special Election 30 Day Post-Special Election
Part I — 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.
Teat cam-- 10/20/2020
Signature of Treasurer,Candidate, or Lobbyist Date(DD/MM/YYYY)
Tara Shakespeare Camp Hill, PA USA
Printed Name Location (City/State/Country)
DSEB-SO3S
Updated 6/24/2020
COMMONWEALTH OF PENNSY.l.VANIA'
CAMPAIGN FINANCE STATEMENT
File this in Iteu.of a full report only"(aggregate receipt% .expenditures, or
liabilities Incurred each did not exceed$254 ..Q:during tile'reporting period.
Fr�ER.iWENTlPIGA'RoN r• :... .,..
bltEEilPAEFOF _
OF'FE.ESTI EMU/TEE,CANDOA'IE:oR TAROT* - •
li cA. SIVL et-E,44_, ,,=, .
STREET •• .
1r/3 door - ' cioc
. .•GTY ETATB� •
ZIP COl7E
�� • #//oxFlcE BoucHr AY cAiitoiegTTi. �� -F .. �Q //. �
TYPE OF e/g.�r�'�om .JS.TWC.T NO. ARTY U',I O, f:l.f::f.f KW
• Yam' y:,a „l. 'Y' t 4i15
•
•
.._ _ ... ;`..00: ;::aAT;;';r'R MO ,17AY:.:: FEAR "1 ...
� gATETi'OF
N.
•
R i,.• REPQRTIN•G TO
pERI
`4'..h:1: '�'ili.iV, CAST I BALANCE'AT END .
OF'REPORTING PERIOD: 6 I 8
Nre,, ',,: :,,.. . .., TOTAL AMOUNT OF OILER'S
';i Lii*t'46'17,- ••;,'.5''.` 'OUTSTANDING Al BTS OR LIABILITIES �}f •.
110 F4 . Nr:':: . V . AT TI'tE END OP REPORTING PERIO . $
YES • NO
AFFIDAVIT SECTION
•
PART'I:.It.....
If statementis fled on behalf of:atjc pali alCommittee orCandidates's.Cgmiytittee,The Treasurer must sign here.
if statement is filed oh behalf of a Candidate,the Candidate must Sign::here.
If statement.Is filed son behaif_of$Contributing Lobbyist,the.Lobbyist must sign here,
: i,SWEAR(OR_AFFITiO icAT tHE.AGGREGATE RECEIPTS'•OR DISBURSEMENTS.OR:ummseES INCURRED THE'.FWORTING PEPIOG INQICATED:AFOVE.DiO.NOT
.EXCEED TWO NoNDRED Oa FIF'rY.061- *.($250 OO)AND TtUs'REPORT IS,TO THE,REST OF MY•f(NOWtRDGE AND BELIEF.TRUE,CORRECT AND CQQQMPLETE. .
SWORN TO.AND SUBSCRIBED BEFORE M 'T EHIS Taus 5� . /b/ o Ivo
OAY OF. 20 $Ki_NATURE OF PERSON SUBMITTING REPORT
promo N.W
slliNATUIIE
MY CoMNIISStON EXPIRES `` le
M0: ' 'DAY YR. AREA.CObE DAYTIME TELEPHONE NUMBER
,PART it-
if statement is filed on behalf of a Candidate's.Authorized Committee,.Candidate must sign here.
•I SWEAR'(OEM AFFIRM)THAT To'THE.BEST to MY KNONREOOEAND ELF THIS POLITICAL COMMITTEE HAS NOT.ViOLaTED ANY PROVISIONS OF THE ACT OF
•
• !Am 3:,1937(Pt.1333,No.120)AS•AMENUED.
SWORN'TO AND SUBSCR1E ED BE FORE ME THIS
SIGNATURE OF CANDIDATE
DAY OF 20
PRINTED NAME
• SIGNATURE
MY COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER
M0. DAY YR.
Department of State + Bureau•of Commissions-,Elections and Legislation )
...•. ,.,,/ .. .. A. 210 Korth Office Bulldinri a Harrighnrn.PA 17120.bb911 a min 7147xoetI ef