HomeMy WebLinkAboutFriends of Nate Silcox - 2020 30-Day Post 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.Pa.gov/campaignfinance • ra-stcampaignfinanceepa.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 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
ends oC Ma+e S-I Cox
Reporting Cycle Name
0 Cycle 1 0 Cycle 2 0 Cycle 3 0 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
TA Cycle 6 p Cycle 7 0 Cycle 8
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 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.
12/2/20
Signature of Treasurer, Candidate,or Lobbyist Date (DD/MM/YYYY)
Craig Mellott Hampden Twp/Cumberland/PA
Printed Name Location (City/State/Country)
DSEB-502R
Updated 6/24/2020
Commonwealth of Pennsylvania-Campaign Finance Report
r ....
(Note:This report must be clear and legible.It should be typed)
'Tite
'afet on' .-RePortTly :gt!:, ialiindato: jflQsrnrnftie. �r
•N• off�Committee,Candiilate i
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or'
frends
'. of Nate Silcox _
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Type of Report(Place x under report type)
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A.Amo unt�up. fot italra;F,om"lst
$ 5,637.51
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Affidavit Section
Part 1-If this is a Committee report,treasurer sign here.if this is a Candidate report,candidate sign h
I swear(or affirm)that this report,including the attached schedules on paper,is to the best of my dge an ief trye„correct and complete.
Sworn to and subscribed before me this
da of 20 L _______ --------.=_________=
Signature of Person Submitting report
Craig Mellott
Signature Printed Name
My Commission expires 717 234-1430
MO. DAY YR. Area Code Daytime Telephone Number
Part II-If this is a report of a Candidate's Authorized Comrrdttee,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 '
1: =7. ... __________ammi
Signature of Candidate
1-97me j P. Sf i--�,.nk
Signature Printed Name
My Commission expires '-) 11 („y( - 2•••01?1—
MO. DAY YR. Area Code Daytime Telephone Number
SCHEDULE III •
Statement of Expenditures •
, ,„4, 10/08/2020 •
5528 r, i.4 r ` Carlisle Pike ; ,,r�, i,, 7 i
Mechanicsburgx_ep PA ,..."-rgita 17055 Service Charge
..i 'M&T Bank ';.�.
. 21/08/20 > 2
.00
4174 .t.fir•. -%: _
H n isle Pace r `-r;' ';�;41..'r7_�z
• ,.; 5528 x' �. 3' Carl '?%.K s.-: -s�,,. _-'�' �,
:::—� Mechanicsburg - n .t. PA r'r•:-TO' 17055 Service Charge
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