HomeMy WebLinkAboutFriends of Fedor - 2020 Annual Report yfil 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•stcampaignfinance@pa.gov
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 (farm 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
(n-tod s aC _e_../ -'
Reporting Cycle Name
❑ Cycle 1 0 Cycle 2 0 Cycle 3 0 Cycle 4 0 Cycle 5
6th Tuesday 2nd Friday 30 Day 6th Tuesday 2hd Friday
Pre-Primary Pre-Primary Post Primary Pre-Election Pre Election
❑ Cycle 6 Cycle 7 0 Cycle 8 0 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.
/o Z /zCUZ
l _
Signature of Treasurer, Candidate, or Lobbyist Date (DD/MM/YYYY)
/ /A) /Jo C,� /W
Printed Name Location (City/State/Country)
DSEB-503S
Updated 6/24/2020
COMMONWEALTH OF PENNSYLVANIA
CAMPAIGN FINANCE STATEMENT
File this in lieu of a full report only if aggregate receipts, expenditures, or
liabilities incurred each did not exceed$250.00 during the reporting period.
FILER IDEllUPICATlON 10,
REPORT ON IEWLLFF eF `_MONATE. L COM 1TEE.: ivd m 1.
MAWR
NAN!OF FDJNS COMMITTEE,CANDDATE OR LOBBYIST •
4 l EI\A S p i✓Df'L
STREET ADDRESS
pa toy (0', . .
CITY STATE zip OOOE
INN OLft- Pi 17 02-5 --
TYPE OF REPORT •NAME OF OFFICE SOUGHT BY CANDDATE DISTRICT NO. PARTY IDATI:OF ELECTION
(ONECN ONE) _' MD. ' -'.cA'r ' YEAR';
S. NoNI6
. 6TH`IUESDAY.•.... -
PRE+PR MAR`f• ; • . • FORCEPCE tiSE ONLY.
:MO. .MAY.. YEAR:• '.MO. '.'OAY .'.'YEAR.
211DTINDAY'7; 2. DATES OF '
2o:wv 3. .
rl
POST4PRIMARY.. . CASH BALANCE AT END / /2. 6 0 rT'I
Brij Tuesedit
4. OF REPORTING PERIOD: $ I
. .PREeEIECT1ON: .. , • LO
TOTAL AMOUNT OF FILER S
g• OUTSTANDING DEBTS OR LIABILRIES /) �'T)
�Nn AT THE END OF REPORTING PERIOD: $ v
PRE-ELfC1ioa fJ
-30.DAY: . . O
906T-ELECiiON. REPORT? YES NO V
7
TERMINATION.,'. YES NO ✓
RFPOkt.• A Aop{IRT •r:
AFFIOAVIT SECTION
PART I-
if statement is filed on behalf of a Political Committee or Candidates's Committee,the Treasurer must sign here.
If statement is filed on behalf of a Cansiicdate,the Candidate must sign here.
If statement is filed on behalf of a Contributino Lobbyist,the Lobbyist must sign here.
1 SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR UABILTTIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EKCEED TWO HUNDRED AND FFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AN EF, r ECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
DAY OF 20 SIGNATURE OF PERSON SUBMITTING REPORT
S.; / , 9/%1,/1/
PRINTED NAME
SIGNATURE
MY COMMISSION EXPIRES 7/7 6201; - a 0-;3
MO. DAY YR. AREA C DAYTIME TELEPHONE NUMBER
PART II-
If statement is filed on behalf of.a Candidate's Authorize(Committee,Candidate must sign here.
I SWEAR(OR AFFIRM)THAT TO THE BEST OF MY IOIOWLEDGE AND BELIEF THIS POLMCAL 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
SIGNATURE OF CANDIDATE
DAY OF 20
PRINTED NAME
SIGNATURE
MY COIMESSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER I
MO. DAY YR. f
DSEB-503(22.99)