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Home My WebLink AboutHampden Township Democratic Club - 2021 6th Tuesday Pre-Primary 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 Declaration 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 unsworn declarations, Campaign Finance Reports (form DSEB-502), Campaign Finance Statements in lieu of full reports (form DSEB-503), Non-Bid Contract Reporting Form (DSEB-504) 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 Hampden Township Democratic Club Reporting Cycle Name ® Cycle 1 ❑ Cycle 2 ❑ Cycle 3 ❑ Cycle 4 ❑ Cycle 5 6th Tuesday 2"d Friday 30 Day 6`h Tuesday 2"d Friday Pre-Primary Pre-Primary Post Primary Pre-Election Pre Election ❑ Cycle 15 ❑ Cycle 7 ❑ Cycle 8 ❑ Cycle 9 30 Day Post-Election Annual Report 2nd Friday Pre-Special Election 30 Day Post-Special Election Part 1- 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 accompanying Campaign Finance Report is true and correct. � 04/06/2021 Signatur- "17easurer, Candidate, or Lobbyist Date (DD/MM/YYYY) Sarah Yerger Camp Hill, PA USA Printed Name Location (City/State/Country) DSEB-502R Updated 1/22/2021 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(alpa.gov Part!!-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 accompanying Campaign Finance Report is true and correct. 04/06/2021 Signature of Treasurer, Candidate, or Lobbyist Date (DD/MM/YYYY) Sarah Yerger Camp Hill, PA USA Printed Name Location (City/State/Country) DSEB-502R Updated 1/22/2021 IILI Reset Form , Print Form iiCommonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible. It should be typed) Filer Identification Report Filed By Candidate Committee X Lobbyist Number 20200298 (Mark X) Name of Filing Committee,Candidate or Lobbyist Hampden Township Democratic Club Street Address 102 Saint Johns Church Road City Camp Hill State PA Zip Code 17011 Type of Report(Place x under report type) 1-6" Tuesday 2- 2"d Friday 3-30 Day Post 4-60 Tuesday 5.2nd Friday 6-30 Day Post 7-Annual ` Special 2"Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post Election Date Of Election Year Amendment Termination (MM/DD/YYYY) 05/18/2021 2021 1 Report Report Summary of Receipts and From Date To Date For Office Use Only Expenditures 01/01/2021 03/29/2021 A.Amount Brought Forward From Last Report $ 4199.10 B.Total Monetary Contributions and Receipts $ 753.35 (From Schedule I) C.Total Funds Available $ 4952.45 (Sum of Lines A and B) D.Total Expenditures $ (From Schedule III) 818.71 E.Ending Cash Balance $ (Subtract Line D from Line C) 4133.74 F.Value of In-Kind Contributions Received $ (From Schedule II) 700.00 G.Unpaid Debts and Obligations $ 0 (From Schedule IV) Affidavit Section Part 1-If this is a Committee report,treasurer sign here.If this is a Candidate report,candidate sign here. I swear(or affirm)that this report,including the attached schedules on paper,is to the best of my knowledge and belief true,correct and complete. Sworn to and subscribed before me this . L day of 20 Signature of Person Submitting report Signature Printed Name My Commission expires MO. DAY YR. Area Code Daytime Telephone Number Part II-If this is a report of a Candidate's Authorized Committee,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 • Signature of Candidate Signature Printed Name My Commission expires MO. DAY YR. Area Code Daytime Telephone Number SCHEDULE I Contributions and Receipts Detailed Summary Page Filer Identification Number I 20200298 1.Unitemized Contributions and Receipts-$50.00 or Less per Contributor I 11 Total for the reporting period (1) $ 523.00 I 1 2.Contributions of$50.01 to $250.7)0(From I Part A and Part 8) • Contributions Received from Political Committees(Part A) $ 0.00 All Other Contributions(Part B) $ 230.00 Total for the reporting period (2) $ 230.00 3.Contributions Over$250.00(From Part C and Part D) Contributions Received from Political Committees(Part C) $ 0.00 All Other Contributions(Part D) $ 0.00 Total for the reporting period (3) $ 0.00 4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E)I I Total for the reporting period (4) $ 0.35 Total Monetary Contributions and Receipts during this reporting period(Add and $ enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report 753.35 Cover Page,Item B) PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) Filer Identification Number: 20200298 Full Name of Contributor Date[MM/DD/YYYYJ $ Vicki Mack 01/15/2021 20.00 House# Street Address Date[MM/DD/YYYY] $ 1120 West Powderhorn Road 02/15/2021 20.00 City State Zip Code Date[MM/DD/YYYY] $ Mechanicsburg PA 17050 20.00 03/15/2021 Full Name of Contributor Date[MM/DD/YYYY] $ John Milliron 01/19/2021 50.00 House# Street Address Date(MM/DD/YYYY] $ 5031 Amelia's Path West 02/27/2021 50.00 City State Zip Code Date[MM/DD/YYYY] $ Mechanicsburg PA 17050 Full Name of Contributor Date(MM/DD/YYYYJ $ Valarie Ryerson 01/03/2021 35.00 House# Street Address Date[MM/DD/YYYY] $ 478 Woodcrest Drive 02/03/2021 35.00 City State Zip Code Date[MM/DD/YYYY] $ Mechanicsburg PA 17050 Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date(MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date(MM/DD/YYYY] $ House# Street Address Date(MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ 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. Filer Identification Number: 20200298 I Full Name Members 1st Federal Credit Union House# 6280 Street Address Carlisle Pike City State Zip Date[MM/DD/YYYY] $ Mechanicsburg PA Code 17050 01/31/2021 0.18 Receipt Description Dividend Full Name Members 1st Federal Credit Union House# 6280 Street Address Carlisle Pike City State Zip Date[MM/DD/YYYY] $ Mechanicsburg PA Code 17050 0.17 02/28/2021 Receipt Description Dividend Full Name House# Street Address City State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address City State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address City State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address City State Zip Date[MM/DD/YYYY] $ Code Receipt Description 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 Filer Identification Number: 20200298 1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR I TOTAL for the reporting period (1) $ 2. IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F) TOTAL for the reporting period (2) $ 3. 1N-KIND CONTRIBUTION RECEIVED-VALUE OVER$250.00(FROM PART G) TOTAL for the reporting period (3) $ 700.00 TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING $ PERIOD(Add and enter amount totals from boxes 1,2,and 3;also enter on Page 1,Report Cover Page,Item F) 700.00 SCHEDULE II Part G In-Kind Contributions Received VALUE OVER$250 I Filer Identification Number: 20200298 Full Name of Contributor Date(MM/DD/YYYY] $ Jenna Behringer 700.00 01/2/2021 House# Street Address Date[MM/DD/YYYY] $ 888 Mandy Lane City State Zip Code Date(MM/DD/YYYY] $ Camp Hill PA 17011 Employer Name PPFF Occupation Office Administrator Employer Mailing Address/Principal Description Place of Business 704 Lisburn Road Camp Hill,PA 17011 of Advertising Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address' Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution Full Name of Contributor Date[MM/DD/YYYYj $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution SCHEDULE III Statement of Expenditures I Filer Identification Number: I 20200298 To Whom Paid Date[MM/DD/YYYY] $ ActBlue 01/06/2021 8.00 House# Street Address Description of Expenditure PO Box 441146 City State Zip Somerville MA Code 02144 Fee To Whom Paid Date[MM/DD/YYYY] $ Vantiv eCommerce 21.47 01/20/2021 House# Street Address Description of Expenditure 8500 Governors Hill Drive City State Zip Symmes Township OH 45249 Fee Code To Whom Paid Date[MM/DD/YYYY] $ GreenGeeks 155.30 01/25/2021 House# Street Address Description of Expenditure 5739 Kanan Road,Suite 300 City State Zip Agoura Hills CA Code 91301 Website To Whom Paid Date(MM/DD/YYYYj $ Deluxe Check 12.25 01/26/2021 House# Street Address Description of Expenditure 3680 Victoria Street North City State Zip Shoreview MN Code 55126 Checks To Whom Paid Date(MM/DD/YYYY] $ ActBlue 02/03/2021 7.13 House# Street Address Description of Expenditure PO Box 441146 City State Zip Somerville MA Code 02144 Fee To Whom Paid Date]MM/DD/YYYY] $ Vantiv eCommerce 02/09/2021 13.57 House# Street Address Description of Expenditure 8500 Governors Hill Drive City State Zip Fee Symmes Township OH Code 45249 To Whom Paid Date(MM/DD/YYYY] $ Keystone Buttoneer 23.32 02/28/2021 House# Street Address Description of Expenditure 219 Briggs Street City State Zip Harrisburg PA Code 17102 Buttons To Whom Paid Date(MM/DD/YYYY] $ USPS 23.30 02/28/2021 House# Street Address Description of Expenditure 1675 Camp Hill Bypass City State Zip Camp Hill PA Code 17011 Stamps SCHEDULE III Statement of Expenditures Filer Identification Number: I 20200298 I To Whom Paid Date[MM/DD/YYYY] $ Members 1st Federal Credit Union 02/28/2021 4.95 House# 6280 Street Address Carlisle Pike Description of Expenditure City State Zip Mechanicsburg PA Code 17050 Bill Pay Fee To Whom Paid Date[MM/DD/YYYY] $ ActBlue 03/03/2021 2.11 House# Street Address Description of Expenditure PO Box 44146 City Y State Zip Somerville MA Code 02144 Fee To Whom Paid Date[MM/DD/YYYY] $ Amazon 03/052021 33.17 House#` Street Address Description of Expenditure 410 Terry Avenue North - City State Zip Seattle WA Code 98109 Office Supplies To Whom Paid Date[MM/DD/YYYY] $ Vantiv eCommerce 03/09/2021 6.74 House# Street Address Description of Expenditure 8500 Governors Hill Drive City State Zip Symmes Township OH Code 45249 Fee To Whom Paid Date[MM/DD/YYYY] $ Cheltenham Printing 254.40 03/06/2021 House# Street Address Description of Expenditure 518 Ryers Avenue City State PA Zip 19012 Postcards Cheltenham Code To Whom Paid Date[MM/DD/YYYY] $ Artistic Imprints 03/10/2021 253.00 House# Street Address Saint Johns Road Description of Expenditure 823 City State Zip T-Shirts Camp Hil PA Code 17011 To Whom Paid Date[MM/DD/YYYY] $ House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/YYYY] $ House# Street Address Description of Expenditure City State Zip Code