HomeMy WebLinkAboutShultz, Sean - 2021 2nd Friday Pre-Primary 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 IDENTIFICATION ' REPORT FILED I. 2 - T
NUMBER ON BEHALF OF ' CANDIDATE �[' COMMITTEE LOBBYIST
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
SeAv, Stty /
STREET ADDRESS
55 F S�-- e4-
CITY STATE ZIP CODE
�r t13/2 �� i 7 0 13 —
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY ,� DATE OF ELECTION
(CHECK ONE) , /4 y o j — Ce l'S/C 3�Q,y, /,� MO. - DAY YEAR
6TH TUESDAY
PRE-PRIMARY FOR OFFICE USE ONLY
NO. DAY YEAR MO. DAY YEAR
2ND FRIDAY 2. DATES OF ) 1 C) ;w
'PRE-PRIMARY / PERIOD REPORTING 1 Z( TO 3 Z RS
30 DAY '.. 3' - rT"t .3'›•
POST-PRIMARY
• CASH BALANCE AT END0
I
6TH TUESDAY' 4' OF REPORTING PERIOD: $ cn
PRE-ELECTION (.`-. L)
TOTAL AMOUNT OF FILER'S •
C) `D
2ND FRIDAY OUTSTANDING DEBTS OR LIABILITIES Cr)
PREELECTION AT THE END OF REPORTING PERIOD: $ 0 C CA.)
s. ---f IN)
3O•DAY -AMENDMENT •
-.0 IN.)
'. °' REPORT?
YES NO x
ANNUAL- : - :TERMINATION '
REPORT- _. -;REPORT? YES NO
AFFIDAVIT SECTION
ART I-
r b a I statement is filed on behalf of a Political Committee or Candidates's Committee,theTreasurer must sign here.
g a ggl•.statement is filed on behalf of a Candidate,the Candidate must sign here.
. c r;;- L statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
7 b p I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR UABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
Z,9, a$ XCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BEUEF,TRUE,CORRECT AND COMPLETE.
C R n Z SW RN AND SUBS IBEO BEFO E ME THIS 5,� C
:; eD_,t C
j Q� w DAY OF 20 SIGNATURE OF PERSON SUBMfTTING REPORT
pow.:~ ~Z I AT RE PRINTED NAME
., . v MY OMMISSION EXPIRES 1 S�tD j�27
MO. D YR. AREA CODE DAYTIME TELEPHONE NUMBER
PART II-
If statement is filed on behalf of a Candidate's Authorized Committee,Candidate must sign here.
I SWEAR(OR AFFIRM)THAT TO THE BEST OF MY KNOWLEDGE AND BEUEF 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
SIGNATURE OF CANDIDATE
DAY OF _ 20_
PRINTED NAME
SIGNATURE .
MY COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR.
Department of State • Bureau of Commissions,Elections and Legislation
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120.0029 • (717)787-5280
0
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