HomeMy WebLinkAboutCoplen, Rick - 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.
NUMBERENTIFIC/1T10N ' n O n O 0/6� REON ORTBEHALF
FILED , :CANDIDATE �'�(� .COMMITTEE:.' 2. -LOBBYIST 3.
.L L ON BEHALF OF /`
NAME OF FILING COMTTEE,CAN ATE OR LOBBYIST '
PFe/ 1,O�/f��t' ASTREET ADDRESS / /
,570 ,4/exa,ihr cr'n go i
Cm
Cr/iT ///� STATE /9� ZIP CODE -7‘IC—_
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) r !
flee" / Boar' J�YeclO r ` A �AJ c eft) S�'�t MO. DAY YEAR:
s- ' 262./
:6TIu...4' .
PRE..PR*IARY,• • FOR'OFFICE':USE;ONLY
... :MO. ,.DAY. .. YEAR-.:. MO. ...DAY • :NEAR-. :. .. .
•2ND`FRIDAY ; 2. REPORTING //,, 5- of �Q2.n
PRE=PRMIARY'::; RE I 0� D� LY2/ TO Q
PERIOD
30`onr .. 3.
POST-PRIi ARY C) r--
CASH BALANCE AT END
.1 -0.----_6TH TUF.SDAY ;.•:: 4' OF REPORTING PERIOD: $ CO �.*-
PRE-ELECTION . ^y^€ .
TOTAL AMOUNT OF FILER'S -"<
ZND'FamAY OUTSTANDING DEBTS OR LIABILITIES r »I I
'PRE-ELECTION,• AT THE END OF REPORTING PERIOD: $
s. -10
. .....
•30•DAY AMENDMENT ` 0
. 'POST-ELECTION REPORTS YES NO X = t,y
7. Z. _
.•:ANNUAL . TERMINATION.. ' YES '"
REPORT :. REPORTr?:. :
AFFIDAVIT 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 Candidate,the Candidate must sign here.
If statement is filed on behalf of a Contributin• Lobbyist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR• 16,55S NTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00) • .THIS- ,TO THE BEST OF �Ia�LEDG�AN• '. LIEF,TRUE,CORRECT AND COMPLETE.
S N TO AND SUBSCRIBED BEFORE ME TH 46,
�FCq/thofp a;�� i
^ t,, c O ' r'�/S?�sl/ OF P N UBMITTING REPORT
DAY OF AA-kit lip` C: .ate 4, �07' —
�_/ (/F/DSO //$ /J
‘......444jz?etz.A._(js2_L_t_:t_„a___
/ss'077F�pp7P 00 A /0, i L.'���rj/P l
SI NATURE lib s✓d { • c% Seo, PRIED NAME
MY COMMISSION EXPIRES "� ` ` IDAY G7 0 `3 e,. /",066 RRi�•.E DAYTIME TELEPHONE MO. 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 BELIEF THIS POUTICAL 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.
DSEB-503(12-99) •