HomeMy WebLinkAboutMiller, David R. - 2021 2nd Friday Pre-Primary Commonwealth of Pennsylvania PAGE 1 OF
- > CAMPAIGN FINANCE REPORT (COVER PAGE)
(NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification ► Report , 1. 2. 3.
Number: Filed By CANDIDATE y COMMITTEE LOBBYIST
Name of Filing ommittee, Candidate or Lobbyist:
Av/.d t2, 1/4 Gt LF/L
Street Address:
/ UJA 1-VA) ,1DX( yr
City: State: Zip C de:
CA41,tsGr �� 190IS -
TYPE OF 6TH TUESDAY 1' 2ND FRIDAY y 30 DAY 3. AMENDMENT YES NO
REPORT PRE-PRIMARY PRE-PRIMARY POST PRIMARY REPORT?
6TH TUESDAY 4. 2ND FRIDAY 5. 30 DAY u• TERMINATION `/
PRE-ELECTION PRE-ELECTION POST ELECTION REPORT? YES NO
(place X to
the right of ANNUAL 7. YEAR FILING METHOD
report type) REPORT ( ) CHECK ONE PAPER DISKETTE
Name of Office Sought by Candidate: DATE OF ELECTION District Office Party County
Number Code Code Code
Se j V` 1J_�� \ �i Y e Q.-cy,- MO. DAY YEAR
5 ( ' A0.2 , (SEE INSTRUCTIONS FOR CODES)
FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR
Summary of Receipts ► (
and Expenditures from: „904aj To 5 3 aDoi
C... 3
, r+
A. Amount Brought Forward From Last Report $
L -; _
B. Total Monetary Contributions and Receipts (From Schedule I) $ — I,1 X"
7) --
C. Total Funds Available (Sum of Lines A and B) $ �-,
2 Cr)
D. Total Expenditures (From Schedule III) $ ' /66•0 9/ Ci yti
C''7 ..:..
E. Ending Cash Balance (Subtract Line D from Line C) $ — 0
c
F. Value of In—Kind Contributions Received (From Schedule II) $
-< CI
G. Unpaid Debts and Obligations (From Schedule IV) $
AFFIDAVIT SECTION
PART I — 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, includi,! th- tached schedules, on paper or computer diskette, are to the best of my knowledge and belief true,
correct and complete. O14i770n
Sworn to and subscribed before me thiju ifwPatth ( �
SA day of "WCom�CO�bRRSPnns�tyfi _ DLO /VL-\/\ —‘
- Coyn s4s,S. tO'4d o107/3 4'Otd Signature of Person Submitting Report
L'Oet,/ 11:0 �`SS��Nv�pPs�a°� Ubtj� ry tr.
I�Av/ig X., �v i L t.FII
Signature n76'/.I''')74 Printed Name
JJ���� 760066 pl3 �1
My commission expires `"1 . Iilr �vOa3 30, 9 Y— 1- .7(
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
I Signature of Candidate
Signature Printed Name
My commission expires
MO. DAY YR. Area Code Daytime Telephone Number
Department of State • Bureau of Commissions, Elections and Legislation
303 North Office Building • Harrisburg, PA 17120-0029 • (717) 787-5280
DSEB-502 (7-99)
PAGE OF
SCHEDULE III
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
,01.11ViD lon I 61-FA, From //1/ 1-0141 To -570-0 71
To Whom PaidMo. DAY ":YEAR<JAMORIt
CONZX CA/E4/9 ,OLINAe 03 19 loll $ Va/IF
Mailing Address Description of Expenditure
//.51,SA ()N-E0011-0(4) „OA SUITI /00 y Ake
City State Zip Code (Plus 4)
Ao54-I.N)
To Whom Whom Paid MO AY YEAR Amount
>V/ iVot OY 9,vt,t i $ / , 61-
Mailing Address Description of Expenditure
3-CO 5. Alex/ .57 ,O5TC4o20
City Siba Ziip,Coaide3(Plus 4)
c-At-us-4 , PA
To Whom Paid ,;',."'.DAYZ,'• YEA/1AAmount
$
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid lAmount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid :- AR Amount
$
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid DAY YEAR•JAmount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid AY10'. 6AY YEAR Amount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid nffItAl Amount
$
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
I PsAGi,TOTAL ?
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D.
DSEB-502 (7-99)