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Home My WebLink AboutCamp Hill Democrats - 2021 2nd Friday 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.eov/campaignfinance • ra-stcamoait=.nfinanceapagov Unsworn Statement 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 unworn declarations, Campaign Finance Reports(form 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 Reports. This form must be signed by hand where a signature is required. Name of Filing Committee, Candidate,or Lobbyist Ca.wtp MCI► o c.ra Reporting C cle Name ❑ Cycle 1 Vi Cycle 2 0 Cycle 3 0 Cycle 4 0 Cycle 5 6th Tuesday 2"d Friday 30 Day 6th Tuesday 2"d Friday Pre-Primary Pre-Primary Post Primary Pre-Election Pre Election ❑ Cycle 6 ❑ Cycle 7 ❑ Cycle 8 ❑ Cycle 9 30 Day Post-Election Annual Report 2"Friday Pre-Special Election 30 Day Post-Special Election Part I-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 foregoing is true and correct. ka 05 I a /zo2t Signature of T asurer, Candidate, or Lobbyist Date(DD/M1'1/YYYY) y . re.l of e-A"? l-l;ll /f A /cvnti.bie-rf^- d Printed Name Location (City/State/Country) DSEB-502R Updated 6/24/2020 lill III I r%caar rune l rnui rune l Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Filer Identification Report Filed By Candidate Committee Lobbyist Number (Mark X) Name of Filing Committee,Candidate or Lobbyist Camp Hill Democrats Street Address 845 Wynnewood Road City Camp Hill State PA Zip Code 17011 Type of Report(Place x under report type) 1-6'h Tuesday 2- 2nd Friday 3-30 Day Post 4-6th Tuesday 5-2nd Friday 6-30 Day Post 7-Annual Special 2"d Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election X Date Of Election Year Amendment Termination (MM/DD/YYYY) 05/18/2021 2021 I Report Report Summary of Receipts and From Date To Date ) For Office Use Only Expenditures 1/1/2021 5/7/2021 A.Amount Brought Forward From Last Report $ 1087.99 C.) r'B.Total Monetary Contributions and Receipts $ (From Schedule I) 2924.00 - - C.Total Funds Available $ rn i"4011.99 r i • (Sum of Lines A and B) 70 -at D.Total Expenditures $ f (From Schedule 111) 2268.18 -.a E.Ending Cash Balance $ -0 (Subtract Line D from Line C) 1743.81 - F.Value of In-Kind Contributions Received $ C 4- (From Schedule II) 196.75 2: G.Unpaid Debts and Obligations $ 0 ...< --I (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 day of 20 ' i �a �_ ISign ure of Person Submitting report Signature 1 Kathy Ireland Printed Name My Commission expires 717 773-5700 • 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 11.Unitemited Contributions and Receipts-$50.00 or Less per Contributor Total for the reporting period (1) $ 1425.00 2.Contributions of$50.01 to $250.00(From Part A and Part B) Contributions Received from Political Committees(Part A) $ 0 All Other Contributions(Part B) $ 1499.00 ( Total for the reporting period (2) $ 1499.00 3.Contributions Over$250.00(From Part C and Part D) Contributions Received from Political Committees(Part C) $ All Other Contributions(Part D) $ Total for the reporting period (3) $ 0 4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) Total for the reporting period (4) 5 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 Cover Page,Item B) 2924.00 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: Full Name of Contributor ' Date[MM/DD/YYYYJ $ Jennifer Hoover 4/2/2021 100.00 House# : IStreet Address Date jMM/DD/YYYY] $ I 127 I S.31 st St I City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17011 Full Name of Contributor Date[MM/DD/YYYY] $ Thomas Fink 04/03/2021 75.00 House# ;Street Address Date[MM/DDJYYYY] $ 514 I Benton Road 100.00 4 05/06/2021 City ' State Zip Code Date[MM/DD/YYYYJ $ Camp Hill i PA 17011 Full Name of Contributor Date[MM/DD/YYYY] $ Kathy Ireland 04/04/2021 1200.00 I House# Street Addressl Date[MM/DD/YYYY] $ 845 Wynnewood Road 04/23/2021 112.00 City I State Zip Code Date(MM/DD/YYYY] $ Camp Hill PA 17011 r Full Name of Contributor Date[MM/DD/YYYY] $ I Bernadette Miller 04/04/2021 1250.00 House# Street Address Date[MM/DD/YYYY] $ 848 Wynnewood Road 04/23/2021 112.00 City 'State Zip Code Date LMM/DD/YYYY] $ Camp Hill I PA 17011 Full Name of Contributor Date(MM/DD/YYYY] $ I Barb LaBine 100.00 04/18/2021 House# Street Address Date[MM/DD/YYYYJ $ 225 Willow Ave City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17011 Full Name of Contributor Date[MM/DD/YYYY] $ I Gayle Sicchiteno 04/27/2021 1100.00 I House# Street Address Date[MM/DD/YYYY] $ 818 Sycamore Circle City ! State Zip Code Date IMM/DD/YYYY] $ Co,l 4 6 C ay- 1_ 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: Full Name of Contributor Date[MM/DD/YYYY] $ Elizabeth Reilly 4/5/2021 100.00 House# Street Address Date[MM/DD/YYYY] $ 117 S. 17th St City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17011 Full Name of Contributor Date[MM/DD/YYYY] $ Marilyn Fetterhoff 04/10/2021 75.00 House# Street Address Date[MM/DD/YYYYj $ 2929 Rathton Rd City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17011 Full Name of Contributor Date[MM/DD/YYYY] $ Jill Family 04/21/2021 100.00 House# Street Address Date[MM/DD/YYYY] $ 362 N.24th St City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17011 Full Name of Contributor Date[MM/DD/YYYY] $ Ronald H Aker 75.00 04/22/2021 House# Street Address Date[MM/DD/YYYY] $ 17 S.29th St City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17011 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] $ • Par ` 6 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: 1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR TOTAL for the reporting period (1) $ 12.00 2. IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F) TOTAL for the reporting period (2) 1 $ 184.75 3. IN-KIND CONTRIBUTION RECEIVED-VALUE OVER$250.00(FROM PART G) TOTAL for the reporting period (3) i $ TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING I $ - PERIOD(Add and enter amount totals from boxes 1,2,and 3;also enter on Page 1,Report Cover Page,Item F) I 195.75 I i I SCHEDULE II PART F in-Kind Contributions Received VALUE OF$50.01 TO$250 Filer Identification Number: Full Name of Contributor 1 Date(MMIDD/YYYY] $ Kristen Acri 0410912021 50.75 House# Street Address Date(MM/DD/YYYY) $ 1709 Lincoln St l _ City State Zip Code Date(MM/DD/YYYYJ $ Camp Hill PA 17011 Description of Contribution Website calendar upgrade,Wix app Full Name of Contributor I Date(MM/DD/YYYY] $ Kathy Ireland 03/30/2021 134.00 House# Street Address Date(MM/DD/YYYYJ $ 845 Wynnewood Rd City State Zip Code Date(MM/DD/YYYY] $ Camp Hill PA 17011 Description of Contribution Year long Post Office Box rental Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date(MM/DD/YYYYJ $ City State Zip Code Date(MM/DD/YYYY] $ Description of Contribution Full Name of Contributor Date[MM/00/YYYY] $ House# (Street Address Date[MM/DD/YYYYJ $ City State Zip Code Date[MM/DD/YYYYJ $ Description 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] $ Description of Contribution SCHEDULE III Statement of Expenditures Filer Identification Number: To Whom Paid Date(MM/DD/YYYY] $ Square credit card processing app 95.34 multiple House# IStreet Address Description of Expenditure City State Zip 1 Code transaction fees for memberships+contributions To Whom Paid Date(MM/DD/YYYY] $ Print for Progress 2172.84 4/23/22021 House# Street Address Description of Expenditure 1635 Market St,Suite 1600 City State Zip Philadelphia PA (Code 19103 Postcard printed&mailed to Borough residents 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 To Whom Paid Date(MM/DD/YYYYJ $ House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date IMM/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 To Whom Paid Date[MM/DD/YYYYJ $ House# Street Address Description of Expenditure City State Zip Code