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Home My WebLink AboutSusquehanna Progress Coalition - 2021 2nd Friday Pre-Primary -, K Pennsylvania Department of State ^.A'•Y' 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 C I. ' Co mittee Candidate,Cp Lo•b ist Susquehanna Progress Coalition Re•orting(4;111banktg ❑ Cycle 1 i] Cycle 2 ❑ Cycle 3 ❑ Cycle 4 ❑ Cycle 5 6th Tuesday 2nd Friday 30 Day 6th Tuesday 2nd 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 2nd Friday Pre-Special Election 30 Day Post-Special Election Part l- 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. 05/05/2021 Signatu reasurer, 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 Fw Bureau of Campaign Finance&Civic Engagement 210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4) www.dos.pa.gov/campaignfinance • ra-stcampaignfinancePpa.gov Part 11-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. Signature of Treasurer, Candidate, or Lobbyist Date (DD/MM/YYYY) Printed Name Location (City/State/Country) DSEB-502R Updated 1/22/2021 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 CANDIDATE I. 1. 3. NUMBER ' ON BEHALF OF ' COMMITTEE X LOBBYIST NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST Susquehanna Progress Coalition STREET ADDRESS 102 Saint Johns Church Road CITY Camp Hill STATE ZIP CODE PA 17011 TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION (CHECK ONE) N/A N/A N/A MO. DAY YEAR BTH TUESDAY *I. _ 05 18 2021 PRE-PRIMARY _ FOR OFFICE USE ONLY MO. DAY YEAR MO. DAY YEAR - - - -"-- 2ND FRIDAY 2. DATES OF PRE-PRIMARY X REPO REPORTING 03 30 21 TO 05 03 21 30 DAY 3. c.> ti POST-PRIMARY {. aro CASH BALANCE AT END 332.35 -""' �', 6TH TUESDAY 4. OF REPORTING PERIOD: $ LJ* - PRE ELECTIONI rT'i - TOTAL AMOUNT OF FILER'S --C 2ND FRIDAY 5. OUTSTANDING DEBTS OR!LIABILITIES 0.00 I PRE-ELECTION AT THE END OF REPORTING PERIOD: $ CI B. C 30 DAY POST-ELECTION AMENDMENT YES NO X C IN) REPORT? ., 7. ANNUAL TERMINATION YES NO .C ^G 11 REPORT REPORT? X 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 Contributing Lobbyist,the Lobbyist must sign here. I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT EXCEED TWO HUNDRED AND FIFTY DOLLARS(S250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE. SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF 20.— SIGT RSON SUBMITTING REPORT Sarah - •er SIGNATURE PRINTED NAME MY COMMISSION EXPIRES 717 856-1388 MO. DAY 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 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 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 -----