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Home My WebLink AboutCommittee to Elect Safronia Perry - 2021 30-Day Post-Primary L t1 t4 ` '1'I'r ' r. .Vr 7;ft�..t.02.7 ,��, 72: a,''�x ti 2 ,i-14,V' 1 ;! .. AIL i4t f r s ,^t.n' `11 :1'� •Q , 4 '1.prwi. .i! tst-.....:, ,•n:—fiallase ra--;r .. .4t. %.',G r 71r-"r .-r-rs.1 t'�.'` X.Z1:+�t.. _ sera.- r,r- . t,l: - 'Y1 t '.r ,y�.� 1' It rr .��'. :x , .v Pennsylvania Department of State ',.;:ri•try Bureau of Campaign Finance&Civic Engagement ::: ,..,,fp.-Anl.i,.;t;.Y 210 North Office Building,Harrisburg,PA 17120 • 717.787.5280 Motion 4) {^ t� r' r%:I�•?�'{, III www.dos.Da.gov/camoaixrtrinancq • ra-stcamoai4nfinancei�Pa ov w ,t.. • r t, Unsworn Statement in Lieu of Sworn Statement for •>. l `g Campaign Finance Reports r'~ " 4 r ,4 Note: Per Act 2020-15, which was signed into law on April 20, 2020 and allows for unsworn r declarations, Campaign Finance Reports(form 0SEB-502), Campaign Finance Statements In lieu t-• 4.,r, y4T4' of full reports(form DSEB-503), and independent Expenditure Reports(form DSEB-50S)need not �,.Ytc,. be notarized. Instead, the filer may file with each report or statement the corresponding version . wM` y}+."• of this form signed by the required individual(s). This particular form is to be used only for ',+dam •'1 Campaign Finance Reports. This form must be signed by hand where a signature is required. - t _committee, Ca.ndidate,CO Lobbb� ist - . • e bl i ;+IL'sL- t 1 cc* Sad o aicy Per ' / "� Reporting ;" "� ,.,,' ,,. ., i0.4 t! 0 Cycle 1 0 Cycle 2 )(Cycle 3 0 Cycle 4 0 Cycle 5 C1. ' -..` ?i-:.` 6th Tuesday 2nd Friday 30 Day 6th Tuesday 2"d Friday " Pre Primary Pre-Primary Post Primary Pre Election Pre Election !;',. • Tx' #-% 0 Cycle 6 ;: 0 Cycle 7 0 Cycle 8 ❑ Cycle 9 `: r;;_; 30 Day Post-Election i;,� '' Ty Annual Report 2"d Friday Pre-Special Election 30 Day Post-Special Election ti ,VI p- 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. M: I declare under penalty of perjury under the law of the Commonwealth of Pennsylvania i' Y that the foregoing is true and correct. w I ,,, i I Al' /1- La :, „. Wj l 1,„ it I ai L.„.ture of Treasurer, Candidate, or Lobbyist l j il Date ( D/MM/YYYY) r • Printed Name M �U �� '� S II i Locat'Ion (City/ tote/Country DSEB-502R Updated 6/24/2020 t :,1r L. r r t rF` 4 +.t 1 .e 1 -..,, i, t►, 1•?,,, r•Ir- .;."• 4t '.. we4.4 -h M t • t .4 r .-..`. , t.r • _ .4. o ** Reset Form i Print Form Commonwealth of Pennsylvania-Campaigi Rnanoe Report (Note:This report must be dear and Iegble.It should be typed) Fier Identification Report Fled By Candidate Committee Lobbyist Number (M ark X) Name of Fling Committee,Candidate or Lobbyist Committee to Elect Safronia Perry greet Address PO Box 1075 City Carlisle gate PA 4p Code 17013 Type of Fieport(Race x under report type) 1-6`h Tuesday 2- 2nd Friday 3-30 Day Post 4-6th Tuesday 5-2m1 Friday 6-30 Day Post 7-Annual Medal 2"O Friday Spedal 30 Day Foe-Primary Pre-Primary Primary Re-Section Fire-Bedion Section Pre Bedion Post-Bedion • Date Of Bedion Year Amendment Termination (M M/DDY YYYY) 11/02/2021 Report Fbport Summary of Feceiptsand From Date To Date For Office Use Only Expenditures 05/04/2021 06/07/2021 A Amount Bought Forward From Last Fbport $ 1774.27 B.Total Monetary Cbntributions and Receipts $ 100.00 (From Sftedule I) c„ "(4,; C Total Funds Available $ `-" (Sim of Lines Aand B) 1874.27 r ri c_.. C i.) D.Total Expenditures $ _� (From Schedule III) 120.75 -- E Ending Cosh Balance $ -- rt1 (Sibtrad Line D from Line Q 1753.52 C) F.Value of In-FGnd Contributions Received $ 0 (From Sdiedule II) 0 C N Z.'G.Unpaid Debts and Obligations $ 0 (From Schedule IV) Affidavit action Part 1-If this is a Committee report,treasurer sign here.If this is a Candidate report,candidate dgn here. I swear(or affirm)that this report,induding 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 I ` day of 3ut e 20r 1 '—?` 9gnature of Parson Sibmitting report __ __'� Pt n � LaMarche Pat 9gnature . 1 Printed Name My Commission expires 207 671-0190 MO. DAY YR Area Code • Dayt i me Telephone Number Part II-If this is a report of aCOandidate'sAuthorized Committee,candidate shall dgn here. I swear(or affirm)that to the best of my knowledge and bell-f this political committee has not violated any provisions of the Act of,Line 3,1937(P.L 1333,NO.320)as amended. �, o,. Sworn to and subscribed before me this o, I ( day of 20 p7‘ Syr �O d�� e%c)N,r' get:4,' 9gnatureofC2ndidate '�i..P;'•y+,P ��` Safronia Perry 9gnature �' . 46 a, Printed Name My Commission ires / "YG��✓'2 4s�f 17 386-6152 MO. DAY YR ��1 e d22r:.Code Daytime Telephone Number Jan.. /N Preg3 eooIf ,Cod' 66 Oj� SCHEDULE! Ghntributionsand Receipts Detailed 3immary Page Her Identification Number 11.Unitemiaed O0ntributionsand FLaceipts$50.00 or Less per Contributor Total for the reporting period (1) $ 2.Cbntributionsof$50.01 to $250.00(From Part A and Part g) CbntributionsFbceived from Political Committees(Part A) $ All Other Contributions(Part B) $ Total for the reporting period (2) $ I •Oontributions Over$250.00(From Part Cand Part D) Contributions Ftceived from Fblitical Committees(Part Ca $ All Other Contributions(Part D) $ Total for the reporting period (3) $ 4.Other FieaeiptsHefunds,Interest Earned,Foturned Checks ETC(From Part E) Total for the reporting period (4) $ n 100 • ° Total Monetary Cbnt ri butions and Paceipts during this reporting period(Add and $ enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Feport .Cover Page,Item B) I DO . °° PART E Other Receipts REFUNIA INTF su INCCIM E RETURNED CHECKS ETC Use this Part to report refunds received,interest earned,returned checks and prior expendituresthat were returned to the filer. Fier Identification Number: Full Name F&M Trust House# greet Address Ritner Highway City `gate I Zp rDate[MM/DD✓YYYY]—_ $- Carlisle �PA (bde 17013 L 06/01/2021 Re 100.00 Receipt Description I Incentive bonus for opening account Full Name House#_ greet Address City -- gate Op Date[MM/DD/YYYY] 03de Receipt Description Full Name House# greet Address City gate Op — r bate[MM/DD/YYYYj $_ tbde Receipt Description Full Name House# 'greet Addressl City j gate Zp i Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# greet Addres1 City -- gate Zp — Date[MM/DiJVYYYY] Gbde Receipt Description - Full Name House# greetAddres1 City gate (Zp Date[MM/DD/YYYYI $" Code Receipt Description SCHEDULE!! IN-KIND CONTRI BUIIONSAND VAWABLETHINGS FBI EV® USE THIS S 6 ULETOFORTALLIN-KINDCONTAIBUTIONSOFVAWABLETHINGSDURINGTHEREPORTINGPS IOD DETAIL®SUMMARY PAGE Filer Identification Number: I1. UNIT MI2IDIN-KIND CONTRIBUTIONS FECHV -VALUEOF$50.000RLEESPK3300NTRIBUTOR TOTALfor the reporting period (1) $ I2. IN-FIND OONTRIBUTIONS FECHVED-VAWE OF$50.01 TO$250.00(FFOM PARTF) TOTALfor the reporting period (2) $ I3. IN-KIND CONTRIBUTION F HVED-VAWEOVER$250.00(FROM PART G) TOTALfor the reporting period (3) $ TOTAL VAWEOF IN-KIND CONTRI BUTTONS DUF4NG THIS REPORTING $ PERIOD(Add and enter amount totalsfrom boxes 1,2,and 3;also enter on Page 1,Feport Cbver Page,Item F) SCHEDULE III Statement of Expenditures Ater Identification Number: To Whom Paid I Date[MM/DCYWYYJ $ Infinity 120.75 05/07/2021 House# Rreet Addres1 121 North Pitt Street Description of Expenditure City 1 Rate ' r21ip ,Carlisle Pa 17013 Printing To Whom Paid Late[AA M/DDrWYYJ $ House# Street Address' Description of Eenditure City Sate Zp Code To Whom Paid I Date[MM/DD✓WYYJ $ .'I House# 9reet Address Description of Expenditure - I City Rate Zp Q3de To Whom Paid 1 Date[MM/DDrYYYYJ $ I House# Street Addre1 Description of Expenditure City l Rate Zip -- ( de To Whom Paid Date[M M/DD/WYYJ $ House# Street Address Description of Expenditure 1. City _. Rate Zp 1 Oode To Whom Paid I Date[M M/DD✓WYYJ $ I House# Street Address [Description of Expenditure City 1 [Rate . Zp -- - . Q3de To Whom Paid 1 Date[M M/DD/WYYJ $ House#'r Street Address I Description of Expenditure 1 City ' ' Rate , Zip 1 _- To Whom Paid [ Date[M MI DD'WYYJ $ House#'—. - - Rreet Address Description ion of Expenditure aty ,' Rate r ip I --- Cade I 93-IEDULE IV Statement of Unpaid Debts Use this 9edion to itemize all unpaid debts and obligat ions which are outstanding at the end of the reporting period. Her Identification Number: Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [M M/DD/YYYYJ City State Zp Code Description of Debt • Name of Creditor Outstanding Balance of Debt House# Street Address I DATE DB3T INCURRED $ RIM/DD/YYYYJ City State— Zp Code Description of Debt Name of Creditor Outstanding Balance of Debt House# •Street Address I DATE DEBT INCURRED $ [MM/DDVYYYYJ City State Zp Cede Description of Debt I _ Name of Creditor 1 Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [M M/DDV YYYY] • City State Zp — Code Description of Debt Name of Creditor Outstanding Balance of Debt House# Street Address I DATE DB3T INCURRED $ [M M/DIY YYYYJ City State Zip -- Code Description of Debt Name of Creditor Outstanding Balance of Debt House# Street Address DATE DER INCURRED-- $ [MM/DIYYYYYJ • City — State Zp Code Description of Debt