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HomeMy WebLinkAboutFriends of Mercedes Evans - 2021 30-Day Post-Primary jig Reset Form Print Form Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Her Identification Report Filedly Candidate -'- Committee Lobbyist — Number (Mark X) X Name of Filing Committee,Candidate or Lobbyist Friends of Mercedes Evans Street Address P.O.Box 3213 City Camp Hill State PA Zip Code 17011 Type of Report(Place x under report type) 1 1-6th Tuesday 2- 2nd Friday 3-30 Day Post 4-6th Tuesday 5-21tl Friday 6-30 Day Post 7-Annual Special r Friday Special 30 Day J Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election c n - Wn Date Of Election Year Amendment �/ Termination ---, (MM/DD/YYYY) 05/18/202t 2021 Report X Report Summary of Receipts and From Date To Date For Office Use Only Expenditures . 05/04/2021 06/0712021 A.Amount Brought Forward From Last Report _ 8 4251.15 C7 r-, B.Total Monetary Contributions and Receipts 8- ,'r; (From Schedule I) 781.16 CU C.Total Funds Available $ r ii (Sum of lines A and B) 5032.31 r D.Total Expenditures . i ct t • (From Schedule Ill) 564.21 C CC_? E.Ending Cash Balance S = C) (Subtract line D from Line C) 4468.10 $0 .si F.Value of In-Kind Contributions Received i -• (From Schedule II) 0 G.Unpaid Debts and Obligations i - (From Schedule IV) 0 Affidavit Section Part 1-it this is a Committee report,treasurer sign here.It 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 • T 2zi ._C �� Signature of Person Submitting report Patricia Smith Signature Printed Name My Commission expires 717 919-8585 MO. DAY YR. Area Code Daytime Telephone Number Part If-if this Is a report of a Candidates 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 dune 3,1937(P.L 1333,NO.320)as amended. Sworn to and subscribed before me this Pot dill" day of 20 Sig6/7/1414...--- nature of Candidate Mercedes Evans Signature Printed Name My Commission expires 717 303-3932 MO. DAY YR. Area Code Daytime Telephone Number } SCHEDULE I Contributions and Receipts Detailed Summary Page Filer identification Number nitemized Contributions and Reecelpts-$50.00 or Less per Contributor 1 1.0 Total-for the reporting period (1) I 50 2.contribution of$50.01 to 1250.00(From Part A and Part 8) Contributions Received from Political Committees(Part A) $ 0 All Other Contributions(Part 8) $ 230s9 Total for the reporting period (2) i 230s9 3.Contributions Over 8250.00(From Part C and Part D) Contributions Received from Political Committees(Part C) 1 0 All Other Contributions(Part D) 8 500 Total for the reporting period (3) $ 500 4.Other Receipts-Refunds,Interest gamed,Returned Checks,ETC.(From Part E) 1 Total for the reporting period (4) i< .17 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 781.18 Cover Page,Item B) PART E Other Receipts REFUNDS,INTEREST INCOME,RETURNED CHECKS,ETC. Use this Part to report refunds received,interest earned,returned checks and prior expenditures that were returned to the filer. Filer Identification Number. Full Name Members 1st Federal Credit Union Houser Street Address P.O.Box ao City State Zip Date[MM/DD/YYYY] 8 Mechanicsburg PA Code 17055 05/31/2021 .17 Receipt Description Dividend Full Name House# Street Address City State Zip Date[MM/DD/YYYY] $ i Code Receipt Description Full Name House# Street Address City State Zip Date[MM/DD/YYYY] 8 Code Receipt Description Fall Name House# Street Address City State Zip Date[MM/OD/YYYY] S Code Receipt Description Full Name House# Street Address City State Zip Date(MM/DD/YYYY] S Code Receipt Description Full Name House# Street Address Cfty State , Zip Date[MM)DDIYYYY] S Code Receipt Description SCHEDULE III Statement of Expenditures Flier Identification Number. To Whom Paid Date[MM/DD/YYYY] f ActBlue 05/052021 1'50 House# Street Address Description of Expenditure 366 Summer Street City Sommerville MA MA Cie 02144 Transaction Fees To W(rom Paid Date[MM/DD/YYYY] i House# rtt Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/YYYY] $ House# Street Address Description of Expenditure City IState Tap Code To W om Paid Date[MM/DD/YYYY] t House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/YYYY] 8 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/YYYY] 8 House# Street Address Description of Expenditure City State Tip Code To Whom Paid Date[MM/DD/YYYY] t } House# Street Address Description of Expenditure E City State Zip Code • IRPennsylvania Department of State 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(u)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 of Filing Committee, Candidate, or Lobbyist Friends of Mercedes Evans Reporting Cycle Name ❑ Cycle 1 0 Cycle 2 © Cycle 3 0 Cycle 4 0 Cycle 5 6t Tuesday 2nd Friday 30 Day 6th Tuesday 2nd Friday Pre-Primary Pre-Primary Post Primary Pre-Election Pre Election ❑ Cycle 6 0 Cycle 7 ❑ Cycle 8 0 Cycle 9 30 Day Post-Election Annual Report 2nd 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 accompanying Campaign Finance Report is true and correct. re , G�,r 06/16/2021 Signature of Treasurer,Candidate, or Lobbyist Date (DD/MM/YYYY) Patricia Smith Harrisburg, PA, USA Printed Name Location (City/State/Country) DSEB-502R Updated 1/22/2021 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.sov/campaignfinance • ra-stcampaienfinancePpa.Pov Part II-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. CYO � f 2�A' 06/16/2021 Signature of Treasurer,Candidate, or Lobbyist Date (DD/MM/YYYY) Mercedes Evans Camp Hill, PA, USA Printed Name Location (City/State/Country) OSEB-502R Updated 1/22/2021 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) X Name of Filing Committee,Candidate or Lobbyist Friends of Mercedes Evans Street Address P.O.Box 3213 City Camp HIII State PA Zip Code 17011 Type of Report(Place x under report type) 1-6th Tuesday 2- 2ntl Friday 3-30 Day Post 4-6thTuesday 5-2nd Friday 6-30 Day Post 7-Annual Special 2"0 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 Report Report Summary of Receipts and From Date To Date For Office Use Only Expenditures 05/04/2021 06/07/2021 A.Amount Brought Forward From Last Report S 4,257.83 r) — B.Total Monetary Contributions and Receipts S 780 f} .a r- (From Schedule I) 99 =n- "" C.Total Funds Available S wry j c (Sum of Lines A and B) s,o38 82 D.Total Expenditures S „-1 (From Schedule III) 562.71 - E.Ending Cash Balance • S 3 , (Subtract Line D from Line C) 4,476.11 C F.Value of In-Kind Contributions Received S 0 Cb (From Schedule II) ---4 w G.Unpaid Debts and Obligations S "< W 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 /,�A' 16 day of June 20 21 • y%�/����1�mil/ lat. l.fit CE Signature of P on Submitting report ItedNa Name 5Mrfh Signature Printed Name My Commission expires -$rr—$3 717 -se3a93� 9,q'�`s�s 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 dune 3,1937(Pl.1333,NO.320)as amended. Sworn to and subscribed before me this InOWv�Jday of 20 A Si u=e of eyJ c Signature '"( Printed Name My Commission expires 1 11 0; - 3 g 3 2 MO. DAY YR. Area Code Daytime Telephone Number SCHEDULE I Contributions and Receipts Detailed Summary Page Filer Identification Number 1.Unitemized Contributions and Receipts-S 50.00 or Less per Contributor Total for the reporting period (1) 8 50 2.Contributions of S 50.01 to 8250.00(From Part A and Part B) • Contributions Received from Political Committees(Part A) 8 0 All Other Contributions(Part B) 8 230.99 Total for the reporting period (2) 8 230.99 I3.Contributions Over.8250.00(From Part C and Part D) . - Contributions Received from Political Committees(Part C) 8 0 An Other Contributions(Part D) 8 500 Total for the reporting period (3) 8 500 I • 4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) I Total for the reporting period (4) S 0 Total Monetary Contributions and Receipts during this reporting period(Add and 8 enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report Cover Page,Item 8) 780.99 PART B All Other Contributions 850.01 TO 8250 Use this Part to itemize all other contributions with an aggregate value from 850.01 TO S 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] S William Cope 0.5 2q I tD LI 100 House# Street Address .Date[MM/DD/YYYY] 8 848 Arlington Road City State Zip Code Date[MM/DDIYYYY] 8 Camp Hill PA 17011 Full Name of Contributor Date[MM/DD/YYYY] 8 Mercedes Evans 05/19/2021 130.99(flyer repayment) House#, Street Address Date[MM/DD/YYYY] 8 3001 Beverly Road City State Zip Code Date[MM/DD/YYYY] 8 Camp Hill PA 17011 Full Name of Contributor Date[MM/DD/YYYY] 8 House# Street Address Date[MM/DD/YYYY] 8 City State Zip Code Date[MM/DD/YYYY] 8 Full Name of Contributor Date[MM/DD/YYYY] l $ House# Street Address Date[MM/DD/YYYY] 8 City State Zip Code Date[MM/DD/YYYY] S Full Name of Contributor Date[MM/DD/YYYY] S House# Street Address Date[MM/DD/YYYY] S City . State Zip Code. Date[MM/DD/YYYY] 8 Full Name of Contributor Date[MM/DD/YYYY]. S House# Street Address Date[MM/DD/YYYY] 8 City State Zip Code Date[MM/DD/YYYY] 8 PART D All Other Contributions Over S 250.00 Use this Part to itemize all other contributions with an aggregate value over S 250.00 in the reporting period. (Exclude contributions from political committees reported in Part C) Filer Identification Number: Full Name of Contributor Date(MM/DD/YYYY] S Robert Penny 500 05/20/2021 House# Street Address Date[MM/DD/YYYY] S 4640 La Cuenta Drive City State. Zip Code Date[MM/DD/YYYY] S San Diego CA 92124 Employer Name Not Employed Occupation Employer Mailing Address/ Principal Place of Business Full Name of Contributor Date[MM/DD/YYYY] S House# Street Address Date[MM/DD/YYYY] $ City State. Zip Code Date[MM/DD/YYYY] S Employer Name Occupation Employer Mailing Address I Principal Place of Business Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY]` S City State Zip Code Date[MM/DD/YYYY] S Employer Name Occupation Employer Mailing Address/ Principal Place of Business A Full Name of Contributor Date[MM/DD/YYYY] S House# Street Address Date[MM/DD/YYYY] S City State Zip Code Date[MM/DD/YYYY] S, Employer Name. Occupation Employer Mailing Address Principal Place of Business SCHEDULE III Statement of Expenditures Filer Identification Number: To Whom Paid Date[MM/DD/YYYY] S USPS 05/13/2021 28 80 House# 1675 Street Address Camp Hill Bypass Description of.Expenditure . City State Zip Camp Hill - CA Code 17011 Postcard Postage To Whom Paid Date[MM/DD/YYYY] 8 FedEx Office 166.80 05/17/2021 House# 3462 Street Address Paxton Street Description of Expenditure City Zip Harrisburg State PA Code 17111 Printing Services TO Whom Paid Date[MM/DD/YYYY] S Zaale Inc 130.99 05/19/2021 House# 1900 Street Address seaport Blvd Description of Expenditure City State Zip Redwood City CA Code 94063 Flyers To Whom Paid Date[MM/DD/YYYY] 8 Staples 05/14/2021 15.89 House# 128 Street Address 5.32nd Street Description of Expenditure City Zip Camp Hill State PA Code 17011 Campaign Business Cards To Whom Paid Date[MM/DD/YYYY] $ ActBlue OP JD3I2D2-1 9.75 House# Street Address Description of Expenditure 366 Summer Street City Zip Somerville State MA Code 02144 Payment Processing Fees To Whom Paid Date[MM/DD/YYYY] 8 House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/YY YY] S Vanvit,LLC 2.49 os t/zort n House# 8500 Street Address Governors Hill Drive Description of,Expenditure City Symmes Township State OH Code 45249 Merchant service processing fees To Whom Paid Date[MM/DD/YYYY] $ postermywall 05/17/2021 7.99 House# Street Address Description of Expenditure 6965 El Camino Real,Suite 105#518 City Zip Carlsbad State CA 92009 Business Card Template Design Cp Code SCHEDULE III Statement of Expenditures Filer Identification Number: To Whom Paid . Date[MM/DD/YYYY] S Shannon Kid Photography 75 05/12/2021 House# Street Address Description of Expenditure 8 Richland Lane City Zip Camp Hill State CA de 17011 Deposit for professional photography services To Whom Paid Date[MM/DD/YYYY] S Shannon Kid Photography 125 06/06/2021 House# s Street Address Richland Lane Description of Expenditure City Zip Camp Hill State PA Code 17011 Remaining payment for photography services To Whom Paid Date[MM/DD/YYYY]• S House# Street Address Description-of Expenditure City State Zip • Code . To Whom Paid Date[MM/DD/YYYY] S House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/YYYY] S House# Street Address Description of Expenditure City State Zip Code To Whom Paid. Date[MM/DD/YYYY] S House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/YYYY] S House# Street Address Description of Expenditure City State Zip • Code To Whom Paid. Date[MM/DD/YYYY] S House# Street Address Description of Expenditure City State Zip Code