HomeMy WebLinkAboutCentral Cumberland Democrats - 2021 30-Day Post-Primary 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 110, REPORT FILED .CANDIDATE - I.
NUMBER ON BEHALF OF , COMMIT.TEE: 2. LOBBYIST 3.
NAME OF FILING TEE CANDIDATE OR LOBBYIST / ZI
CFr/MTT1e' 6,4.(J ✓!fit Hal htciCIe��S
STREET ADDRESS
c2/. 1106 E.sY-ow,t RI
CITY - L/ STATE ZIP CODE
l F l'( a I S Lou, j ?4 4 / �h�
TYPE OF REPORT NAME OF OFFICE BOUgHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO. DAY YEAR
1.
6TH TUESDAY'
PRE-PRIMARY: `' FOR OFFICE USE ONLY
... .MO. DAY ._ YEAR``. ..MO. DAY :":YEAR. .. - .
2ND`FI21DAYS'i °'2. DATES OF �j l
PRE•PRMARY...' . : PE(UOD NG [C� al TO 62 ? CX
30:DAY .. 3.
POST-PRIMARY ✓ l r.
CASH BALANCE AT END /�Cc.
OF REPORTING PERIOD: $ �7 J ` Q7 `-" '"'^)
6TH.TUESDAY: .
PRE-ELECTION . w:.« (-
TOTAL AMOUNT OF FILER'S T r 1 C_
5. OUTSTANDING DEBTS OR LIABILITIES �^�
2ND'FRIDAY R-
PRE-ELECTION:_. AT THE END OF REPORTING PERIOD: $ V .....
-40
s. i)
30 DAY
POST-ELECTION R� ? YES AMENDMEtfT
NO ✓ 0 -
«.7
ANNUAL
REPORT TEOIHILTION.. YES NO '/ ---I
REPORT? ✓ ..< In
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 Candid- e,the Candidate must sign here.
If statement is filed on behalf of a Conti. = obbyist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIP'-OR DIS , I S OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT ,
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250 R I)AND e� TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE, AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE M- IS MyCp� C k, js23,11,,,t... . (-� L
4. 1
DAY OF&14.4.�IJe-� CO��t (`Ot '+ OF
I , d ry'Dt, 7l� I 5
/4,
SIGNATURE 716p0 102 PRINTED NAME
MY COMMISSION EXPIRES C , N` I yg293 66 3 / -0 C 2 0 O =— 3 ` VS—
MO. DAY YR. -EA 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.
DSEB-503(12-99)