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Home My WebLink AboutHampden Township Democratic Club - 2021 30-Day Post-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.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 of Filing Committee, Candidate, or Lobbyist Hampden Township Democratic Club Reporting Cycle Name El Cycle 1 ❑ Cycle 2 l] Cycle 3 El 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 El Cycle 7 ❑ Cycle 8 ❑ Cycle 9 30 Day Post-Election Annual Report 2"d 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. 06/11/2021 Signature o 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 II II Reset Form I Print Form 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 20200298 (Mark X) n Name of Filing Committee,Candidate or Lobbyist Hampden Township Democratic Club Street Address 102 Saint Johns Church Road City Camp Hill State PA Zip Code 17011 Type of Report(Place x under report type) 1-6th Tuesday 2. 2nd Friday 3-30 Day Post 4-6t^Tuesday 5-2nd Friday 6-30 Day Post 7-Annual Special 2"Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election 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 $ 3891.76 C) t B.Total Monetary Contributions and Receipts $ (From Schedule I) 83.14 CJ t M C.Total Funds Available :0 .Z' 3974.90 (Sum of Lines A and B) -- D.Total Expenditures $ 1~ (From Schedule III) 715.75 CZ) E.Ending Cash Balance $ C? ::'�` (Subtract Line D from Line C) 3259.15 0 - C F.Value of In-Kind Contributions Received $ ": •C.. (From Schedule II) 0.00 -< CA G.Unpaid Debts and Obligations $ (From Schedule IV) 0.00 • 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 • �1 IIII �} N. Signature• •• ubmitting report Sarah Verger Signature Printed Name My Commission expires 717 856-1388 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 20200298 1.Unitemized Contributions and Receipts-$50.00 or Less per Contributor I Total for the reporting period (1) $ 83.00 2.Contributions of$50.01 to $250.00(From I Part A and Part 8) Contributions Received from Political Committees(Part A) $ 0.00 All Other Contributions(Part B) $ 0.00 Total for the reporting period (2) $ 0.00 I3.Contributions Over$250.00(From Part C and Part D) I Contributions Received from Political Committees(Part C) $ 0.00 All Other Contributions(Part D) $ 0.00 Total for the reporting period (3) $ 0.00 I4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) I Total for the reporting period (4) $ .14 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 83.14 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: 20200298 Full Name Members First Federal Credit Union House# 6280 Street Address Carlisle Pike City State Zip Date[MM/DD/YYYY] $ Mechanicsburg PA Code 17050 05/31/2021 0.14 Receipt Description Dividend Full Name House# Street Address City State Zip Date[MM/DD/YYYYJ $ Code Receipt Description • Full Name House# Street Address City State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address City State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name ' House# Street Address City State Zip Date[MM/DD/YYYY] $ Code Receipt,Description Full Name House# Street Address City State Zip Date[MM/DD/YYYY] $ Code Receipt Description SCHEDULE III Statement of Expenditures Filer Identification Number: 20200298 To Whom Paid Date[MM/DD/YYYY] $ Amazon 148.50 05/03/2021 House# Street Address Description of Expenditure 410 Terry Avenue North City State Zip Seattle WA Code 98109 Election Day Supplies To Whom Paid Date[MM/DD/YYYY] $ Vistaprint 103.84 05/05/2021 House# Street Address Description of Expenditure 275 Wyman Street City State Zip Waltham MA Code 02451 Slate Cards To Whom Paid Date[MM/DD/YYYY] $ ActBlue 1.28 05/05/2021 House# Street Address Description of Expenditure . - 366 Summer Street City State Zip Somerville MA Code 02144 Fee To Whom Paid Date[MM/DD/YYYY] $ Squarespace 152.64 O5/06/2021 House# Street Address Description of Expenditure 225 Varick Street,12th Floor City State Zip New York NY Code 10014 Website To Whom Paid Date[MM/DD/YYYY] $ Walmart 296.60 05/07/2021 House# Street Address Description of Expenditure 702 SW 8th Street City State Zip Bentonville AK Code 72716 Election Day Supplies To Whom Paid Date[MM/DD/YYYY] $ Vantiv eCommerce 5.94 - 05/11/2021 House# Street Address Description of Expenditure 8500 Governors Hill Drive City State Zip Fee Symmes Township OH Code 45249 To Whom Paid Date[MM/DD/YYYY] $ Members First Federal Credit Union 4.95 05/31/2021 House# Street Address Description of Expenditure 6280 Carlisle Pike City State Zip Mechanicsburg PA Code 17050 Bill Pay Fee To Whom Paid Date[MM/DD/YYYY] $ ActBlue 2.00 06/03/2021 House# Street Address Description of Expenditure 366 Summer Street City State Zip Somerville MA Code 02144 Fee