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HomeMy WebLinkAboutFriends of Rick Coplen - 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 unworn 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 {r i.ems A.5 ©F PA c-k Cop l 2.r' Reporting Cycle Name 0 Cycle 1 0 Cycle 2 I.i Cycle 3 0 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 0 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. 7-7ato � ��� ( Signature of Treasurer, andidate, or Lobbyist e (DD/MM/YYYY) t� L . _(► zip,/' ( - ,/0I 1 1 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.gov/campaignfinance • ra-stcampaignfinance@pa.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. (ipd 4 / Zo2/ easurer, Candidate, or Lobbyist Date (DD/MM/YYYY) ;/\----;cje 6),../e4 6,-4/./44/Comie,1/41 Printed Name Location State Cit ( Y/ /Countr Y) DSEB-502R Updated 1/22/2021 —Reset Form Print Form 1 111 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 20200165 (Mark X) n Name of Filing Committee,Candidate or Lobbyist FRIENDS OF RICK COPLEN Street Address 806 ALEXANDER SPRING ROAD City Carlisle State PA Zip Code 17015 Type of Report(Place x under report type) 1-6th Tuesday 2- 2nd Friday 3-30 Day Post 4 6th Tuesday 5-2nd Friday 6-30 Day Post 7-Annual Special 2n°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 $ 1,869.11 B.Total Monetary Contributions and Receipts $ C) ." (From Schedule I) 550.00 c:_- tr.l C.Total Funds Available $ 2,419.11 CJ (--- (Sum of Lines A and B) d-rr-I C D.Total Expenditures $ ' :I= 2,168.13 (From Schedule Ili) 'ter .,,J E.Ending Cash Balance $ `x (Subtract Line D from Line C) 250.98 ~a C) F.Value of In-Kind Contributions Received $ 0 C Cr'? (From Schedule II) G.Unpaid Debts and Obligations $ 0 C)(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 17th day of June 20 21 ' I Signature of Per n S fitting report • r Rod Frazier Signature I Printed Name My Commission expires 717 241-6677 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 17th day of June 20 21 . S' didate Rick Signature Printed Name 717 254-6448 My Commission expires MO. DAY YR. Area Code Daytime Telephone Number SCHEDULE I Contributions and Receipts Detailed Summary Page Filer Identification Number 20200165 1.Unitemized Contributions and Receipts-$50.00 or Less per Contributor Total for the reporting period (1) $ 50.00 I2.Contributions of$50.01 to $250.00(From I Part A and Part B) Contributions Received from Political Committees(Part A) $ 0 All Other Contributions(Part B) $ 100.00 Total for the reporting period (2) $ 100.00 3.Contributions Over$250.00(from Part C and Part D) I Contributions Received from Political Committees(Part C) $ 0 All Other Contributions(Part D) $ 400.00 Total for the reporting period (3) $ 400.00 I4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) Total for the reporting period (4) $ 0 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 550.00 Cover Page,Item B) PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) Flier identification Number: 20200165 Full Name of Contributor Date[MM/DD/YYYY] $ Delano Lantz 05/08/2021 100.00 House# Street Address Date[MM/DD/YYYY]. $ 603 West Old York Road City State Zip Code Date[MM/DD/YYYY] $ Carlisle PA 17015 Full Name of Contributor Date[MM/DD/YYYY] $ Ndtbirl'g FdiidWs 0 House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MAIM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor ' Date[MM/DD/YYYY] $ House# Street Address Date[MMJDD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DDJYYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ PART D All Other Contributions Over$250.00 Use this Part to itemize all other contributions with an aggregate value over$250.00 in the reporting period. (Exclude contributions from political committees reported in Part C) Filer Identification Number: 20200165 Full Name of Contributor Date[MM/DD/YYYY] $ Rick Coplen 400.00 05/12/2021 House# Street Address Date[MM/DD/YYYY] $ 806 Alexander Spring Road City State Zip Code Date[MM/DD/YYYY] $ Carlisle PA 17015 Employer Name Occupation U.S.Army War College Professor Employer Mailing Address/ Principal Place of Business 122 Forbes Ave Carlisle Barracks, PA 17013 Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/ Principal Place of Business Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/ Principal Place of Business Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/ Principal Place of Business SCHEDULE III Statement of Expenditures Filer Identification Number: 20200165 To Whom Paid Date[MM/DD/YYYY] $ Act Blue 11.26 05/05/2021 House# Street Address Description of Expenditure 366 Summer Street City State Zip Somerville MA Code 01244 Service Fee To Whom Paid Date[MM/DD/YYYYI $ Act Blue 16.88 05/11/2021 House# Street Address Description of Expenditure 366 Summer Street City State Zip Somerville MA Code 01244 Service Fee To Whom Paid Date[MM/DD/YYYY] $ Unigraphics 05/14/2021 1,897.95 House# Street Address Description of Expenditure One Jeffrey Road City State Zip Mechanicsburg PA Code 17050 Mailers To Whom Paid Date[MM/DD/YYYY] $ Unigraphics 234.54 O5/14/2021 House# Street Address Description of Expenditure One Jeffrey Road City State Zip Mechanicsburg PA Code 17050 Postage for Mailing To Whom Paid Date[MM/DD/YYYY] $ Act Blue 7.50 06/03/21 House# Street Address Description of Expenditure 366 Summer Street City State Zip Somerville MA Code 01244 Service Fee To Whom Paid Date[MM/DD/YYYY] $ 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/YYYYj $ House# Street Address Description of Expenditure City State Zip Code