HomeMy WebLinkAboutPerry, Safronia - 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 -
NUMBER OF ON BEHALF FILED
NUMBER :CANDIDATE . I.
COMMITTEE.:- 2. •LOBBYIST 3•
NAME OF FILING C/O�Mt/M`ITnTEE, i• • •.. BYLOBBYIST
STREET ADDRESS
r) I,c:Porn- •e- ..S-\ .
CITY STATE ZIP CODE
(Oa Ii -e_ RA 1701 —_
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO. DAY YEAR: '
:1.
.>6TM`TUESDAY ;::
FRE=PRIMARy' . 'FOR OFFICE':USE.ONLY :
... .. :MO.. ..DAY'.. . YEAR.`:. MO. .. .DAY ' :.':YEAR.
• Z• DATES OF
PREZN 411.1MDAY. . REPORTING �( r� TO /^ 1
-PRIMARY:<; PERIOD S I a i. to 7 02 l
• 30.DAY ..• .. . .. ti n
•POST-PRIMARY
V
C.
. CASH BALANCE AT END
4• OF REPORTING PERIOD:
eni suEsnAy:•••:,:' $ O •
PREeELECTION
TOTAL AMOUNT OF FILER'S --,. —
• T_
OUTSTANDING DEBTS OR LIABILITIES
• ITI
ZNO FRIDAY
• AT THE END OF REPORTING PERIOD: $
PRE-ELECTION ? C,
6. 0 .
—
30 DAY C
POST-ELECTION AMENDMENTYES NO / '„„1 4J1
try .
:ANNUAL TERMINATION.: ''
REPORT ' • REPORT7. • YES NO
AFFIDAVIT SECTION
PART 1-
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 Candidate,the Candidate must sign here.
If statement is filed on behalf of a Contributing Lo, • •st,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISCI - EME9•- LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND IS REPORT IT• HE BEST OF MY KNOWLEDGE AND BELT TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS 4. S4,4°• / ,
DAY OF V 4., fy, SIG •i'URE OF PE MITTI G REPORT
( A/1 1 -"If
4>4)4, ,:t.r 41, • 1 Un I t�i I�1(I
`�(/, SIGNATURE ���1��� �6��dy PRINTED NAME l
MY COMMIS ION EXPIRES �A.I,ti • D f 6 0a3 '40AY YR' ,,'6 C�0i c"DAY IsMO. ELEPHONE 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 POUTICAL 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) •