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Commonwealth of Pennsylvania-Campaign Finance Report
(Note:This report must be clear and legible.It should be typed)
Filer Identification Report Filed By Candidate . X Committee Lobbyist '
Number (Mark X)
Name of Filing Committee,Candidate or
Lobbyist Karen Maliah
Street Address 2203 Parkside Rd
City Camp Hill State PA Zip Code 17011
•
Type of Report(Place x under report type)
1-6"'Tuesday 2- 2"d Friday 3-30 Day Post 4-6"'Tuesday 5-2"d Friday 6-30 Day Post 7-Annual Special 2'O 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 $ 0
B.Total Monetary Contributions and Receipts $ C.) ►---
(From Schedule 1) 250.00 .. . ram
.'
C.Total Funds Available $ 0 C
(Sum of Lines A and B)
D.Total Expenditures $ r"-
(From Schedule III) 0
E.Ending Cash Balance $ t
(Subtract Line D from Line C) 0
F.Value of In-Kind Contributions Received $
(From Schedule II) 0
G.Unpaid Debts and Obligations $ -< —
(From Schedule IV) 0
Affidavit Section
Part 1-If this is a Committee report,treasurer sign h r-. this is a Candidate report,candidate sign here.
I swear(or affirm)that this report,including the a c j c-.• les on paper,is to the best of my knowledge and belief true,correct and complete.
�Swo n,to and subscrib•. before me this
�,` 'yf�4,hor
dayof , mac./ 20 fi 'y Cod C its,14Ylr v< �i����L�Iir/ZrC///
Co oiler! r +�ld Signature of Person Submitting report
L/ _ / I �i �oi/ti co 'Yp �fo aliah
Signature "� es !y 461k 74y/ Printed Name
My Commission expire> J.1L.t'1 . ("i h AtYd-. 7 r16op6.2o, 303 229 2615
MO. DAY YR. Ar•.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(Pl.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
1.Unitemized Contributions and Receipts-$50.0O or Less per Contributor I
Total for the reporting period (1) $ 150
I2.Contributions of$50.01 to $250.00(From _
Part A and Part B)
Contributions Received from Political Committees(Part A) $ 0
All Other Contributions(Part B) $ 100
Total for the reporting period (2) $
100
3.Contributions Over$250.00(From Part C and Part D)
Contributions Received from Political Committees(Part C) $
0
All Other Contributions(Part D) $ 0
Total for the reporting period (3) $
0
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
Cover Page,Item B) 0
,fi
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^r+'``44, a E'R ';'
A '.` : k.. r.r i
l'
A rt.
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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.)
Filer identification Number:
Full Name of Contributor Date[MM/DD/YYYY] $
Melissa Petigrew Rhen 05/04/2021 100
House# Street Address Date(MM/DD/YYYYJ $
398 • N 25th St
City State Zip Code Date(MM/DD/YYYY] $
Camp Hill PA 17011
Full Name of Contributor Date[MM/DD/YYYYfj"- $
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(MM/DD/YYYY] $
City State Zip Code Date'(MM/DO/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/DO/YYYY] $
House# Street Address Date[MM/DD/YYYY] $
City State Zip Code Date[MM/DD/YYYY] $'