HomeMy WebLinkAboutPerry, Safronia - 2021 6th Tuesday Pre-Election 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 100 REPORT FILED ' CANDIDATE I. 3.
NUMBER ON BEHALF OF .COMMITTEE LOBBYIST
NAME OF FILING COMMITTEE,CANDNIIRTE OR LOBBYIST
�3iC2 ��tn) 0 L- c:-.)06-1-c‘,(P-- SA-
STREET ADDRESS
CITY STATE ZIP CODE
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) �J �O 0%,Coi, MO. DAY YEAR
1. �Jj
6TH TUESDAY
PRE-PRIMARY;'' FOR OFFICE`.USE ONLY
:.. -MO. DAY ..YEAR
2ND FRIDAY 2. DATES OF
PRE-PRIMARY REPORTING & g a l TO 9 139,1
30 DAY 3.
POST4RIMARY. . n
CASH BALANCE AT END ``��
6r„yu y:: 4• OF REPORTING PERIOD: $ C_J . ,
al
PRE,-.ELECTION .
TOTAL AMOUNT OF FILER'S XI -rn
0
OUTSTANDING DEBTS OR LIABILITIES n t`"'
PRE ELECTIRIDAY AT THE END OF REPORTING PERIOD: $ / f�,3
PRE-ELECTION
PO DAY AMENDMENT
POST-ELECTION REPORTS YES NO
CO
ANNUAL: . a.- -
TERNIINATK)N.; ' / --I, CO
REPORT REPORT? YES NO
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 Candidate,the Candidate must sign here.
If statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00) D THIS REPORT IS,TO THE BEST OF MY WLEDGE AND Bal., RUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME TH
�/ S� DAY OFr4yd�, SIGN E OF PE-•,•N -MITTING REPORT
C'i��`���G�-(/ J{-A cOn 4 lo* �dr 046.bt L O m PRINTED NAME
MY COMMISSION EXPIRES SJ1.1 IE /`l �D Ai,
�� t 6% I i .k(S)" to 1S )
MO. DAY YR. AREA 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)