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HomeMy WebLinkAboutSchmitz, Mary Kathryn - 2021 2nd Friday Pre-Election 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 Statement 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), 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 1Y4 ^OCTh 1 J j V� dill - Reporting Cycle Name ❑ Cycle 1 ❑ Cycle 2 ❑ Cycle 3 ❑ Cycle 4 v Cycle 5 6th Tuesday 2"d Friday 30 Day 6th Tuesday 2"d Friday Pre-Election Pre-Primary Pre-Primary Post Primary Pre-Election ❑ Cycle 6 ❑ Cycle 7 ❑ Cycle 8 0 Cycle 9 30 Day Post-Election Annual Report 2nd Friday Pre-Special Election 30 Day Post-Special Election Part 1- 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 foregoing is true and correct. IC) -S4 ate; l Signa r of Trea er, Candi•%or Lobbyist Date (DD/MM/YYYY) c‘tvsir I;I ctM L rL,,L co . Printed Name Location State Countr (City/ / Y) DSEB-502R Updated 6/24/2020 llII . if-----...-r.,-„, 11.----,-„,..,,..-,-,.„,„--] 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 Mary Kathryn Schmitz Street Address 759 Country Club 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 4-6th Tuesday 5-2"d 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) 11/02/2021 2021 Report Report Summary of Receipts and From Date To Date For Office Use Only Expenditures Sept 20 October 22 A.Amount Brought Forward From Last Report $ 0 B.Total Monetary Contributions and Receipts $ (From Schedule I) 0 C.Total Funds Available $ Cm) (Sum of Lines A and B) 0 ,.y D.Total Expenditures $ . cisz 1514 C4 (From Schedule III) Cr c E.Ending Cash Balance $ —4(Subtract Line D from Line C) 0 > f F.Value of In-Kind Contributions Received $ :t'. C.11 (From Schedule II) 0 1)G.Unpaid Debts and Obligations $ (")0 C) v (From Schedule IV) •• C Affidavit Section -4 C7 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 % 1 day of 20 �� nature of P on Submitting rep• Mary Ka Schmitz Signature Printed Name My Commission expires 610 731-1320 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 III Statement of Expenditures Filer Identification Number: To Whom Paid Date[MM/DD/YYYY] $ Konhaus Printing 1205 10/01/2021 House# Street Address Description of Expenditure 3544 Gettysburg Road City Zip Camp Hill State PA Code 17011 door hangers and lawn signs To Whom Paid Date[MM/DD/YYYY] $ Custom Ink 309 9/20/2021 House# Street Address Description of Expenditure 160 N Guiph Road Suite 2309 City Zip King of Prussia State PA Code 19406 tshirts 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/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/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