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