HomeMy WebLinkAboutColleen for PA - 2021 2nd Friday Pre-Election ylvania Department of State
I rBureauPenns of Campaign Finance&Civic Engagement
210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4)
www.dos.pa.sov/campaignfinance • ra-stcampaienfinance(a1pa.eov
Unsworn Declaration 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 unworn
declarations, Campaign Finance Reports (form DSEB-502), Campaign Finance Statements in lieu
of full reports (form DSEB-503), Non-Bid Contract Reporting Form (DSEB-504) 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
Colleen for PA
Reporting Cycle Name
❑ Cycle 1 0 Cycle 2 0 Cycle 3 0 Cycle 4 • Cycle 5
6th Tuesday 2nd Friday 30 Day 6th Tuesday 2nd Friday
Pre-Primary Pre-Primary Post Primary Pre-Election Pre Election
❑ Cycle 6
0 Cycle 7 0 Cycle 8 0 Cycle 9
30 Day Post-Election
Annual Report 2"d Friday Pre-Special Election 30 Day Post-Special Election
Part I- 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 I declare under penalty of perjury under the law of the Commonwealth of Pennsylvania
that the accompanying Campaign Finance Report is true and correct.
Occ..4140 ,./ z ___ _,
19/10/2021
Signature of Treasurer, Candidate, or Lobbyis Date (DD/MM/YYYY)
Carol E. Thornton Mechanicsburg, PA, USA
Printed Name Location (City/State/Country)
DSEB-502R
Updated 1/22/2021
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.govJcampaignfinance • ra-stcampaignfinance@pa.gov
Part II-If this form is submitted with a report by a Candidate's Authorized Committee, the
candidate must sign here.
I declare under penalty of perjury under the law of the Commonwealth of Pennsylvania
that the accompanying Campaign Finance Report is true and correct.
COLA_ 20/10/2021
Signature of Treasurer, Candidate, or L byist Date (DD/MM/YYYY)
Colleen Gray Nguyen Enola, PA, USA
Printed Name Location (City/State/Country)
DSEB-502R
Updated 1/22/2021
4
Commonwealth of Pennsylvania PAGE 1 OF 18
Campaign Finance Report
(NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification Report Candidate ' Committee 2 Lobbyist s.
Number: 20210153 Filed By: ❑ ❑✓ y ❑
Name of Filing Committee,Candidate or Lobbyist:
Colleen for PA
Street Address:
1750 Yorkshire Place
City: State: Zip Code:
Enola PA 17025
IIMINIIIIIII Bo
6th Tuesday 1. 2nd Friday 2. 30 Day 3. Amendment
TYPE OF Pre-Primary ❑ Pre-Primary ❑ Post Primary ❑ Report? Yes ❑ No 0
REPORT 6th Tuesday 4.❑ 2nd Friday 5. 30 Day 6. ❑ Termination Yes ❑ No ❑✓
Pre-Election Pre-Election ❑ Post Election Report?
Other 7.
Annual Report ❑ YEAR 2021
Name of Office Sought by Candidate: le],tl I c VIPRJ 1 District Number. Office Code: Party Code:: County
Code:
Representative in the General 11/08/2022 087 STH DEM 21
Assembly
Summary of Receipts and From Date To Date FOR OFFICE USE ONLY
Expenditures 06/08/2021 10/18/2021
A. Amount Brought Forward From Last Report $1,766.81
r)
B. Total Monetary Contributions and Receipts(From Schedule I) $6,305.59 c y o
C. Total Funds Available(Sum of Lines A and B) $8,072.40 ,
D. Total Expenditures(From Schedule III) $1,363.18 I 'I
E. Ending Cash Balance(Subtract Line D from Line C) $6,709.22 r N
F. Value of In-Kind Contributions Received(From Schedule II) $0.64 C_.-; 13
$0.00
G. Unpaid Debts and Obligations(From Schedule IV) N
Affidavit Section -, LA.)
PART I-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 or by electronic medium,are to the best of my knowledge and belief
true,correct,and complete.
Sworn to a bscribed before me this
day o 20
Signature erson Submi ing Report
Si re Pri ted Name
My commission expire 1 3 �`/v,
MO. DAY Y . Area Code Daytime Telephone Number
PART II-If t 's is a report of a Candidate's Authorized Committee,candidate shall sign here.
I swear(or affirm at to the best of my knowledge and bel' is political committee has not violated any provisions of the Act of June 3,1937
(P.L. 1333,No. 320 amended.
Sworn to and subscribed be me this / v
day of 20 2L------ 1
Signature of Person miffing Report
Signature ' Pri d Nan(
My Comm' n expires i I 9'7? - 3 7 9'
MO. DAY YR. Area Code Daytime Telephone Number
a
SCHEDULE I PAGE 2 OF 18
Contributions and Receipts
Detailed Summary Page
Filer Identification Number: 20210153
1. UNITEMIZED CONTRIBUTIONS AND RECEIPTS-$50.00 OR LESS PER CONTRIBUTOR
TOTAL for the Reporting Period (1) $2,040.00
2. CONTRIBUTIONS$50.01 TO$250.00 (FROM PART A AND B)
Contributions Received from Political Committees (Part A) $0.00
All Other Contributions (Part B) $3,375.00
TOTAL for the Reporting Period (2) $3,375.00
3. CONTRIBUTIONS OVER$250.00 (FROM PART C AND D)
Contributions Received from Political Committees (Part C) $589.95
All Other Contributions (Part D) $300.00
TOTAL for the Reporting Period (3) $889.95
4. OTHER RECEIPTS-REFUNDS, INTEREST EARNED, RETURNED CHECKS, ETC. (FROM PART E)
TOTAL for the Reporting Period (4) $0.64
TOTAL MONETARY CONTRIBUTIONS AND RECEIPTS DURING
THIS REPORTING PERIOD (Add and enter amount totals from $6,305.59
Boxes 1,2,3 and 4;also enter this amount on Page 1,Report Cover Page,Item B.)
PAGE 3 OF 1R
PART B
All Other Contributions
$50.01 TO$250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to$250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Filer Identification Number: 20210153
Full Name of Contributor MO. DAY YEAR
Michael Alsher 6 11 2021 $25.00
Mailing Address
72 Pine Ridge Cir
City State Zip Code(Plus 4)
Enola PA 17025-2057
Full Name of Contributor 'MO. DAY YEAR
Michael Alsher 6 11 2021 1 $25.00
Mailing Address
72 Pine Ridge Cir
City State Zip Code(Plus 4)
Enola PA 17025-2057
Full Name of Contributor MO. DAY YEAR
Michael Alsher 7 11 2021 $25.00
Mailing Address
72 Pine Ridge Cir
City State Zip Code(Plus 4)
Enola PA 17025-2057
Full Name of Contributor MO. DAY YEAR
Michael Alsher 8 11 2021 $25.00
Mailing Address
72 Pine Ridge Cir
City State Zip Code(Plus 4)
Enola PA 17025-2057
Full Name of Contributor MO. DAY YEAR
Michael Alsher 9 11 2021 $25.00
Mailing Address
72 Pine Ridge Cir
City State Zip Code(Plus 4)
Enola PA 17025-2057
Full Name of Contributor 'MO. DAY YEAR
Michael Alsher 10 11 2021 $25.00
Mailing Address
72 Pine Ridge Cir
City State Zip Code(Plus 4)
Enola PA 17025-2057
Full Name of Contributor MO. DAY YEAR
Stephanie Andrejack 6 15 2021 $100.00
Mailing Address
2914 Sunset Dr
City State Zip Code(Plus 4)
Camp Hill PA 17011-1646
Full Name of Contributor MO. DAY YEAR
Chrystalle Ball 6 26 2021 $100.00
Mailing Address
6200 Wilson Blvd Apt 716
City State Zip Code(Plus 4)
Falls Church VA 22044-3207
Enter Grand Total of Part B on Schedule I,Detailed Summary Page,Section 2. PAGE TOTAL
$350.00
PAGE 4 OF 18
PART B
All Other Contributions
$50.01 TO$250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to$250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Filer Identification Number: 20210153
Full Name of Contributor SMOU IDAYI IICYEA1 1
Harrison Sink 6 16 2021 $100.00
Mailing Address
1115 2nd St
City State Zip Code(Plus 4)
Enola PA 17025-3263
Full Name of Contributor IMO1 IDAYI IIIYEAR1
Jessica Bock 7 29 2021 $100.00
Mailing Address
749 Manor Rd
City State Zip Code(Plus 4)
Camp Hill PA 17011-1718
Full Name of Contributor lM01 IDAYI IYEARI
Stephen Bruder 7 8 2021 $100.00
Mailing Address
260 Herr St
City State Zip Code(Plus 4)
Harrisburg PA 17102-2924
Full Name of Contributor 1MO1 IDAYI lY
Leigh Chow 6 8 2021 $50.00
Mailing Address
1175 Fleming Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-5798
Full Name of Contributor IMOi IDAYI IYEAR1
Leigh Chow 6 26 2021 $10.00
Mailing Address
1175 Fleming Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-5798
Full Name of Contributor 'MOW IDAYI(YEARS
Leigh Chow 7 26 2021 $10.00
Mailing Address
1175 Fleming Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-5798
Full Name of Contributor IMO1 IDAYI■YEAR1
Leigh Chow 8 26 2021 I $10.00
Mailing Address
1175 Fleming Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-5798
Full Name of Contributor UMO1 IDAYI,IYEARII
Leigh Chow 9 26 2021 $10.00
Mailing Address
1175 Fleming Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-5798
Enter Grand Total of Part B on Schedule I,Detailed Summary Page,Section 2. PAGE TOTAL
$390.00
PAGE 5 OF 18
PART B
All Other Contributions
$50.01 TO$250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to$250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Filer Identification Number: 20210153
Full Name of Contributor MO. DAY YEAR
Shanna Danielson 7 2 2021 $25.00
Mailing Address
170 Martel Cir
City State Zip Code(Plus 4)
Dillsburg PA 17019-8717
Full Name of Contributor MO. DAY YEAR
Shanna Danielson 10 15 2021 $50.00
Mailing Address
170 Martel Cir
City State Zip Code(Plus 4)
Dillsburg PA 17019-8717
Full Name of Contributor MO. ,DAY YEAR
Brittany Echt 7 1 2021 $100.00
Mailing Address
584 Seneca Ct
City State Zip Code(Plus 4)
Magnolia NJ 08049-1639
Full Name of Contributor MO. DAY YEAR
Joe Fidler 8 20 2021 $100.00
Mailing Address
19 Charisma Dr
City State Zip Code(Plus 4)
Camp Hill PA 17011-1010
Full Name of Contributor MO. DAY YEAR
Bernadette Flinchbaugh 6 21 2021 $100.00
Mailing Address
2930 Old Trail Rd
City State Zip Code(Plus 4)
York Haven PA 17370-9075
Full Name of Contributor MO. DAY YEAR
Asheleigh Forsburg 7 16 2021 $100.00
Mailing Address
5010 Mcdonald Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-2424
Full Name of Contributor MO. DAY YEAR
Rachele Fortier 6 18 2021 $100.00
Mailing Address
1817 S 13th St
City State Zip Code(Plus 4)
Philadelphia PA 19148-2125
Full Name of Contributor HMO_ DAY YEAR
Kevin Juliano 6 _ 8 2021 $25.00
Mailing Address
115 Steven Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-2616
Enter Grand Total of Part B on Schedule I,Detailed Summary Page,Section 2. PAGE TOTAL
$600.00
PAGE 6 OF 18
PART B
All Other Contributions
$50.01 TO$250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to$250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Filer Identification Number: 20210153
Full Name of Contributor IIMO1 IDAYJ ci A"R*
Kevin Juliano 7 8 2021 $25.00
Mailing Address
115 Steven Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-2616
Full Name of Contributor IMO1 MDAYA IYEARI
Kevin Juliano 8 8 2021 $25.00
Mailing Address
115 Steven Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-2616
Full Name of Contributor IMOw MAYA WEAR-1
Kevin Juliano 9 8 2021 $25.00
Mailing Address
115 Steven Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-2616
Full Name of Contributor re MOU IDAYA&YEAR'
Kevin Juliano 10 8 2021 $25.00
Mailing Address
115 Steven Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-2616
Full Name of Contributor ■KIO1 ID'AYA IIIYEARI
Kathleen Keadan 8 17 2021 $100.00
Mailing Address
4713 Delbrook Rd
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-3088
Full Name of Contributor 'MO1 IDAYJ&YEAR.*
wayne landon 6 8 2021 $100.00
Mailing Address
872 Acri Rd
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-2279
Full Name of Contributor BIv101 IDAYJ`YEAR.*
wayne landon 7 7 2021 $100.00
Mailing Address
872 Acri Rd
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-2279
Full Name of Contributor =MOB ID'AYJ`YEAR.*
wayne landon 9 29 2021 $50.00
Mailing Address
872 Acri Rd
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-2279
Enter Grand Total of Part B on Schedule I,Detailed Summary Page,Section 2. PAGE TOTAL
$450.00
PAGE 7 OF in
PART B
All Other Contributions
$50.01 TO$250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to$250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Filer Identification Number: 20210153
Full Name of Contributor .MO. DAY YEAR I
Karl Larson 7 16 2021 $100.00
Mailing Address
6255 Cider Press Rd
City State Zip Code(Plus 4)
Harrisburg PA 17111-4722
Full Name of Contributor /MO_ DAY YEAR
Drew Lawrence 6 8 2021 $100.00
Mailing Address
1009 Oak Ln
City State Zip Code(Plus 4)
New Cumberland PA 17070-1329
H
Full Name of Contributor MO. DAY YEAR
Kenneth Levin 7 15 2021 $100.00
Mailing Address
2230 Lehman Ct
City State Zip Code(Plus 4)
Enola PA 17025-1184
Full Name of Contributor MO. ,DAY YEAR
Alysson Light 6 21 2021 $80.00
Mailing Address
9 Station Rd Apt 3
City State Zip Code(Plus 4)
Ardmore PA 19003-2326
Full Name of Contributor /:MO_ DAY YEAR
Margaret Loyd 8 11 2021 $100.00
Mailing Address
514 Benton Rd
City State Zip Code(Plus 4)
Camp Hill PA 17011-2111
Full Name of Contributor MO. , bAY YEAR A
Barbara Pearce 6 8 2021 $40.00
Mailing Address
171 Brindle Rd
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-9515
Full Name of Contributor MO. DAY . YEAR I
Barbara Pearce 8 15 2021 $25.00
Mailing Address
171 Brindle Rd
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-9515
Full Name of Contributor MO. DAY YEAR
Barbara Pearce 9 30 2021 $30.00
Mailing Address
171 Brindle Rd
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-9515
Enter Grand Total of Part B on Schedule I,Detailed Summary Page,Section 2. PAGE TOTAL
$575.00
PAGE 8 OF 18
PART B
All Other Contributions
$50.01 TO$250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to$250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Filer Identification Number: 20210153
Full Name of Contributor MO. DAY YEAR
Barbara Pearce 10 13 2021 $25.00
Mailing Address
171 Brindle Rd
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-9515
Full Name of Contributor MO. DAY YEAR
Jean Peragine 10 10 2021 ( $100.00
Mailing Address
17 Neponsit Ln
City State Zip Code(Plus 4)
Camp Hill PA 17011-7917
Full Name of Contributor MO. DAY, YEAR
Rebecca Poyourow 6 8 2021 $25.00
Mailing Address
445 Lyceum Ave
City State Zip Code(Plus 4)
Philadelphia PA 19128-3420
Full Name of Contributor MO. DAY YEAR
Rebecca Poyourow 7 8 2021 $25.00
Mailing Address
445 Lyceum Ave
City State Zip Code(Plus 4)
Philadelphia PA 19128-3420
Full Name of Contributor MO. DAY YEAR
Rebecca Poyourow 8 8 2021 $25.00
Mailing Address
445 Lyceum Ave
City State Zip Code(Plus 4)
Philadelphia PA 19128-3420
Full Name of Contributor MO. DAY YEAR
Rebecca Poyourow 9 8 2021 $25.00
Mailing Address
445 Lyceum Ave
City State Zip Code(Plus 4)
Philadelphia PA 19128-3420
Full Name of Contributor 'MO. DAY YEAR
Rebecca Poyourow 10 8 2021 $25.00
Mailing Address
445 Lyceum Ave
City State Zip Code(Plus 4)
Philadelphia PA 19128-3420
Full Name of Contributor MO. DAY YEAR
Allie Samsel 7 6 2021 $50.00
Mailing Address
3027 Chestnut St
City State Zip Code(Plus 4)
Camp Hill PA 17011-4527
Enter Grand Total of Part B on Schedule I,Detailed Summary Page,Section 2. PAGE TOTAL
$300.00
PAGE 9 OF is
PART B
All Other Contributions
$50.01 TO$250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to$250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Filer Identification Number: 20210153
Full Name of Contributor MO. DAY YEAR
Allie Samsel 8 6 2021 $50.00
Mailing Address
3027 Chestnut St
City State Zip Code(Plus 4)
Camp Hill PA 17011-4527
Full Name of Contributor MO. DAY YEAR
Allie Samsel 9 6 2021 $50.00
Mailing Address
3027 Chestnut St
City State Zip Code(Plus 4)
Camp Hill PA 17011-4527
Full Name of Contributor MQ DAY YEAR
Allie Samsel 10 6 2021 $50.00
Mailing Address
3027 Chestnut St
City State Zip Code(Plus 4)
Camp Hill PA 17011-4527
Full Name of Contributor MO. DAY YEAR
Ruth Seitz 8 29 2021 $60.00
Mailing Address
70 Sharon Rd
City State Zip Code(Plus 4)
Enola PA 17025-1827
Full Name of Contributor MO. DAY YEAR
Tara Shakespeare 6 8 2021 $100.00
Mailing Address
1813 Letchworth Dr
City State Zip Code(Plus 4)
Camp Hill PA 17011-5934
Full Name of Contributor /MO. DAY YEAR
Joseph Swartz 8 15 2021 $100.00
Mailing Address
1706 Letchworth Rd
City State Zip Code(Plus 4)
Camp Hill PA 17011-7528
Full Name of Contributor MO. DAY YEAR I I
Jaime Willis 9 26 2021 $100.00
Mailing Address
6707 5th St NW
City State Zip Code(Plus 4)
Washington DC 20012-2733
Full Name of Contributor /MO. DAY YEAR
Sam Winters 6 22 2021 $100.00
Mailing Address
9 Neponsit Ln
City State Zip Code(Plus 4)
Camp Hill PA 17011-7917
Enter Grand Total of Part B on Schedule I,Detailed Summary Page,Section 2. PAGE TOTAL
$610.00
PAGE 10 OF 18
PART B
All Other Contributions
$50.01 TO$250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to$250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Filer Identification Number: 20210153
Full Name of Contributor MO. DAY YEAR
Karyn Yingling 10 13 2021 $100.00
Mailing Address
505 Maple Ave
City State Zip Code(Plus 4)
Lewistown PA 17044-1156
Enter Grand Total of Part B on Schedule I,Detailed Summary Page,Section 2. PAGE TOTAL
$100.00
PAGE 11 OF is
PART C
Contributions Received From Political Committees
OVER$250.00
Use this Part to itemize only contributions received from Political Committees
with an aggregate value over$250.00 in the reporting period.
IFiler Identification Number: 20210153 I
Full Name of Contributing Committee MO. DAY YEAR $589.95
Friends of Tara Shakespeare 9 2 ' 2021
Mailing Address
1813 Letchworth Dr
City State Zip Code(Plus 4)
Camp Hill PA 17011-5934
PAGE TOTAL
Enter Grand Total of Part C on Schedule I,Detailed Summary Page,Section 3. $589.95
PAGE 12 OF 18
PART D
All Other Contributions
OVER$250.00
Use this Part to itemize all other contributions with an aggregate value of
over$250.00 in the reporting period.
(Exclude contributions from Political Committees reported in Part C)
Filer Identification Number: 20210153
Full Name of Contributor MO. DAY YEAR
Kathy Yorkievitz 6 111 12021 $100.00
Mailing Address
251 N 27th St
City State Zip Code(Plus 4)
Camp Hill PA 17011-3627
Employer Name Occupation
Not Employed Not Employed
Employer Mailing Address/Principal Place of Business
251 N 27th St Camp Hill, PA 17011-3627
Full Name of Contributor MO. DAY YEAR
Kathy Yorkievitz 8 112 12021 $200.00
Mailing Address
251 N 27th St
City State Zip Code(Plus 4)
Camp Hill PA 17011-3627
Employer Name Occupation
Not Employed Not Employed
Employer Mailing Address/Principal Place of Business
251 N 27th St Camp Hill, PA 17011-3627
Enter Grand Total of Part D on Schedule I,Detailed Summary Page,Section 3. PAGE TOTAL
$300.00
PAGE 13 OF 18
PART E
Other Receipts
REFUNDS,INTEREST INCOME,RETURNED CHECKS,ETC.
Use this Part to report refunds received,interest earned,returned checks and
prior expenditures that were returned to the filer.
Filer Identification Number: 20210153
Full Name MO. DAY YEAR
Members 1st Federal Credit Union 7 31 2021 $0.18
Mailing Address
5000 Louise Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-4899
Receipt Description
Dividend
Full Name MO. DAY YEAR
Members 1st Federal Credit Union 8 31 2021 $0.22
Mailing Address
5000 Louise Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-4899
Receipt Description
Dividend
Full Name MO. DAY YEAR
Members 1st Federal Credit Union 9 30 2021 $0.24
Mailing Address
5000 Louise Dr
City State Zip Code(Plus 4)
Mechanicsburg PA 17055-4899
Receipt Description
Dividend
Enter Grand Total of Part E on Schedule I,Detailed Summary Page,Section 4. PAGE TOTAL
$0.64
SCHEDULE II PAGE 14 OF 18
In-Kind Contributions And Valuable Things Received
USE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS
DURING THE REPORTING PERIOD
Detailed Summary Page
Filer Identification Number: 20210153
1.UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR
TOTAL for the Reporting Period (1) $0.64
2.IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F)
TOTAL for the Reporting Period (2) $0.00
3.IN-KIND CONTRIBUTION RECEIVED-VALUE OVER$250.00(FROM PART G)
TOTAL for the Reporting Period (3) $0.00
TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS
REPORTING PERIOD (Add and enter amount totals from Boxes 1,2,
$0.64
and 3;also enter on Page 1. Report Cover Page,Item F.)
Schedule Ill PAGE 15 OF 18
Statement of Expenditures
Filer Identification Number: 20210153
0Whom ai IMOnAY�YFARI
ActBlue 7 1 6 12021 $37.05
Mailing Address
366 Summer St
City State Zip Code(Plus 4)
Somerville MA 02144-3132
Description of Expenditure
Service Fee
To Whom Paid iM0imr)AYawFARi
ActBlue 8 5 12021 $19.24
Mailing Address
366 Summer St
City State Zip Code(Plus 4)
Somerville MA 02144-3132
Description of Expenditure
Service Fee
To Whom Paid {MOmmnAYAYFARI
ActBlue 9 I 3 12021 $12.55
Mailing Address
366 Summer St
City State Zip Code(Plus 4)
Somerville MA 02144-3132
Description of Expenditure
Service Fee
To Whom Paid MyrnAYANYFARi
ActBlue 10 1 4 2021 $18.13
Mailing Address
366 Summer St
City State Zip Code(Plus 4)
Somerville MA 02144-3132
Description of Expenditure
Service Fee
To Whom Paid fTflAVVFAP1
Grace Brulia 7 I 6 12021 $30.00
Mailing Address
14 Altoona Ave
City State Zip Code(Plus 4)
Enola PA 17025-2501
Description of Expenditure
Child care for event
To Whom Paid iMOtahAYrvFAPI
East Pennsboro Township ` 7 I 7 2021 $54.16
Mailing Address
98 S Enola Dr
City State Zip Code(Plus 4)
Enola PA 17025-2704
Description of Expenditure
Pavilion rental
Enter Grand Total of Expenditures on Page 1,Report Cover Page,Item D. PAGE TOTAL
$171.13
Schedule III PAGE 16 OF 18
Statement of Expenditures
Filer Identification Number: 20210153
0 om al MCL. nAY YFAR
Keystone Buttoneer 6 1 8 12021 $48.76
Mailing Address
219 Briggs St
City State Zip Code(Plus 4)
Harrisburg PA 17102-3217
Description of Expenditure
Buttons
To Whom Paid Keystone Buttoneer iT7161202rI $84.80
Mailing Address
219 Briggs St
City State Zip Code(Plus 4)
Harrisburg PA 17102-3217
Description of Expenditure
Buttons
To Whom Paid MO New Pennsylvania Project IT0J2021 1 $51.83
Mailing Address
717 Market St Ste 295
City State Zip Code(Plus 4)
Lemoyne PA 17043-1581
Description of Expenditure
Event
To Whom Paid MO 1AYYFAR
NGP VAN 8 1 12 12021 $159.00
Mailing Address
PO Box 392264
City State Zip Code(Plus 4)
Pittsburgh PA 15251-9264
Description of Expenditure
Online software fee
To Whom Paid MO nAY YFAR
NGP VAN 9 1 1 1 2021 $159.00
Mailing Address
PO Box 392264
City State Zip Code(Plus 4)
Pittsburgh PA 15251-9264
Description of Expenditure
Online software fee
To Whom Paid MO fAY YFAR
NGP VAN 10 1 11 1 2021 $159.00
Mailing Address
PO Box 392264
City State Zip Code(Plus 4)
Pittsburgh PA 15251-9264
Description of Expenditure
Online software fee
Enter Grand Total of Expenditures on Page 1,Report Cover Page,Item D. PAGE TOTAL
$662.39
Schedule Ill PAGE 17 OF 18
Statement of Expenditures
Filer Identification Number: 20210153
O Om ai MO_ fAY YFAR
Sam's Club Checks 6 I 8 12021 $38.97
Mailing Address
PO Box 351100
City State Zip Code(Plus 4)
New Braunfels TX 78135
Description of Expenditure
Checks and stamp
To Whom Paid MO_ nix)/ VFAR
Sam's Club 8 115 12021 $78.72
Mailing Address
6520 Carlisle Pike
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-5251
Description of Expenditure
Volunteer Kick Off Supplies
To Whom Paid MO nAY. VFAR
Vantiv, LLC 6 1 8 12021 $33.67
Mailing Address
8500 Governors Hill Dr
City State Zip Code(Plus 4)
Symmes Twp OH 45249-1384
Description of Expenditure
Merchant processing fees
To Whom Paid MO nAY YFAR
Vantiv, LLC 7 1 8 12021 $69.30
Mailing Address
8500 Governors Hill Dr
City State Zip Code(Plus 4)
Symmes Twp OH 45249-1384
Description of Expenditure
Merchant processing fees
To Whom Paid MO IlAY YFAR
Vantiv, LLC 8 1 9 12021 $39.79
Mailing Address
8500 Governors Hill Dr
City State Zip Code(Plus 4)
Symmes Twp OH 45249-1384
Description of Expenditure
Merchant processing fees
To Whom Paid j g tlAY 1202R $1.28
Vantiv, LLC
Mailing Address
8500 Governors Hill Dr
City State Zip Code(Plus 4)
Symmes Twp OH 45249-1384
Description of Expenditure
Merchant processing fees
Enter Grand Total of Expenditures on Page 1,Report Cover Page,Item D. PAGE TOTAL
$261.73
Schedule III PAGE 18 OF 18
Statement of Expenditures
Filer Identification Number: 20210153
0 om ai O�. DAY VFAR
Vantiv, LLC 9 I 8 12021 $25.59
Mailing Address
8500 Governors Hill Dr
City State Zip Code(Plus 4)
Symmes Twp OH 45249-1384
Description of Expenditure
Merchant processing fees
To Whom Paid MO,Q -Vantiv, LLC11V, A1
2021 $33.87
Mailing Address
8500 Governors Hill Dr
City State Zip Code(Plus 4)
Symmes Twp OH 45249-1384
Description of Expenditure
Merchant processing fees
To Whom Paid MO YFAR
Walmart 1715 12021 $12.37
Mailing Address
6520 Carlisle Pike Ste 550
City State Zip Code(Plus 4)
Mechanicsburg PA 17050-5257
Description of Expenditure
Volunteer Kick Off supplies
To Whom Paid MO Wix.com LTD1AvT1
9 125 12021 $20.14
Mailing Address
40 Namal
City State Zip Code(Plus 4)
Tel Aviv Is 6350671
Description of Expenditure
Web site fee
To Whom Paid Zippit Print LLC 1T12021 $175.96
Mailing Address
1600 E 23rd St
City State Zip Code(Plus 4)
Cleveland OH 44114-4208
Description of Expenditure
Flyers
Enter Grand Total of Expenditures on Page 1,Report Cover Page,Item D. PAGE TOTAL
$267.93