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Home My WebLink AboutCamp Hill Republican Committee - 2021 2nd Friday Pre-Election • HIReset Form L Print Form Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Filer Identification Report Filed By Candidate Committee \ Lobbyist Number (Mark X) n Name of Filing Committee,Candidate or Lobbyist Camp Hill GOP Committee Street Address 103 N.21 St Street City Camp Hill State PA Zip Code 17011 Type of Report(Place x under report type) 1-6`"Tuesday 2- 2nd Friday 3-30 Day Post 4-6th Tuesday 5-2nd Friday 6 30 Day Post 7-Annual Special 2"tl 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) Report Report Summary of Receipts and From Date To Date For Office Use Only Expenditures 07/01/2021 10/18/2021 A.Amount Brought Forward From Last Report $ 853.47 B.Total Monetary Contributions and Receipts $ • (From Schedule I) 450.00 C-7 C.Total Funds Available $ t! rr+ (Sum of Lines A and B) 1,303.47 D.Total Expenditures $ t (From Schedule III) • 2734.39 r"I CM E.Ending Cash Balance $ r" (Subtract Line D from Line C) 254.67 ..� N F.Value of In-Kind Contributions Received $ tZD (From Schedule II) 0.00 C7 • • G.Unpaid Debts and Obligations $ CD (From Schedule IV) 4,753.38 C C? Affidavit Section —I Part 1-If this is a Committee report,treasurer sign here.If this is a Candidate report,candid.te sign - I swear(or affirm)that this report,including the attached schedules on paper,is to the••st of ief t• e,correct and complete.• . . Sworn tp ajd subscribed before me this • &fJ day ofcCh F/ 20 c- / • C-"—i • 4C' ' ' I :-.ture of Pers. Submitting report . ` •• ID D.BUELL S:gfketttre I Pr' ted Name Commonwealth of Pennsylvania-No ary Seal _ �Ien McCullq+No,tenPu.l0�3 717 712-3392 . NyCom i sion,pxpires - C UrnbeiiSC lity AY Area Code Daytime Telephone Number• . - My commission expires December 7,20Y3 p bnlAt;npio u bC Gai 7 ommittee,candidate shall sign here. I S edill 'a iYhS)' RbYi'd'fReagi`S'R crnoakeedg 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 I Contributions and Receipts Detailed Summary Page Filer Identification Number Camp Hill GOP Committee 11.Unitemized Contributions and Receipts-$50.00 or Less per Contributor Total for the reporting period (1) $ 200.00 12art.Contributionsand of8) $50.01 to $250.00(From i Contributions Received from Political Committees(Part A) $ 250.00 All Other Contributions(Part B) $ Total for the reporting period (2) $ 0.00 3.Contributions Over$250.00(From Part C and Part D) Contributions Received from Political Committees(Part C) $ 0.00 All Other Contributions(Part D) $ 0.00 Total for the reporting period (3) $ 0.00 4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) Total for the reporting period (4) $ 0.00 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) 450.00 PART A Contributions Received From Political Committees $50.01 TO$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value from$50.01 TO$250.00 in the reporting period. Filer Identification Number Camp Hil GOP Committee Amount Full Name of Contributing Date[MM/DD/YYYY] $ Committee Friends of Greg Rothman 10/12/2021 250.00 House# Street Address Date[MM/DO/YYYY] $ PO Box 1471 City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17001 Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date[MM/OD/YYYY] $ City State Zip Code Date[MM/DD/YYYY) $ Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date(MM/DO/YYYYJ $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributing Date[MM/DD/YYYYJ $ Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYYJ $ Full Name of Contributing Date[MM/DD/YYYYj $ Committee House# Street Address Date[MM/DD/YYYYJ $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date[MM/DO/YYYY] $ City State Zip Code Date[MM/DD/YYYYJ $ SCHEDULE II 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 Flier Identification Number: Camp Hil GOP Committee I1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR I j TOTAL for the reporting period (1) $ I2. IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F) TOTAL for the reporting period (2) $ 3. IN-KIND CONTRIBUTION RECEIVED-VALUE OVER$250.00(FROM PART G) TOTAL for the reporting period (3) $ TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING $ PERIOD(Add and enter amount totals from boxes 1,2,and 3;also enter on Page 1,Report Cover Page,Item F) 0.00 SCHEDULE II PART F In-Kind Contributions Received VALUE OF$50.01 TO$250 Filer Identification Number: Camp Hil GOP Committee Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State ' Zip Code Date[MM/DD/YYYY] $ Description of Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Description of Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Description of Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Description of Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Description of Contribution SCHEDULE it Part G In-Kind Contributions Received VALUE OVER$250 Filer Identification Number: Camp Hit GOP Committee Full Name of Contributor Date(MM/DD/YYYYJ $ House# Street Address Date[MM/DO/YYYYJ $ City State Zip Code Date[MM/DD/YYYYJ $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution Full Name of Contributor Date[MM/DD/YYYYJ $ House# Street Address Date[MM/DO/YYYYJ $ City State Zip Code Date[MM/DD/YYYYJ $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution Full Name of Contributor Date[MM/DD/YYYYJ $ House# Street Address Date[MM/DD/YYYYJ $ City State Zip Code Date(MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution Full Name of Contributor Date[MM/DD/YYYYJ $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution SCHEDULE III Statement of Expenditures Filer Identification Number: Camp Hil GOP Committee To Whom Paid Date(MM/DD/YYYY] $ Haas Printing 519.80 07/22/2021 House# Street Address Description of Expenditure 1000 Hummel Ave, City State Zip Lemoyne PA Code 17043 Literature To Whom Paid Date[MM/DD/YYYYJ $ Haas Printing 159.00 08/16/21 House# Street Address Description of Expenditure 1000 Hummel Ave. City State Zip Lemoyne PA Code 17043 Literature To Whom Paid Date[MM/DD/YYYY] $ Marie's Cafe 80.16 10/16/2021 House# Street Address Description of Expenditure 4401 Carlisle Pike City State Zip Code Campaign Event To Whom Paid Date[MM/DD/YYYY] $ Marie's Cafe 83.01 10/09/2021 House# Street Address Description of Expenditure 4401 Carlisle Pike City Zip Camp Hill State PA Code 17011 Campaign Event To Whom Paid Date(MM/DD/YYYY] $ UHAUL 59.68 10/18/2021 House# Street Address Description of Expenditure 4725 Gettysburg Rd. City State Zip Mechanicsburg PA Code 17055 Sign delivery To Whom Paid Date[MM/DD/YYYY] $ Print-o-stat 1,832.74 10/18/2021 House# Street Address Description of Expenditure 1128 Rosevelt Rd. City PA Zip York State Code 17404 Yard signs To Whom Paid Date[MM/DD/YYYYJ $ House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/YYYYJ $ House# Street Address Description of Expenditure City State Zip Code SCHEDULE IV Statement of Unpaid Debts Use this Section to itemize all unpaid debts and obligations which are outstanding at the end of the reporting period. Filer Identification Number: Camp Hil GOP Committee Name of Creditor Red Maverick Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ 1426 N.3rd Street [MM/DD/YYYY] 10/21/2019 City Harrisburg State PA ZCiopde 17102 2860.96 Description of Debt Election material 2019 Name of Creditor David Buell Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ 441 Parkside Rd. [MM/DD/YYYY] 10/18/2021 City State Zip 1892.42 Camp Hill PA Code 17011 Description of Debt Loan to pay for signs and delivery Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip Code Description of Debt Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip Code Description of Debt Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYYj City State Zip Code Description of Debt Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip Code Description of Debt