HomeMy WebLinkAboutCentral Cumberland Democrats - 2021 2nd Friday 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 REPORT FILED CANDIDATE COMMITTEE LOBBYIST
NUMBER ' ON BEHALF OF , I L ?.
NAME OF FILING COMMITTEE,�CAANDIDATEE�ORRLLOOBBYIST ` / {�
C ? 1 7`Ytt.(� C _Ul N/�f✓1 Gs 01 d 0£v✓1 O Gv akig
STREET ADDRESS
o2/3 �/17,ss44ih Ado'.
CITY n,� STATE P CODE
/`I EcMi4m1c36I/r�a �� ZIP _._.- /70j0
TYPE OF REPORT NAME OF OFFICE SOUG BY CANDIDATE 'DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO. I DAY YEAR
6TH TUESDAY 1.
PRE-PRIMARY FOR OFFICE USE ONLY
Mo. OAT l YEAR MO. I OAT 1 YEAR
2ND FRIDAY 2. DATES OF
PRE-PRIMARY PERIO
D
tD O REPORTING fir_ 1 �j ,2,1 TO I6 / . /
30 DAY 3. ...,•, '..
POST-PRIMARY t,,.�",'I
CASH BALANCE AT END �J C.,
4. OF REPORTING PERIOD: $ 5-9
5 ' --^1
6TH TUESDAY II—
PRE-ELECTION ,w„R NO
j
TOTAL AMOUNT OF FILER'S c.
2N0 FRIDAY i5,'/ OUTSTANDING DEBTS OR LIABILITIES
PRE-ELECTION V AT THE END OF REPORTING PERIOD: S 0 3
CD
6. .. "":-
30 DAY . AMENDMENT
POST-ELECTION REPORT? YES NO ti p
cr
7.
ANNUAL TERMINATION YES NO
REPORT REPORT? 1...,....
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.
t If statement is filed on behalf of a Contribut • Lobbyist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS••DINIR MENTS CR LIABILITIES INCURRED DURING Th_'REPORTING PERIOD INDICATED ABOVE DID NOT
MYKNOWLEDGETRUE. AND COMPLETE.
EXCEED
TWO HUNDRED AND FIFTY DOLLARS(S250.01 AND.+HS 'T IS,TO THE BEST OF AND S'cLLE ,
Cts,ci Nilkik
SWORN TO AND SUBSCRIBED BEFORE
�MJET . MyC Q9, \
DAY OF �l+�,11,4%, ' *NATURE OF Pip•N Si:MIFT NG REPORT .
•
NATURE (// ij�yl0 M P�RIINTED NAME
MY COMMISSION EXPIRES / / 6 �, I . 0 6 gS'— t' ys-
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.
Department of State • Bureau of Commissions,Elections and Legislation
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120=0029 • (717)787-5280