HomeMy WebLinkAboutFoschi, Jean - 2021 2nd Friday Pre-Election IrilPennsylvania 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 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
Je.cu 'FOS6,6
Reporting Cycle Name
❑ Cycle 1 0 Cycle 2 ❑ Cycle 3 0 Cycle 4 Ei'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 2nd 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 declare under penalty of perjury under the law of the Commonwealth of Pennsylvania
that the accompanying Campaign Finance Report is true and correct.
0/ .� 4 rCgdt-- d 4/ if1oz-f/
ture of Treasurer, Candidate, or Lobbyist Date (DD/MM/YYYY)
i-eCULSC-k;- n/LAC-filtSix,"1 , PA/ US il
Printed Name Location ( ' /Stat /Country)
DSEB-502R
Updated 1/22/2021
moot I u ii, J . mitt um.
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 I 1 Lobbyist
Number (Mark X)
Name of Filing Committee,Candidate or Jean Foschi
Lobbyist
Street Address 2195 Brunswick Avenue
City Mechanicsburg State PA Zip Code 17055
Type of Report(Place x under report type)
1-6th Tuesday 2- 2nd Friday 3-30 Day Post 4-6th Tuesday S-2nd Friday 6-30 Day Post 7-Annual Special 2"°Friday Special 30 Day
Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election
it
LI1 o fl
Date Of Election Year Amendment — Termination
(MM/DD/YYYY) J I Report Report
Summary of Receipts and from Date To Date For Office Use Only
Expenditures
9/14/2021 10/18/2021
A.Amount Brought Forward From Last Report $ 0
B.Total Monetary Contributions and Receipts $ 0
(From Schedule i)
C.Total Funds Available $ 0
(Sum of Lines A and B) CD
.Total Expenditures $ ! Q//� 00
(From Schedule III) ,! atm
E.Ending Cash Balance $ 0 c�
(Subtract Line D from Line C) r"""
i7 N.)F.Value of In Kind Contributions Received $ 0 ......
(From Schedule II) C7
G.Unpaid Debts and Obligations $ 0 C'
` (From Schedule IV) \ CD A
Affidavit Section
Part 1-If this Is a Committee report,treasurer sign here.If this Is a Candidate report,candidate sign here. --1 IV
I swear(or affirm)that this report,including the attached schedules on paper,Is to the best of my knowledge and belief true,correct arld complete.
Sworn to and subscribed before me this
da of 20
r , a urriif riyttti port
Signature Pr Pr nted Name
3
My Commission expires .
�l �7( �.3
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.1.1333,NO.320)as
amended.
Sworn to and subscribed before me this
day of 20
Signature Printed Name3My Commission expires igilli
c 1 1^ 33(/
MO. DAY YR. Area Code Daytime Telephone Number
SCHEDULE III
Statement of Expenditures
Filer Identification Number:
To Whom Paid Cumberland County Sheriff Date[MM/DD/YYYY] $ 100.00
09/15/2021
House# Street Address 1 Courthouse Square Description of Expenditure
City Carlisle State PA Zip 17013 Shopping with the Sheriff Donation
Code
To Whom Paid Carlisle Area Democratic Committee Date[MM/DD/YYYY] $ 250.00
09/18/2021
House# Street Address PO Box 993 Description of Expenditure
City Carlisle State PA Zip 17013 Donation
Code
To Whom Paid Cumberland County Conservation District Date[MM/DD/YYYY] $ loo.00
09/23/2021
House# Street Address 310 Allen Road,Suite 301 Description of Expenditure
City Carlisle State PA Zip 17013 Golf Fundraiser Donation
• Code
To Whom Paid Cumberland County Bar Foundation Date[MM/DD/YYYY] $ 2,555.00
09/25/2021
House# Street Address 32 South Bedford Street Description of Expenditure
CitY Carlisle State PA Zip 17013 Diego's Tail Gate Fundraiser
Code
To Whom Paid Army Heritage Foundation Date[MM/DD/YYYY] $ 65.00
09/23/2021
House# Street Address 950 Soldiers Drive Description of Expenditure
City Carlisle State PA Zip 17013 Recognition Dinner and Fundraiser ticket
Code
To Whom Paid Cumberland County Farm Bureau Date[MM/DD/YYYY] $ 100.00
09/28/2021
House# Street Address Description of Expenditure
CitY Mechanicsburg State PA Zip 17055 Annual Membership
Code
To Whom Paid Friends of Heather MacDonald Date[MM/DD/YYYY] $ 548.00
09/29/2021
House# Street Address Description of Expenditure
City Mechanicsburg State PA Zip 17050 In Kind-fundraiser
Code
To Whom Paid Friends of Rick Coplen Date[MM/DD/YYYY] $ 200.00
10/16/2021
House# 806 Street Address Alexander Spring Road Description of Expenditure
City Carlisle State PA Zip 17015 Donation
Code