HomeMy WebLinkAboutCover, John - 2021 2nd Friday Pre-Election Commonwealth of Pennsylvania PAGE 1 OF
CAMPAIGN FINANCE REPORT (COVER PAGE)
(NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification ► Report ► 1.
2. 3.
Number: Filed By: CANDIDATE COMMITTEE LOBBYIST
Name of Filing Committeree Candida or Lobbyist:
Jp`tt� GvG�
Street Address:7 Led rtf-+_ Rd
City: A IV rlV✓ " Stater, Zip Code:7 2-r 0
7
TYPE OF 6TH TUESDAY • 1- 2ND FRIDAY 2. 30 DAY 3. AMENDMENT YES NO �(
REPORT PRE-PRIMARY PRE-PRIMARY POST PRIMARY REPORT? /
6TH TUESDAY 4. 2ND FRIDAY 30 DAY 6. TERMINATION YES NO
(place X to PRE-ELECTION PRE-ELECTION /\ POST ELECTION REPORT?
the right of ANNUAL 7. YEAR FILING METHOD
report type) REPORT ( ) CHECK ONE , PAPER DISKETTE
Name of Office Sought by Candidate: DATE OF ELECTION District Office Party County
Number Code Code Code
�� MO. DAY YEAR
/Ownstp S1
A '/. ../k )vLsor ) C a/ (SEE INSTRUCTIONS FOR CODES)
FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR
Summary of Receipts ► g a To 1 0
and Expenditures from:
A. Amount Brought Forward From Last Report $
C
B. Total Monetary Contributions and Receipts (From Schedule I) S
110
Pi C7)
C. Total Funds Available (Sum of Lines A and B) $ V
D. Total Expenditures (From Schedule III) $ 5 f.Si 7 3 > �5
E. Ending Cash Balance (Subtract Line D from Line C) $ A
F. Value of In—Kind Contributions Received (From Schedule II) $ 0 Q
G. Unpaid Debts and Obligations (From Schedule IV) $ O —4
AFFIDAVIT SECTION
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 t iabsGrytv chedules, on paper or computer diskette, are to the best of my knowledge and belief true,
correct and complete. 1rd
"teSworn / ril --
tot-oo and
/•subscribed before me this Myc_ r6*- i-
✓ aay of Dth/ X Nye eta _
r? ?0?j Sign re of Per n Submittin Report
---444.67 04..04
Signature /1 Printed Name
My commission expires f/t '� ),Oa3 /// /2- — 05-3 flumber
MO. DAY YR. Area Code Daytime Telephon
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
I Signature of Candidate
Signature Printed Name
My commission expires
MO. DAY YR. Area Code Daytime Telephone Number
Department of State • Bureau of Commissions, Elections and Legislation
303 North Office Building • Harrisburg, PA 17120-0029 • (717) 787-5280
DSEB-502 (7-99)
PAGE OF
SCHEDULE III
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
704/ 1- Ce Ur—r From To
To Whom Paid :MO;
/ YEAB:,
_Sak_ ,5//45, 4:2/41 cef2eJ $
Mailin Address Description of Expenditure
City State Zip Code (Plus 4)
r
To Whom Pal op 4 1 ,P) MO. DAY 'YEAR
Amount_ ,
7 zi $ . 7'71, 73
Mailing Address Description of Expenditure
ig 0 BOX 611 2-4:7>
City State Zip Code (Plus 4)
gii-14415 75( 71-261-7203
To Whom Paid • 11 Amount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid bAY 'YEAFC,j Amount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid :.YEAR . Amount
$
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid :6t:1:1AY YEARA Amount
$
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid ' ;MO." YEAR:' Amount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid ‘.. :DAY: !yEARlAmount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
PAGE TOTAL
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D. $ 95 73
DSEB-502 (7-99)