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Home My WebLink AboutFriends of David Fish - 2021 2nd Friday Pre-Election IrifPennsylvania 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 Friends of David Fish Reporting Cycle Name ❑ Cycle 1 ❑ Cycle 2 0 Cycle 3 0 Cycle 4 RI Cycle 5 6th Tuesday 2nd Friday 30 Day 6th Tuesday 2nd Friday Pre-Primary Pre-Primary Post Primary Pre-Election Pre Election ❑ Cycle 6 ❑ Cycle 7 0 Cycle 8 ❑ 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. 10/d //,Re, / Signature of Treasurer, Candidate, or Lobbyist Date (DD/MM/YYYY) Gregory C Gavazzi Hampden Twnp&Cumberland County/PA/USA Printed Name Location (City/State/Country) DSEB-502R Updated 1/22/2021 gji7Pennsylvania Department of State Bureau of Campaign Finance&Civic-Engagement 210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4) vwvw.dos.pa.gov/campaignfinance • ra-stcampaignfinance@pa.gov Part!!-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. (-1!--jaj ./Srli 0/).-0/ d--(791 Signature of reasurer, Candidate, or Lobbyist Date (DD/MM/YYYY) YG-VL.O 4,1(, us,4 Printed Name Location (City/State/Country) OSEB-502R Updated 1/22/2021 Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be dear and legible.It should be typed) Filer Identification Report Filed By Candidate Committee X Lobbyist — Number (Mark X) — Name of Filing Committee,Candidate or Friends of David Fish Lobbyist Street Address 405 Lamp Post Lane 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 4-6thTuesday 5_2nd Friday 6-30 Day Post 7-Annual i Special 2""Friday Special'30 Day' Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre Election Post-Election Date Of Election • Year Amendment Termination (MM/DD/YYYY) 11/02/2021 2021 Report Report 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 $ 102.39 . B.Total Monetary Contributions and Receipts $ 5585 r) (From Schedule I) L: a C.Total Funds Available $ (Sum of lines A and B) 5687.39 ri s D.Total Expenditures $ :l:r (From Schedule III) 3325.93 f"` .y tV E.Ending Cash Balance $ 2361.46 V t (Subtract Line D from line C) t-.7 F.Value of In-Kind Contributions Received '$ > (From Schedule II) $144.16 G.Unpaid Debts and Obligations $ • C_--, •• o(From Schedule IV) � 0.00 r Affidavit Section -< Part 1-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,is to the best of my knowledge and belief true,correct and complete. Sworn to and subscribed before me this day of 20 I �,P ) Signature of Person Submitting report CSYYitAeli G, -c ve 7.;, Signature r J Printed Name My Commission expires 7)7 7 7e1-6 3 i 7 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:L 1111,NO.320)as amended. Sworn to and subscribed before me this !/ '/ % day of 20 OtIt / Iture of Candidate, VI lt: r/S"f Signature I Printed Name � 1 r) - 6l My Commission expires S MO. DAY YR. Area Code Daytime Telephone Number SCHEDULE I Contributions and Receipts Detailed Summary Page Filer Identification Number 1.Unitemized Contributions and Receipts-$50.00 or Less per ContributorI I Total for the reporting period (1) $ 210 I2.Contributions of$50.01 to $250.00(From Part A and Part B) Contributions Received from Political Committees(Part A) $ 0 All Other Contributions(Part B) $ 600 Total for the reporting period (2) $ 600 3.Contributions Over$250.00(From Part C and Part D)I I Contributions Received from Political Committees(Part C) $ 4775 All Other Contributions(Part D) $ 0 Total for the reporting period (3) $ 4775 4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) I Total for the reporting period (4) $ 0 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 5585 Cover Page,Item B) PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) filer Identification Number: Full Name of Contributor Date[MM/DD/YYYY] $ Mary Gere 07/10/2021 100 House# Street Address Date[MM/DD/YYYY] $ 3815 Candle Light Drive City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17011 Full Name of Contributor Date[MM/DD/YYYY] $ Connie Sajer 07/07/2021 100 House# Street Address Date[MM/DD/YYYY] $ 140 Rodney Lane City State Zip Code Date[MM/DD/YYYY] $ Mechanicsburg PA 17055 Full Name of Contributor Date[MM/DD/YYYY] $ Timothy Scott 09/18/2021 100 House# Street Address Date[MM/DD/YYYY] $ 8 S Hanover St Apt 304 City State Zip Code Date[MM/DD/YYYY] $ Carlisle PA 17013 Full Name of Contributor Date[MM/DD/YYYY] $ J.L.Brunner 100 09/19/2021 House# Street Address Date[MM/DD/YYYY] $ 225 Woods Drive City State Zip Code Date[MM/DD/YYYY] $ Mechanicsburg PA 17050 Full Name of Contributor Date[MM/DD/YYYY] $ Francis Nash 100 10/01/2021 House# Street Address Date[MM/DD/YYYY] $ 204 S West Street City State Zip Code Date[MM/DD/YYYY] $ Carlisle PA 17013 Full Name of Contributor Date[MM/DD/YYYY] $ Jesse White 100 09/16/2021 House# Street Address Date[MM/DD/YYYY] $ 1831 Vista Drive City State Zip Code Date[MM/DD/YYYY] $ Mechanicsburg PA 17055 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. Filer Identification Number: Full Name of Date[MM/DD/YYYY] $ Contributing Committee Turn SouthCentral Pennsylvania Blue 09/16/2021 1500 House# Street Address Date[MM/DD/YYYY] $ 701 N 2nd Street 10/08/2021 875 City State Zip Code Date[MM/DD/YYYY] $ Harrisburg PA 17102 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Friends of Jeffrey Filer 900 10/18/2021 House# Street Address Date[MM/DD/YYYY] $ PO Box 432 City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17001 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Cumberland County Democratic Committee 08/23/21 1000 House# Street Address Date[MM/DD/YYYY] $ 46 West Louther St City State Zip Code Date[MM/DD/YYYY] $ Carlisle PA 17013 Full Name of Date[MM/DD/YYYY] $ Contributing Committee Hampden Township Democratic Club 09/06/2021 500 House# Street Address Date[MM/DD/YYYY] $ 102 Saint Johns Church Road City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17011 Full Name of Date[MM/DD/YYYY] $ Contributing Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ 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 Filer Identification Number: 1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR TOTAL for the reporting period (1) $ 0.00 I2. IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F) TOTAL for the reporting period (2) $ $144.16 I3. IN-KIND CONTRIBUTION RECEIVED-VALUE OVER$250.00(FROM PART G) I 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,and 3;also enter on Page 1,Report Cover Page,Item F) $144.16 SCHEDULE II PART F In-Kind Contributions Received VALUE OF$50.01 TO$250 Filer Identification Number: Full Name of Contributor Date[MM/DD/YYYY] $ Hampden Township Democratic Club 09/23/2021 $144.16 House# Street Address Date[MM/DD/YYYY] $ 102 Saint Johns Church Road City State Zip Code Date[MM/DD/YYYY] $ Camp Hill PA 17011 Description of Contribution Flyers including candidate 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 III Statement of Expenditures Filer Identification Number: To Whom Paid Date[MM/DD/YYYY] $ Vantiv eCommerce 0.50 07/09/2021 House# Street Address Description of Expenditure 8500 Governors Hill Drive City State Zip Symmes Township OH Code 45249-1384 Vantiv Merchant Fee To Whom Paid Date[MM/DD/YYYY] $ Deluxe Checks 21.95 07/27/2021 House# Street Address Description of Expenditure 801 S Marquette Ave City Minneapolis State MN Zide 55402 Checkbook To Whom Paid Date[MM/DD/YYYY] $ David Fish 100 08/04/2021 House# Street Address Description of Expenditure 405 Lamp Post Lane City State Zip Camp Hill PA 17011 Filing Fee Reimbursement Code To Whom Paid Date[MM/DD/YYYY] $ ActBlue 2.4 08/05/2021 House# Street Address Description of Expenditure 366 Summer Street City State Zip Somerville MA Code 02144 ActBlue Service Fee To Whom Paid Date[MM/DD/YYYY] $ Vantiv eCommerce 6.06 08/10/2021 House# Street Address Description of Expenditure 8500 Governors Hill Drive City State Zip Symmes Township OH Code 45249-1384 Vantiv Merchant Fee To Whom Paid Date[MM/DD/YYYY] $ Amazon 59.35 08/14/2021 House# 410 Street Address Ter Ave N Description of Expenditure ry City Seattle State WA Zip 98109 9 Printer Cartridges Code To Whom Paid Date[MM/DD/YYYY] $ Staples 28.59 08/18/2021 House# Street Address Description of Expenditure 500 Staples Ave City State Zip Printer Framingham MA Code 01702Paper To Whom Paid Date[MM/DD/YYYY] $ ActBlue 1.50 09/03/2021 House# Street Address Description of Expenditure 366 Summer Street City State Zip ActBlue Service Fee Somerville MA Code 02144 SCHEDULE III Statement of Expenditures Filer Identification Number: To Whom Paid Date[MM/DD/YYYY] $ Vantiv eCommerce 4.91 09/09/2021 House# Street Address Description of Expenditure 8500 Governors Hill Drive City State Zip Symmes Township OH Code 45249-1384 Vantiv Merchant Fee To Whom Paid Date[MM/DD/YYYY] $ ActBlue 12.75 10/04/2021 House# Street Address Description of Expenditure 366 Summer Street City State Zip Somerville MA Code 02144 ActBlue Service Fee To Whom Paid Date[MM/DD/YYYY] $ David Fish 120.84 10/06/2021 House# Street Address Description of Expenditure 405 Lamp Post Lane City State Zip UPS Store Flyer Reimbursement Camp Hill PA Code 17011 Y To Whom Paid Date[MM/DD/YYYY] $ Vantiv eCommerce 24.87 10/12/2021 House# Street Address Description of Expenditure 8500 Governors Hill Drive City State Zip Symmes Township OH Code 45249-1384 Vantiv Merchant Fee To Whom Paid Date[MM/DD/YYYY] $ Just Yard Signs,Inc 2599.00 10/14/2021 House# Street Address Description of Expenditure 2235 Mercator Dr City State Zip Orlando FL Code 32807 Yard Signs To Whom Paid Date[MM/DD/YYYY] $ Amazon 46.58 10/15/2021 House# 410 Street Address Ter Ave N Description of Expenditure ry City Seattle State WA Zip 98109 Button Materials Code To Whom Paid Date[MM/DD/YYYY] $ Keystone Buttoneer 46.64 46.64 House# 219 99 Street Address gri s St Description of Expenditure City Harrisburg State PA Zip 17102 Buttons Code To Whom Paid Date[MM/DD/YYYY] $ David Fish 249.99 10/18/2021 House# Street Address Description of Expenditure 405 Lamp Post Lane City State Zip Camp Hill PA 17011 ZippityPrint Flyer Reimbursement Code