HomeMy WebLinkAboutMorrow, Douglas - 2021 2nd Friday Pre-Election Pennsylvania Department of State
Bureau of Campaign Finance&Civic Engagement
210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4)
www.dos.pa.govf:arinaignfinance ia-stcanunaignfinanscr@pa.nov
Unsworn Statement 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 unsworn
declarations, Campaign Finance Reports(form DSEB-502), Campaign Finance Statements In lieu
of full reports(form DSEB-503), 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.
Namie of Filing committee,candidate, or Lobbyist
. la.s /va,otrrow
Reporting de Name
❑ Cycle 1 ❑ Cycle 2 ❑ Cycle 3 ❑ Cycle 4 ❑ Cycle 5
6'h Tuesday 2nd Friday 30 Day 6th Tuesday 2nd Friday
Pre-Primary Pre-Primary Post Primary Pre-Election Pre Election
❑ Cycle 6 ❑ Cycle 7 ❑ 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 decla de • of perjury under the law of the Commonwealth of Pennsylvania
tha he fo ue and correct.
i la 92.g .2/
I
Sign 'reasurer,Candidate, or Lobbyist ate (D /MM/YYYY)
A`y/J- Jq} Nft) cum,beclAa
Printed NameLocation ty/State/Country) v5R,
DSEB-502R
Updated 6/24/2020
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 reportin rind.
OP
j J
rl R a>annlunaN REPORT CA/roIMTE 41. COMMITTEE 1 I. I weans! 11- OR MALI - C
MANE OF HMG CLNARrtFE,CANDIDATE OR unarm'
r v- . 0 rro
c7.23 /4-41C ,VP
aTAT;(41____ it il:And_rt CON 0TYPE OF REPORT NAME OfAl-e(Ai C/V BY CANDIDATE TKETRTI:T NO. PARTY ' '.DATE OF ELECTION*MAW
(dace cue) , . MO. DAY _ YEAR
6TTM TUESDAY
I. AY '/4a ,
PRE•PRIFARY - FOR OFFICE USE ONLY
NO. DAY YEAR MO. OAP YEAR , /
2ND FRDAY of1 / i2 z,
PRE•PR'MARY PERIOD q /y,2/REPOIMNGT O V /94/
30 AAY 3' l
POSTiIi TAAY CASH BALANCE AT ENDrTh . -
Gm FUESI}AY � V
' OF REPORTING PERIOD: $ f
PRE-ELECTIQN
TOTAL AMOUNT OF FILER'S O 2.� .�
2uso move5. / OUTSTANDING DEBTS OR LIABILITIES K.)PREELECTION VVV AT THE END OF REPORTING PERIOD: $ .
30 DAY J
AMENDMENT
POST-ELECRON YES HO c /
VVV tV
ANNUAL r TERMINATION
REPORT REPORT'? YES No CS'I
,,` '). , . ;'•_ 4, `"v"•' s- 'r' '``'' .. •AFFIDAVITrSECTION . cy..?, t :c•t.;,,;.
PART I.
If statement is filed on behalf of a Political Committee 9r Candidates's Cornrn ttee,the Treasurer must sign here.
if statement is filed on behalf of a Candidate,the Candidate must sign here.
If statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
I SWEAR(OR AF,vv)THAT THE AGGREGATE RECEIPTS OR OISBURSEMENTS OR UABQJTIES RICURREO THE REPORTING D INDICATED ABOVE DID NOT ..
EXCEED TWO HUNDRED AND FIFTY DOLLARS 0250.00)AND THIS REPORT Es'TO THE BEST OF MY EDGE AND..ta EF. AND OOLG'LETE.
SWORN TO AND BSCRIBED RE ME THIS
, ,•°' //:
DAY OF 20 HA U- - . ON SUBMITTING REPORT
PRINTED HAMS
Q'
MY COMMISSIONTURF
EX ES C74�7
MO. DAY YR. CODE DAYTIME TELEPH•N &UMBER
PART II-
if statement is filed on behalf of a Candidate'k Authorized Committee,Candidate must sign here.
I SWEAR(OR AFFIRM)THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS POLITICAL.CONINTTEE HAS NOT VIOLATED ANY PROVISIONS OF THE ACT OF
,PINE 3,1937(P.L.. 333,No. AS AMENDED. ..
SWORN TO AND SUBSC EFORE ME THIS
IMMATURE OF CANDIDATE
DAY OF 20
PRINTED tNAMIE
BIG RE
MY COTAMISSDN AREA CODE DAYTIME TELEPHONE NUMBER
NO. DAY YR.
Department of State • Bureau of Commissions.Elections and Legislation
LISC13•503(I2-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (7t7)787-6280
a