HomeMy WebLinkAboutWhitcomb, Al - 2021 30-Day Post 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 NUMBER IDENTIFICATION ' REPORT ON BEHALF OF ' •CAND�TE I. .COMMITTEE;,2.
-LOBBYIST 3. '
NAM^E�RUNG COMM CANDIDATE OR LOBBYIST YV
ri L t.J v� i T--,,,- /LA.
STREET ADDSS
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CITY STA LP CODE
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TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) ' C, . NTn �L �^K9 M0. DAY YEAR`Lii_ �`Y `l a Z -Zi
:GTH Tl1ESDAY"
PRE-PR0OARY '' FOR OFFICE:USE:ONLY
:MO. ..DAY. .. YEAR'. MO. •.DAY " :'YEAR.
•2ND`FRIDAY. .::.':' 2• DATES OF
. .PREPRMfARY:,. .•. P NG ft. /9 2( TO ) / 22 2 r
301iAr 3.
'POST-PRIMARY.
CASH BALANCE AT END --•6TIf.TUESDAY'i':; 4. OF REPORTING PERIOD: $
PRETELECTION .
TOTAL AMOUNT OF FILER'S ,,vim.,
OUTSTANDING DEBTS OR LIABILITIES
2rE rimier AT THE END OF REPORTING PERIOD: $ - •• . c-)
'PRE-ELECTION:'; r.I
•
6.
30 DAY,
POST-ELECTION. REPORTS YES NO X L
ANNUAL TERMINATION.. YES , 1J
NO X
•REPORT REPORT?. •
W
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 Candidat: e Candidate must sign here.
If statement is filed on behalf of a Contrib rfa)L;•bvist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIP -OR DISBU-•• •S OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($25, 10)AI,p THI ' tT • TO THE BEST OF MY WLED AND BELIEF T CO ECT AND COMPLETE.
`CO c 4.0°fA
SWORN TO AND SU RIBED BEFORE ME TH, ro„�i�,s Goa�q/J, /1.
ZIi DAY OF ssi 4b./id4/d ATURE OF PERSON UBMITTIIN{G-REPORT
�� 4� COG 2A .+0 Gc2JL� \I, I 1 cc)
� � TU �6P_�1 �s `6/C rdIV. PRINTED NAME
MY COMMISSION EXPIRES JCU'.. )L E0' 6°°66t)., `7 7 . 74> - q q-Cp J
MO. DAY YR. 1.EA 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. -
DSEB-503(12-99) 3