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HomeMy WebLinkAboutGurgiolo, Melanie - 2021 30-Day Post Election Reset Form Print Form 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 Lobbyist - Number (Mark X) Name of Filing Committee,Candidate or Lobbyist Melanie Gurgiolo • Street Address 430 Arlington Road City Camp Hill State PA Zip Code 17011 Type of Report(Place x under report type) 1 1-6th Tuesday 2- 2' Friday 3-30 Day Post 4-6th Tuesday 5-2nd Friday 6-30 Day Post 7-Annual Special 2"tl Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election X 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 . 10/19/2021 11/14/2021 A.Amount Brought Forward From Last Report $ 0 B.Total Monetary Contributions and Receipts $ (From Schedule I) 0 r; C.Total Funds Available $ (Sum of Lines A and Et) 0 ; D.Total Expenditures $ r"•1 i (From Schedule III) 55.28 -J - s E.Ending Cash Balance $ • "`- (Subtract Line D from Line C) 0 - - F.Value of In-Kind Contributions Received $ ,� T�,> (From Schedule II) 0 C1 G.Unpaid Debts and Obligations $ cr. '- (From Schedule IV) 0 . - CI 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 Signature of Person Submitting report Signature Printed Name My Commission expires 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.1333,NO.320)as amended. Commonwealth of Pennsylvania-Notary Seal Sworn to and subscribed before me this Jessica C.Smith,Notary Public I day of --// Pumberland County p IVOJC,vA b.ekr 20 ram') , coMMIsslo expires Septemher C AA A. (lYlk� w C ('' '���Y�"COmmi ion number 1320 Signature of ndidate (J Signature q 7 Printed Name u My Commission expires 6 i or 09OQS' -1 f�-/ 3/7- 73 7 ^ / 757 MO. DAY YR. Area Code Daytime Telephone Number do SCHEDULE III Statement of Expenditures Filer identification Number: To Whom Paid Date[MM/DD/YYYY] $ CVS 4.44 10/26/2021 House# Street Address Description of Expenditure 1200 Market Street City State Zip Lemoyne PA Code 17043 Envelopes To Whom Paid Date[MM/DD/YYYY] $ CVS 4.44 10/26/2021 House# Street Address Description of Expenditure 3201 Market Street City Camp Hill State PA CoZip de 17011 Envelopes To Whom Paid Date[MM/DD/YYYY] $ United States Postal Service 46.40 10/26/2021 House# Street Address Description of Expenditure 1675 Camp Hill Bypass City State Zip Postage Stamps Hill PA Code 17011 g To Whom Paid Date[MM/DD/YYYY] $ House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/YYYY] $ House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MMJDD/YYYY] $ House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MMJDD/YYYY] $ House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/YYYY] $ House# Street Address Description of Expenditure City State Zip Code