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HomeMy WebLinkAboutFiller, Jeffrey - 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 IDENTIFICATION lo, REPORTFILED t .CANDIDATE IX COMMITTEE.' 2. 'LOBBYIST 3. NUMBER ONBEHBEHALF� '\ NAME OF FILING de`(Ll_Ll(�`r MRiEF,CANDIDATE ORS c,b *I Lur STREET ADDRESS l 9,1) 4 cr-pa y-- l'v-e_-, CRY STATE ZIP CODE coy 11 SLe PA j7013 "-- TYPE OF REPORT NAME OF OFFICE E�SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE O F ELECTION (CHECK ONE) �„/,/L-e�L�1 CAI- ©t �il .S f\ v �!J\ MyO. DAY YEAR 6TH'TUESDAY' {l a�a I PRE-PRIMARY i" FOR OFFICE USE,ONLY ... MO. ..DAY .. YEAR". ..MO. .. .DAY ' .':YEAR. .. .. 2ND'FRIDAY .' 2. DATES OF '1 PREPRWARY REPORTING I0 //1 PJ^ I TO // as a I 30DAY 3. POST-PRIMARY CASH BALANCE AT END ;. 4. OF REPORTING PERIOD: $ PI i.. ; PRE-ELECTION . .. .) TOTAL AMOUNT OF FILER'S OUTSTANDING DEBTS OR LIABILITIES6 ` 2ND'FRIDAY - . PRE-ELECTION.' AT THE END OF REPORTING PERIOD: $ 30 DAY 6 .. y L.1 POST-ELECTION AMENDMENT YES NO N.,,) REPORT? 7. . _a ANNUAL TERMINATION. YES NO REPORT REPORT? 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 Candidate,th= Candidate must sign here. If statement is filed on behalf of a Contributin• -. ist,the Lobbyist must sign here. -:° I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS 0- •ISBURS :- •R LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.I I, AND THIS RE$ -.)S, 0 THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AN COMPLETE. y r� SWORN TO AND SUBSC ED BEFORE ME THIS o ti °; DAY OF OVE'���,h€Y 90 s•oyj0 g •:`1URE.], P SO UBMTTT R ORT/ 4�`+g^ago<d2��y �� \\l(( (b e— • `'/!'1 �f SI(04... '-' r� G% 4✓d< .A‹?;°td I PRINTED NAME ,, MY COMMISSION EXPIRES . ao�3 ��600��� � � Qn --MO. DAY YR. 6 1� ODE DAME 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)