HomeMy WebLinkAboutCentral Cumberland Democrats - 2021 30-Day Post Election COMMONWEALTH OF PENNSYLVANIA
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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 10, REPORT FILED CANDIDATE ; CCOMMITTEELOBBYIST
NUMBER ON BEHALF OF , ' 2.NAME OF FILING COP! 4a(
ITTEE,CANDIDATE OR LOB YIST / / `
r al 0 vithE v A tie//0 F klt Or
STREET ADDRESS �J
213 fs Yo n,A,k, 71
CITY Y STATE ZIP CODE
TYPE OF REPORT NAME OF OFFICE SOUGHT CANDIDATE !DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO. DAY YEAR
6TH TUESDAY ?
PRE-PRIMARY FOR OFFICE USE ONLY
MO. I DAY k2_i
I YEAR .M.O. I DAY YEAR
2ING /h /n TO �+ ao i�30 DAYVV `` /7 // ! -
POST-PRIMARY I r . rw�
CASH BALANCE AT END ��
6TH TUESDAY 4_ OF REPORTING PERIOD: S ((/f5 �
/ •:J
PRE-ELECTION .-`j cry
TOTAL AMOUNT OF FILER'S
ZND FRIDAY 15' OUTSTANDING DEBTS OR LIABILITIES 0 ` � t
PRE-ELECTION f AT THE END OF REPORTING PERIOD: S M.
6.
30 DAY / t„�.
POST-ELECTION K REPORTS NT
/ YES NO N.)
7.
ANNUAL I TERMINATION YES NO ✓ •
REPORT REPORT?
` r k• •• , AFFIDAVIT'SECTION' -AI''
PARTI-
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,the Candidate must sign here.
If statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
SWEAR(DR AFFIRM)THAT THE AGGREGATE RECEIPTS CR DI b-SEMENTS CR LIABILITIES INCURRED DURING THE.P.EPPCRT ING PERIOD IN r'ATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS(S250.00)AN TI -PORT IS.TO THE BEST OF MY KNO':CLEDG 'LIEF,TRUE. '-_CT,ND COt.t LETE.
SWORN TO AND SUBSCRIBED BEFORE ME TH'
DAY OF Ill y_Co44' ,T y SIGN TURF OF P S UBM, TIN SPORT
t..4141.7 _ C¢d id PRINTED NAME
SIGNATURE r� G N`� Z� ,
MY COMMISSION EXPIRES ,( I( �O `� r 4. i tit(3 /VS—
MO. DAY YR. �Oo66?oj� •EA CODE DAYTIME TELEPHONE NUMBER
PART Il-
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.
Department of State • Bureau of Commissions,Elections and Legislation
USLR-=01(1 2-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280
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