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Home My WebLink AboutTri-County FDW PAC - 2021 30-Day Post Election ePennsylvania Department of State t Bureau of Campaign Finance&Civic Engagement 210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4) www.dos.pa.eov/campaienfinance • ra-stcampaienfinancePoa.eov Unsworn Declaration 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), Non-Bid Contract Reporting Form (DSEB-504) 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. Name of Filing Committee, Candidate, or Lobbyist Tn-County FDW PAC Reporting Cycle Name ' 0 Cycle 1 0 Cycle 2 0 Cycle 3 0 Cycle 4 0 Cycle 5 6th Tuesday 2nd Friday 30 Day 6th Tuesday 2"d Friday Pre-Primary Pre-Primary Post Primary Pre-Election Pre-Election Cycle 6 0 Cycle 7 0 Cycle 8 0 Cycle 9 30 Day Post-Election Annual Report 2"d 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 declare under penalty of perjury under the law of the Commonwealth of Pennsylvania that the accompanying Campaign Finance Report is true and correct. 22/11/2021 &,t5/.;_14 7411/1' nature of Treasure, ndidat o Lobbyist y Date (DD/MM/YYYY) Lisa Ann Budwig Lemoyne PA USA Printed Name Location (City/State/Country) DSEB-SO2R Updated 1/22/2021 a 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. nnw giummAtio. ' 20 180439 rimer nLED , CANDIDATE'' MANATEE LOBBYIST LOBBYIST 3 ON BEHALF of RARE OF FROM CONNRTER,CANDIDATE OR LOBBYIST Tri-County FDW PAC GIATST ADDRESS 285 Laurel Run Road(P.O.Box 212) CRY STATE VP CODE Landisburg PA 17040 — 0000 TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION (SCE owE) MO. DAY YEAR 6TH TUESDAY 1. 11 02 2021 _ _ PRE-PRIMARY FOR OFFICE USE ONLY NO. DAY YEAR 110. DAY YEAS 2No MOAT2 DATES OF PRE-PRIMARY 19 2021 TD 11 22 2021 OD 30 DAY s POST-PRIMARY CASH BALANCE AT END 1104.99 6Tih TUEsDAY 4. OF REPORTING PERIOD: $ PRE-ELECTION TOTAL AMOUNT OF FILER'S 2Nn FRIDAY 5. OUTSTANDING DEBTS OR LIABILITIES 0.00 PRE-ELECTION AT THE END OF REPORTING PERIOD: $ G. 30 DAY POST-ELECTION X AE AM DM NT YES No X 7 A ANNUAL TERMINATION YES No X 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,the Candidate must sign here. It statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here. I SVYEAR(OR AFFIRM)THAT'THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILII'ES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE OiD NOT EXCEED TWO HUNDRED AND FIFTY DOUARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KN61$I.EDOS AND BELIEF,TRUE,CORRECT AND COMPLETE. SWORN TO AND SUBSCRIBED BEFORE ME THIS 22nd DAY OF November 20 21 SIGNATURE OF P SUBMITTING R RT Lisa Ann Budwig (: ‘, -"" NATURE PRINTED NAME COMMISSION EXPIRES 12/ / 2021 717 364-8774 MO. DAY YR. AREA 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 T1/15 POLITICAL COMMITTEE HAS NOT VIOLATED ANT PROVISIONS OF THE ACT OF lime 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 D5111.50?(12.99) 210 North Office Building • Harrisburg,PA 17120.0029 a (717)7874280 s - .r _rr"'-�.._ .- '.y"�":."�.'- "'--_._."_ T'+C.�I'7t- _,.• »�.1.+�.�.Y'_'��T .s. +.-. ...._Y .`:..r�is�C - _ ..