HomeMy WebLinkAboutSean Shultz for Carlisle - 2021 30-Day Post Election 111 Reset Form Print Form
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Commonwealth of Pennsylvania-Campaign Finance Report
(Note:This report must be clear and legible.It should be typed)
Filer Identification Report Filed By Candidate Committee Lobbyist
Number (Mark X)
Name of Filing Committee,Candidate or
Lobbyist Sean Shultz For Carlisle
Street Address
58 F Street
City Carlisle State PA Zip Code 17013
1 Type of Report(Place x under report type)
1-6th Tuesday 2- 2n t Friday 3-30 Day Post 4-6th Tuesday S-2"d Friday 6-30 Day Post 7-Annual Special 2h*Friday Special 30 Day
Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election
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Date Of Election Year Amendment Termination
(MM/DD/YYYY) 11 / D 2 2O 02/ Report Report .
Summary of Receipts and From Date To Date For Office Use Only
Expenditures
to fig J.26.2 I ii/Zi)2 I .
A.Amount Brought Forward From Last Report $
B.Total Monetary Contributions and Receipts $ ----�
(From Scl edule I)
C.Total Funds Available $ F '
(Sum of Lines A'and B) l' 3/5✓13 '~ }
D.Total Expenditures $ c
,(From Schedule,111) „ , :: . G. I B
E.Ending Cash Balance $ ,/ - p
(Subtract Line D.from Line C) 1, 3071 S t
F.Value of In Kind Contributions Received '• $ �--J
(From Scheduiell) , • . 3, 00 w
G.Unpaid Debts and Obligations $ .r-:
(From ScFiedule IV)' ® : _
._.
cfl
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 meI this
t1 day of IVdvcnl,�o>!r 20 o2)
h���� Signature of Person Submitting report
(it •PA,1-.e-/ it), Lee
Signature A. �1 r Printed NameD
My Commission expires 0?/i�J1jl/a-0•.S /4 510 - ekS•zz.
MO. D Y 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. ,
Swornrn to andsubscribed beforeJ me this S 02/ day of.Weible,f�{r 20 a.f '
ate
Datta4 /144:6That.4' -e,-, na/11 . 5��d,(f'Z-
Sigure Q J Printed Name
My Commission expires 0 f�Qf �QO95 � — �J z7
MO. DA YR. Area Code Daytime Telephone Number
Commonwealth of Pennsylvania-Notary Seal Commonwealth of Pennsylvania-Notary Seal
Dawn T.Heilman,Notary Public Dawn T.Heilman,Notary Public
Cumberland County Cumberland County ,
My commission expires September 4,2025 My commission expires September 4,2025
Commission number 1251803 Commission number 1251803
Member,Pennsylvania Association of Notaries Member,Pennsylvania Association of Notaries
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SCHEDULE I
• Contributions and Receipts
Detailed Summary Page
Filer Identification Number
c5PGN S),u,(4. Foy ZlaizI,sle-
1.Unitemized Contributions and Receipts-$50.00 or Less per Contributor I
Total for the reporting period (1) $ •
`E9-
2.Contributions of$50.01 to $250.00(From
Part A and Part B)
Contributions Received from Political Committees(Part A) $ ---e9r
All Other Contributions(Part B) $
Total for the reporting period (2) $
I3.Contributions Over.$250.00(From Part C and Part D). .
Contributions Received from Political Committees(Part C) $
All Other Contributions(Part D) $
Total for the reporting period (3) $
.10
I4.Other Receipts-Refunds,Interest Earned,Returned Checks;ETC.(From Part E)
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Total for the reporting period (4) $ —
Total Monetary Contributions and Receipts during this reporting period(Add and $
enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report Q
Cover Page,Item B)
SCHEDULE II
IN-KIND CONTRIBUTIONS AND VALUABLE THINGS RECEIVED
USE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS DURING THE REPORTING PERIOD
DETAILED SUMMARY PAGE
Filer Identification Number:
SecA) S1,K1*? (.ate Cap-lisle.
1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR • '
TOTAL for the reporting period (1) $
2. IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F) - I
• TOTAL for the reporting period (2) $ 5_t jG
3. IN-KIND CONTRIBUTION RECEIVED-VALUE OVER$250.00(FROM PART.G)
I •
.
TOTAL for the reporting period (3) $ —0:94`—
- TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING $ •
PERIOD(Add and enter amount totals from boxes 1,2,and 3;also enter • 5-3..C,Cj
on Page 1,Report Cover Page,Item F) •
SCHEDULE II
PART F
In-Kind Contributions Received
VALUE OF$50.01 TO$250
Filer Identification Number:
I
Full Name of Contributor Date[MM/DD/YYYY] $
(-O - /4/427 1)0P% C COMP*• i�/moo ja0.2i Ste. o(:,
House# Street Address Date[MM/DD/YYYY] $
�-' 60.$ CM
City State Zip Code Date[MM/DDJYYYY] $
04.1 i 61€ ,�. /10,3
Description of Contribution �r,
,00 P- )4 Wa /LS
Full Name of Contributor Date:[MM/DD/YYYY] $
House# Street Address Date[MM/DD/YYYY] $
City State Zip Code Date[MM/DD/YYYYJ $
Description of Contribution
Full Name of Contributor Date[MM/DD/YYYY] $
House# Street Address Date[MM/DD/YYYY] $
City State . -Zip Code Date[MM/DD/YYYY] $
Description of Contribution
Full Name of Contributor
Date[MM/DD/YYYY] $
House# Street Address Date[MM/DD/YYYY] $
City State Zip Code Date[MM/DD/YYYY] $
Description of Contribution
Full Name of Contributor Date[MM/DD/YYYY] $
House# Street Address Date[MM/DD/YYYY] $
City State Zip Code Date[MM/DD/YYYY] $
Description of Contribution
b
' SCHEDULE III
Statement of Expenditures
Filer Identification Number:
6ea10 5110,[-te Pa. cr i;c fQ I
To Whom Paid Date[MM/DD/YYYYJ $
a -BRA_ 11 I o3 A/ 3, e' d
House# Street Address Description of Expenditure
4O, 6C7Y, `ft/)1yb •
City State Zip
S:ir-t.e(2vi (It l?74.5 . Code 4o?/tf(-1• 4.1,0 :-I Can-el cat.
To Whom Paid ��//JJ,�, �� Date[MM/DD/YYYYJ $
!1t"evh6014 (Irt `. !I ) 0i 20zJ S. 2
House# Street Address Description of Expenditure
Sboo 4e)u:S4t 1D/140) Rp, Q&X Vo
City State ,Q Zip
in4k-bra1t?i�6 f tt� Code 1.1oSS— �n0A.,soc-4ioN ccQ,
To Whom Paid e Date[MM/DD/Y•YYY] $ '
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid 1 Date[MM/DD/YYYY] $
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid Date IMM/DD/YYYY] $
House# Street Address Description of Expenditure
City State Zip
Code
To Whom.Paid Date[MM/DD/YYYY]. $
House# Street Address Description of p 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[MM/DD/YYYY] $
House# Street Address Description of Expenditure
City State Zip
Code