HomeMy WebLinkAboutFreedman, Daniel - 2021 30-Day Post Election Pennsylvania Department of State
Bureau of Campaign Finance&Civic Engagement
210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4)
www.dos.pa.gov/campaignfinance • ra-stcampaignfinancec pa.gov
Unsworn Declaration in Lieu of Sworn Statement for
Campaign Finance Statements -;: ,
'
Note: Per Act 2020-15, which was signed into law on April 20, 2020 and allows fiat' unsworn
declarations, Campaign Finance Reports (form DSEB-502), Campaign Finance Statem2ts in lieu
of full reports (form DSEB-503), Non-Bid Contract Reporting Form (DSEB-504) ari"d Independent
Expenditure Reports (form DSEB-505) need not be notarized. Instead, the filer may file fff tth 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 Statements. This form must be
signed by hand where a signature is required.
C Committee, Candidate, CP lobb ist
c ,--FCeQdN\Q
Reportin: Name
❑ Cycle 1 0 Cycle 2 0 Cycle 3 0 Cycle 4 0 Cycle 5
6th Tuesday 2nd Friday 30 Day 6th Tuesday 2nd Friday
Pre-Primary Pre-Primary Post Primary Pre-Election Pre-Election
(Cycle 6 0 Cycle 7 0 Cycle 8 ❑ Cycle 9
30 Day Post-Election Annual Report 2nd Friday Pre-Special Election 30 Day Post-Special Election
Part I — If this form is submitted with a statement in lieu of full report by a political
committee, the treasurer must sign here. If this form is submitted with a statement in lieu
of a full report by a candidate, the candidate must sign here. If this form is submitted with
a statement in lieu of full 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 accom a ' Camp ' ' ance Statement is true and correct.
I2. 63 Z0ZI
Signature of Treasurer, Candidate, or Lobbyist Date (DD/MM/YYYY)
'" O OAaucLL PA U.S.A.
Printed Name Location (City/State/Country)
DSEB-503S
Updated 1/22/2020
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 , REPORT FILED ' CANDIDATE , COMMITTEE ? LOBBYIST
NUMBER ON BEHALF OF v
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
Daniel J. Freedman
STREET ADDRESS
325 Bonnybrook Road
CITY STATE ZIP CODE
Carlisle PA 17015 -
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) Magisterial District Judge Rep M0. DAY YEAR
6TH TUESDAY
1. 11 02 2021
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR
2ND FRIDAY 2. DATES OF
PRE-PRIMARY REPORTING
10 19 21 TO 11 22 21
OD
30 DAY 3.
POST-PRIMARY
CASH BALANCE AT END 0 » t
4. OF REPORTING PERIOD: $ r "a
6TH TUESDAY
PRE-ELECTION rw
TOTAL AMOUNT OF FILER'S
5. OUTSTANDING DEBTS OR LIABILITIES
2ND
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ "w 0
6. :':)
DAY
POST-ELECTION v AMENDMENT
PO YES NO
REPORT?
7. C J
ANNUAL TERMINATION YES NO
REPORT REPORT? 11Y��
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.
If statement is filed on behalf of a Contributing Lobbyist, the Lobbyist must sign here
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR -IES I ■" '0. NG THE RI-*STING PERIO I ATED ABOVE DID NO
EXCEED TWO HUNDRED AND FIFTY DOLLARS(S250.00)AND THIS REPORT IS,TO\THE BEST OF MY KN• *GE AND AEU=F,TRU:.C RRECT OMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS [t
DAY OF 20 SIGNA' RE OF PERS" ING REPORT
�J�INlEL J. % CEDNA3
SIGNATURE -�71 - 7IN,TED NAME (8-
MY COMMISSION- EXPIRES `
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 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
DSEB-503(12 99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280