HomeMy WebLinkAboutFoschi, Jean - 2021 30-Day Post Election tiPennsylvania Department of State
Bureau of Campaign Finance&Civic Engagement
210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4)
www.dos.pa.eov/campaienfinance • ra-stcampaienfinanceepa.eov
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 for; unsworn
declarations, Campaign Finance Reports (form DSEB-502), Campaign Finance Stafemelits 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 file4ith each
report or statement the corresponding version of this form signed by the required in `idual(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.
Name of Filing Committee, Candidate, or Lobbyist
Jean Foschi
Reporting Cycle Name
0 Cycle 1 0 Cycle 2 0 Cycle 3 0 Cycle 4 0 Cycle 5
6th Tuesday 2"d 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 ❑ 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 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 t he accompanyin Campaign Finance Statement is true and correct.
fk/
• / a
Signa ,re of Treasurer, Candidate, or Lobbyist Date (DD/MM/YYYY)
i {�2c D4 CcS6 / PA" Os
Printed Name Location (City ate/Country)
DSEB-5035
Updated 1/22/2020
lii1 RG•7GL I was A I Inn?Vln1
Commonwealth of Pennsylvania-Campaign Finance Report
(Note:This report must be clear and legible.It should be typed)
Filer Identification Report Filed By Candidate x Committee Lobbyist -
Number {Mark X) ,
Name of Filing Committee,Candidate or Jean Foschi
Lobbyist
Street Address 2195 Brunswick Avenue
City 'Mechanicsburg State PA Zip Code '17055
JType of Report(Place x under report type) I
1-6th Tuesday 2- 2nd Friday 3-30 Day Post 4-6th Tuesday 5-2nd Friday 6-30 Day Post 7-Annual Special 2n°Friday Special 30 Day
Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election
Li 1xI —
Date Of Election Year Amendment n Termination
(MM/DD/YYYY) , Report I I Report
Summary of Receipts and From Date To Date For Office Use Only
Expenditures
II/i w2/ l yz 2/�z/
A.Amount Brought Forward From t Report a
O
B.Total Monetary Contributions and Receipts t
(From Schedule i) 0 C
C.Total Funds Available 8 ' r' '=`
(Sum of lines A and B) (-71 ca
D.Total Expenditures t 397.27 :0 rC)
(From Schedule ill) 1-, 1
E.Ending Cash Balance : • ...„1
(Subtract Line D from Line C) 0 i-
F.Value of In-Kind Contributions Received = z >
(From Schedule II) 0 9
G.Unpaid Debts and Obligations $ - o
(From Schedule IV) 6 M
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 me this
day of 20 -
nS l u r re o •• fn S Itri report
Signature ,��.P (fi�
. r
My Commission expires ill 5_7
f - 56`f 3
MO. DAY 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.
Sworn to and subscribed before me this
E.------------ -----------"l
day of 20
Signature of Candidate
Signature Printed Name
•
My Commission expires
MO. DAY YR. Area Code Daytime Telephone Number
SCHEDULE III
Statement of Expenditures
I Filer Identification Number
1
To Whom Paid Colleen for PA Date[MM/DD/YYYY] $ 397.27
10/23/2021
House# 1750 Street Address Yorkshire Place Description of Expenditure
City Enola State PA Zip 17025 In kind contribution-fundraiser
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] 3
House# Street Address Description of Expenditure
City ` State Zip
I Code
To Whom Paid Date LMM/DD/YYYY] $
House# Street Address Description of p Expenditure
City State Zip
Code
To Whom Paid Date[MM/DD!YYYY] 8
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
To Whom Paid Date jMM/DD/YYYY] 8
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