HomeMy WebLinkAboutScott, Timothy - 2021 Annual Report 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 IDENTiflCATION REPORT FLED CANDIDATE I� 6 COMMhTEE-.2. LOBBYIST 3
NUMBER ON BEHALF OF ,
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
t i NA/kVA-AA-1 A_ . 5( ,A--- V--.
STREET ADDRESS
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` " STATE ZIP CODE
Ce —Vis�K VA- 1-200 -
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO:- 'DAY YEAR'
i \ `
''.6TH TUESDAY 1. . 0- 0` �oNe I i V 1S z
PRE-PRIMARY ✓ FOR OFFICE USE ONLY
MO. -.DAY YEAR -MO. :. DAY......YEAR C, ... Ih-
2ND FRAY 2. DATES OF j 2 C �"
PRE-PRIMARY PERT LNG `)I V 1 2 I TO 17, 3 t c
30 DAY 3 t fri :=
POST-PRIMARY .. -
CASH BALANCE AT END *
4. OF REPORTING PERIOD: $
6TH TUESDAY CI
PRE-ELECTION
TOTAL AMOUNT OF FILER'S 2 . _
OUTSTANDING DEBTS OR LIABILITIES C
2ND PRE-ELECTION
AT THE END OF REPORTING PERIOD: $ fe
PRE-ELECTION _ M
4 m
30 DAY-' ,
POST-ELECTION. :AMENDMENT YES NO }L
REPORT? (/\
ANNUAL .:TERMINATION
REPORT - REPORT? YES NO \/
AFFIDAVIT SECTION
m raj-
n O at'bment is filed on behalf of a Political Committee or Candidates's Committee,the Treasurer must sign here.
Jo o ement is filed on behalf of a Candidate,the Candidate must sign here.
o a a dement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
ID Ip C j 'V AR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR UABILI'ITES INCURRED DURING THE REPORTING P3-OD INDICATED ABOVE DID NOT
c O = -�eIU D TWO HUNDRED AND FIFTY DOLLARS(S250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRU- CORRECT AND COMPLETE.
5 Z �p. SWORN TO AND SUBSCRIBED BEFORE ME THIS _
c 0 c U 7 a
dE •S.C c `1 DAY 0 � }�Zi ��/�/� 20 ZL SIGNAT RE OF PERS. " M`ITTING REPORT
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MMEE
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PRINTED NA
3 C •C E 0-MY COMMISSION EXPIRES 1 0 P LI bo - 1 t i I(e( •-- 0 2 4.
E . :U $`r MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
EY j C
0 $AF#i`•11-
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 COMMIT Itt HAS NOT VIOLATED ANY PROVISIONS OF THE ACT OF
JUNE 3,1937(P.L.1333,No.320)ASS 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
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