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HomeMy WebLinkAboutCoplen, Rick - 2021 Annual Report a 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-stcampaignfinance@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 for unworn 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 Statements. This form must be signed by hand where a signature is required. col mig Committee, Ca didate,p?Lobbyist , Rick Coplen Resorting Q 3 JUXQ;. _ _ 0 Cycle 1 El Cycle 2 El Cycle 3 0 Cycle 4 ❑ Cycle 5 6th Tuesday 2nd Friday 30 Day 6th Tuesday 2nd Friday Pre-Prima ry Pre-Primary Post Primary Pre-Election Pre-Election B Cy..I.. 6- El Cycle 7 ❑ 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 accompanying Campaign Finance Statement is true and correct. 01 /27/2022 _IP Signs o reasurer, Candidate, or Lobbyist Date (DD/MM/YYYY) Rick Coplen Carlisle, PA, USA Printed Name Location (City/State/Country) DSEB-503S Updated 1/22/2020 IIReset Form Print Form J 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 20200165 (Mark X) Name of Filing Committee,Candidate or Lobbyist RICK COPLEN Street Address 806 ALEXANDER SPRING ROAD City Carlisle State PA Zip Code 17015 Type of Report(Place x under report type) j 1-6`h Tuesday 2- 2nd Friday 3-30 Day Post 4-6u'Tuesday S-2"d Friday 6-30 Day Post 7-Annual Special 2' Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election X Date Of Election Year Amendment Termination (MM/DD/YYYY) 11/02/2021 2021 Report Report Summary of Receipts and From Date To Date For Office Use Only Expenditures 11/23/2021 12/31/2021 A.Amount Brought Forward From Last Report $ 0 4 B.Total Monetary Contributions and Receipts $ M 0 (From Schedule I) f-Yi . C.Total Funds Available $ (Sum of Lines A and B) 0 y. D.Total Expenditures $ (From Schedule III) 0 © "d E.Ending Cash Balance $ 4 (Subtract Line D from Line C) 0 C N F.Value of In-Kind Contributions Received $ C!! (From Schedule II) 0 G.Unpaid Debts and Obligations $ (From Schedule IV) 0 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 Signature f Person Submitting report Rick Cop�Ji Signature Printed Name My Commission expires 717 254-6448 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 day of 20 • Signature of Candidate Signature Printed Name • My Commission expires MO. DAY YR. Area Code Daytime Telephone Number