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Home My WebLink AboutKutz for Lower Allen - 2021 Annual Report Iii ii J Ir -feset-Form---1,-'—ennurorm-i Commonwealth of Pennsylvania-Campaign Anance Report (Note:This report must be dear and legible.It should be typed) Fier Identification Fbport Fled By Candidate Committee Lobbyist - Number (Mark)) X Name of Fling Committee,Candidate or Kutz for Lower Allen Lobbyist Sreet Address - PO Box 3093 aty Camp Hill Sate PA Zipoxle 17011 Type of Feport(Place x under report type) 1-6th Tuesday 2- 2nd Friday 3-30 Day Post 4-6th Tuesday 5-2"d Friday 6-30 Day Post 7-Annual *edal 2n"Friday Sedal 30 Day Pre Primary Pre Primary Primary Pre-Election Fire-Section Section Pre-Section Post-Election X Date Of Bedion 11/05/2019 Year Amendment Termination (M M/DD/YYYY) Fbport Fbport S immary of Faceipts and From Date To Date For Office Use g .' Expenditures -ei/01/2021 12/31/2021 rn rn 0 co A.Amount Brought Forward From Last Fbport $ 4,932.86 r- f B.Total Monetary Cbntributionsand Iboeipts $ 5,047.58 t7 . :_ (From S hedule I) C =. C Total FundsAvailable $ 9,980.44 0 G (:Sam of Lines and B) D.Total Expenditures $ 2,062.80 -C • ...-CCr (From S hedule III) -- E Ending Cash Balance $ 7,917.64 (Sabtrad line D from Line Ca Value of InCommonwealth of Pennsylvania•Notary teal F. fend Cbntritxrtions Fbceived $ 461.81 Alexandra M.Vaccaro,Notary Public (From Siledule II) Cumberland County G.Unpaid Debts and Obligations $ 14,620 My commission expires July 17,2023 (From Siiedule IV) Commission number 1351757 Affidavit SBction Member,Pennsylvania Association of Nota ies Part 1-If this is a Committee report,treasurer sgn here.If this is a Candidate report,candidate sign here. I swear(or affirm)that this report,induding the attached schedules on paper,is to the best of my knowledge and belief true,correct and complete. SNorn to and subscribed before me this ay of U 20 2-2- ' I 1 Sgnature of Ferson Sibmitting report r �VI Qn hvt2- 9giature r -7 FYinted Name uJ 2 9 _ My Cbmmisson expires 01 I-7 20 l/ 7 / MO. DAY YR Area Code Daytime Telephone Number Part II-If this is a report of a Ca ndidate'sAuthoriaed Committee,candidate ,all sgn 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..line 3,1937(P.L 1333,NO.320)as amended. SNorn to and subscribed before me this 291 ofJ nUa zo a at • Pai,eZiAs I . Sate of Caro jdath gnature Panted Name My(bmmiss 4on expires 01 )1 202 7/7 O2` 5-7 C/ I Ma. DAY YR Area Cbde Daytime Telephone Number Commonwealth of Pennsylvania-Notary Seal . Alexandra M.Vaccaro,Notary Public Cumberland County My commission expires July 17,2023 Commission number 1351757 -- Member,Pennsylvania Association of Notaries SCHEDULE! C ontributionsand Receipts Detailed Summary Page Filer Identification Number 11.Unitemiaed Cbntributionsand Fieoeipts$50.00 or:Lessper Oantributor Total for the reporting period (1) $ 470.05 2.Cbntributionsof$50.01 to $250.00(From I Part A and Part B) Contributions Received from Political Committees(Part A) 1 $ 485 All Other Cbnt ributions(Part $ 1,370 Total for the reporting period (2) $ 1,855 I'3._CbntributionsOver$250.00(From Part Cand Part D) (bntribut ions F ceived from Political Cbmmittees(Part Q $ 600 All Other Cbntributions(Part D) $ 2,120 Total for the reporting period (3) $ '2,720 4.Other Raceiptstefunds,Interest Earned,Ftturned Chedts;ETC.(From Part E) Total for the reporting period (4) $ 2.53 Total Monetary Cbntributions and Fècipts during this reporting period(Add and $ enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Ftport 5047.58 Cover Page,Item B) PARTA Contributions FLaceived From Political Committees $50.01 TO$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value from$50.01 TO$250.00 in the reporting period. Filer Identification Number Amount Full Name of Contributing Date[M M/ YYYYj $ Committee MIKE REGAN FOR SENATE 250 9/27/21 House# Sreet Addresi Date[M M/DD'YYYY] $ P.O.BOX 811 City Sate ZpCode Date[MM/DD'YYYY] $ MECHANICSBURG PA 17055 Full Name of Contributing Date[MM/DIY YYYYJ $ Committee FRIENDS FOR SHERYL DELOZIER 10/2/21 75 House# Sreet Addresi Date[MM/DD'YYYYj $ P.O. BOX 66 City Sate ZpCbde Date[M M/DIY YYYYj $ NEW CUMBERLAND PA 17070 Full Name of Contributing Date[M M/DIY YYYYJ $ Committee DUANE MORRIS GOVERNMENT COMMITTEE 10/07/2021 160 House# greet Addresi Date[M M/DD'YYYYj $ 30 S. 17TH ST. City Sate Zp Code Date[M M/DLYYYYYj $ PHILADELPHIA PA 19103 Full Name of Contributing Date[MM/DIY YYYYI $ Committee House# Sreet Address Date[MM/DD'YYYYI $ City Sate ZpCbde Date[MM/DCYYYYYJ $ Full Name of Contributing Date[M M/DCYYYYY] $ Committee House# Sreet Address Date[M M/DD'YYYY] $ City Sate Zp Code Date[M M/DD'YYYY] $ Full Name of Contributing Date[MM/DCYYYYY] $ Committee House# greet Addreel Date[M M/DD'YYYYj $ City Sate ZpOade Date[MM/DIY YYYYJ $ PART B All Other thntributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exdude co ntributionsfrom political committees reported in Part A) Fier Identification Number: Full Name of Contributor Date[MM/DD(YYYYJ $ KATE KLUNK 09/30/2021 75 House# areet Addresi Date[MM/DDfYYYYJ $ OAK ST. City Sate Zp Code Date[M M/DD'YYYYJ $ HANOVER PA 17331 Full Name of Cant ributor Date[M M/DD/YYYY] $ JESSICA KEMMERER 10/01/2021 75 House# Street Address Date[M M/DD/YYYYJ $ GREEN ST.APT. 107 City Sate Zp Cade Date[MM/DDfYYYYJ $ HARRISBURG PA 17102 Full Name of Contributor Date[MM/DD'YYYYJ $ CHRISTINE RESTREPO 09/29/2021 75 House# 9 reet Addrel Date[MM/DIY YYYYJ $ MERIDIAN WAY APT.6 City Sate Zp Cbde Date[M M/DIYYYYYJ $ MECHANICSBURG PA 17055 Full Name of Gbntributor 'Date[MM/DD'YYYY]. $ JOHN&ELIZABETH STATLER 09/21/2021 90 House# Sreet Addresi Date[MM/DD'YYYYJ $ CANDLELIGHT DR. City • Sate ZpCbde Date[MM/DD!YYYYJ $ MECHANICSBURG PA 17055 Full Name of Contributor Date[M M/DD'YYYY] $ MICHAEL PYKOSH 100 09/21/2021 House# Sreet Addres1 Date[M M/DD'YYYYJ $ MARKET ST. City Sate ZpCode Date[MM/DIY YYYY] $ CAMP HILL PA 17011 Full Name of Qmtributor Date[MM/DD/YYYYJ $ BRUCE MCLANAHAN 09/27/2021 100 House# areet Addresi Date[M M/DDY YYYYJ $ 16 CHERISH DR. City Sate Zp 03de Date[M M/DD'YYYYJ $ CAMP HILL PA 17011 PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other oontribut ions wit h an aggregate value from $50.01 TO$250 in the reporting period. (6cdudecontributionsfrom political committees reported in Part A) IFiler Identlfka3tlon Number: Full Named Contributor Date[M M/DD/WYYJ $ RONALD&SUSAN KIRKLAND 09/24/2021 100 House# greet Address Date[M M/DIY WYY] $ 11 DISHLEY DR. aty Rate Zp Code Date[M M/DD/WYY] $ MECHANICSBURG PA 17055 Full Name of Contributor Date[M M/DD/WYY] $ JOHN&DEBRA SNOKE 10/02/2021 100 House# Street Address Date[M M/DD/YYYY] $ 222 EWE RD. aty sate Zp Code Date[M M/DCY WYY] $ MECHANICSBURG PA 17055 Fill Name of Contributor Date[M M/DD/WYY] $ FRANCIS VACCARO 10/02/2021 100 House# Street Addresd Date[M M/DCV WYY] $ 397 I BENYOU LN. aty Rate Zp Code Date[M M/DCV WYY] $ NEW CUMBERLAND PA 17070 Full Name of Contributor Date[M M/DCY WYY] $ BRIAN KUTZ 10/02/2021 160 House# Sreet Addres1 Date[M M/DIY WYY] $ 1038 DOGWOOD LN. aty Sate Zp Code Date[M M/DD'YYYY] $ ENOLA PA 17025 Fill Name of Contributor Date[M M/Do Perri $ CLAIR E.WEIGLE III 09/30/2021 160 house# Street Address Date[M M/DD✓WYYJ $ 1670 NORTHVIEW RD. City sate Zip Code Date[M M/DCY WYYJ $+ YORK PA 17406 Rill Name of Oantributor Date[M M/DIY'MY) $ W.GREG ROTHMAN 10/09/2021 160 House# Sreet Address Date[M M/DD/WYYJ $ 3 LEMOYNE DR. aty Rate 2ip Code Date[M M/CO/WYY] $ LEMOYNE PA 17043 PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exdudecontributionsfrom political committees reported in Part A) Fier Identification Number: Full Name of Contributor Date[M M/DLY YYYYJ $ Josh Nagy 75.00 11/1/2021 House# Sreet Address925 Sheffer Ln Date[MM/DD'YYYYJ $ aty Camp Hill sate PA Zip0 de 17011 Date[MM/OD'YYYYJ $ Full Name of Contributor Date[MM/DD"YYYYJ $ House# Street Address Date[M M/DD/YYYYJ $ aty Sate ZpCode Date[M M/DD/YYYYJ $ Full Name of Contributor Date[MM/DD"YYYYJ $ House# sreet Addrel Date[M M/DIY YYY11 $ aty Sate Zp(ode Date[M M/DIY YYYYJ $ Full Name of Contributor Date[M M/DDr'YYYYJ $ House# Sreet Addrel Date[MM/DIY YYYYJ $ aty Sate ZpCode Date[MM/DDfYYYYJ $ Full Name of Contributor Date[MM/DD✓YYYYJ $ House# s reet Addrel Date[M M/DD/YYYYJ $ aty Sate ZpCode Date[MM/DD'YYYY] $ Full Name of Contributor Date[MM/DD✓YYYYJ $ Haase# Street Addresi Date[M M/DD✓YYYYJ $ City Sate bp Code Date[M M/DD/YYYYJ $ PART C Contributions Received From Political Committees Over$250.00 Use this Part to itemize only contributions received from Political Gbmmittees with an aggregate value over$250.00 in the reporting period. Filer Identification Number: Full Name of Date[M M/DDYYYYYJ $ Contributing Committee TAXPAYERS FOR TORREN 09/30/2021 300 House# greet Addres1 Date[MM/DD'YYYY] $ 80 STONYBROOK LN. aty Sate by Code Date[MM/DD'YYYYJ $ NEW OXFORD PA 17350 Full Name of Date[MM/DD/YYYYJ $ CbntributingCbmmittee MCNEES PAC 09/28/2021 300 House# Sreet Addresi Date[M M/DD'YYYYJ $ 100 PINE ST.P.O. BOX 1166 aty Sate ZpOode Date[MM/DD/YYYY] $ HARRISBURG PA 17101 Full Name of Date[M M/DCY YYYYJ $ Contributing Committee House# Sreet Addresi Date[M M/DCYYYYYJ $ aty Sate by Code Date[M M/DD/YYYYJ $ Full Name of Date[M M/DD/YYYYJ $ Contributing Committee Hoge# SreetAcddress Date[MM/DDUYYYYJ $ aty Sate Bp Code Date[MM/DD YYYYJ $ Full Name of Date[M M/DDfYYYYJ $ Contributing Committee House# greet Addr Date[MM/DD/YYYYJ $ aty Sate Bp Code Date[MM/DDcYYYY] $ Full Name of Date[M M/DDr YYYYJ $ Contributing Cbmmittee House# Sreet Addrel Date[MM/DDYYYYY] $ City Sate ZpCode Date[MM/DDfYYYYJ $ PART D All Other Contribution Over$250.00 Use this Part to itemize all other contributions with an aggegate value over$250.00 in the reporting period. (Exclude contributionsfrom political committees reported in Part q Rler Identification Number: Full Name of Contributor Date[MM/DCYYYYYJ $ ROBERT LEIPZINGER 320 09/25/2021 House# S reet Address Date[M M/DDf YYYYJ $ 25 HEATHER RIDGE DR. City Sate Zp Code Date[M M/DD'YYYYJ $ N E WTO W N PA 18940 Employer Name ROB'S TOWING Occupation MANAGEMENT Employer MailingAddress/ 3231 BATH RD. BRISTOL, PA 19007 Principal Race of Business Full Name of Contributor Date[M M/DD'.YYYY] $ GARY EICHELBERGER 09/29/2021 300 House# S reet Address Date[M M/DCY YYYYJ` $ 606 S.ARCH ST. City Sate Zp.Code. Date[MM/DD'YYYYJ $ MECHANICSBURG PA 17055 Employer Name COUNTY OF CUMBERLAND, PENNSYLVANIA Occupation COMMISSIONER Employer MailingAddress/ 1 COURTHOUSE SQ.CARLISLE, PA 17013 Prindpal Race of Business Full Name of Contributor Date[MM/DDfYYYYJ $, ROBERT BOWMAN 09/24/2021 500 House# Sreet Address Date[MM/DD'YYYYJ $ 322 N.ARCH ST. aty Sate Zp(ode Date[MM/ YYYYJ $ LANCASTER PA 17603 • Employer Name CHARTER HOMES&NEIGHBORHOODS Q:cuPation PRESIDENT Employer MailingAddress/ 1190 DILLERVILLE RD. LANCASTER, PA 17601 Prindpal Race of Business Full Name of Contributor Date[MM/DDYYYYYJ $ W.SCOTT BURY 500 Hoge# S reet Address Date[M M/DCY YYYYJ: $ 33 ARGALI LN. aty Sate Zpaxle Date[MM/DCYYYYYJ $ MECHANICSBURG PA 17055 Employer Name SELF-EMPLOYED Occupation BUSINESS OWNER Employer Mailing Address/ 33 ARGALI LN. MECHANICSBURG,PA 17055 Alndpal Place of Business PART D All Other Contributions Over$250.00 Use this Part to itemize all other contributions with an aggregate value over$250.00 in the reporting period. (Bcdudecontributionsfrom political committees reported in Part q Rler Identification Number: FUII Name of Contributor Date[M M/DDVYYYY] $ JAMES W.KUTZ 500 09/30/2021 House# greet Address Date[M M/DD/YYYY] $ 25 ARGALI LN. City gate Zip Code Date[MM/DEVYYYYJ $ MECHANICSBURG PA 17055 Bnployer Name SELF-EMPLOYED Occupation ATTORNEY Bnployer Mailing Address/ Prindpal Place of Buelrtess 100 PINE ST.HARRISBURG,PA 17101 Fu I Name of Contributor Date[M M/DDf YYYY] $ House# greet Addressl Date[M M/DO/WYYJ $ City gate Zip Code Date[M M/DD/YYYY] $ Bnpioyer Name Occupation Employer Mailing Address/ Prindpai Place of Business Rill Name of Contributor Date[M M/DD/YYYYJ $ House# greet Addreel Date NW DD/YYYYJ $ City gate Zjp Code Date[M M/DIY YYYY] $ Bnployer Name Occupation Bnployer Mailing Address/ Prindpal Place of Business Fill Name of Contributor Date[M M/DO/YYYYJ $ House# greet Address ; Date(M M/DIY YYYYJ $ City gate Zip Code Date[M M/DLYYYYYJ $ Bnpioyer Name - Occupation Bnployer Mailing Address/ Principal Place of Business PART E Other Receipts REAJND4 INTREST INCOM E RETURNED CHEO EFC. Use this Part to report refunds received,interest earned,returned diedcsand prior expendituresthat were returned to the filer. Filer Identification Number: Full Name Members First FCU House# 5000 areet Address Louise Dr aty Mechanicsburg Sate PA ZP 17055 Date[MM/DD/YYYYJ $ 0.34 Cbde 12/31/2021 Receipt Description Full Name Members First FCU House# 5000 Street Addresl Louise Dr aty Mechanicsburg Rate PA ZP 17055 Date[MM/DD/YYYYJ $ 0.21 Cade 07/31/2021 Fbceipt Description Full Name Members First FCU House# 5000 Street AddresslI Louise Dr City Sate Zip Date[MM/DD/YYYYJ $ Mechanicsburg PA Code 17055 0.21 08/31/2021 Receipt Description Full Name House# Street Address City I Sate Op Date[MM/DLYYYYYJ $ Cade Feceipt Description Full Name House# 3reetAddress� City I Sate Op Date[MM/DLYYYYYJ $ Code Receipt Description Full Name House# Street Address aty Sate • Op Date[MM/DO/YYYYJ $ Code Receipt Description PART E Other Receipts REFUNDS INTEREST INCOM E RETURN®CHECI ETC Use this Part to report refunds received,interest earned,returned chedcsand prior expendituresthat were returned to the filer. Filer Identification Number: Rill Name MEMBERS 1ST FCU HOUe# 5000 Sreet Address LOUISE DR. aty Sate Zp Date[MM/DD/YYYYJ $ MECHANICSBURG PA 17055 0.20 09/30/2021 Ftaeipt Description DIVIDEND EARNED Full Name MEMBERS 1ST FCU House# 5000 Sleet Addressi LOUISE DR. aty Sate Zp Date[MM/DQfYYYYJ $ MECHANICSBURG PA Die 17055 0.19 02/28/2021 Raceipt Description DIVIDEND EARNED Full Name MEMBERS 1ST FCU Hou9e# 5000 Sreet Address LOUISE DR. aty Sate ' Zp Date[MM/DCYYYYY] $ MECHANICSBURG PA 03de 17055 03/31/2021 0.21 Raceipt Description DIVIDEND EARNED Full Name MEMBERS 1ST FCU House# 5000 Sreet Addres1 LOUISE DR. aty Sate Zp Date[MM/DD/YYYYJ $ MECHANICSBURG PA Code 17055 0.20 04/30/2021 Raceipt Description DIVIDEND EARNED Full Name MEMBERS 1ST FCU Hou9e# 5000 Sreet Address{LOUISE DR. aty I Sate Zp Date[MM/DGYMY] $ MECHANICSBURG PA Gbde 17055 0.21 05/31/2021 Raceipt Description DIVIDEND EARNED Full Name MEMBERS 1ST FCU House# 5000 Sreet AddresE LOUISE DR. aty Sate Zp Date[MM/DCYYYYYJ $ MECHANICSBURG PA Gbde 17055 06/30/2021 0.20 Raceipt Description DIVIDEND EARNED PART E Other Fbceipts RERJNDS, !WREST INOOME, RETURNED CHECKS ETC Use this Part to report refunds received,interest earned,returned chedcsand prior expenditures that were returned to the filer. filer Identification Number: Full Name Member's First Federal Credit Union House# greet Address 5000 Louise Dr aty Mechanicsburg Sate PA OP 17055 Date[MM/DD'YYYYJ $ 0.23 de 10/31/2021 Receipt Description Interest Full Name Members First Federal Credit Union House# Sreet Addresi5000 Louise Dr aty Mechanicsburg gate PA Zp 17055 Date[MM/DD/YYYYJ $ 0.33 Wde 11/30/2021 Receipt Description Interest Full Name House# a reet Address aty I Sate Zp Date[MM/DDfYYYYJ $ Code Fbceipt Description Full Name House# S reet Addres1 aty Sate Zp Date[MM/DD/YYYYJ $ Code Fbceipt Description Full Name House# greet Addres1 City Sate Zp Date[MM/DCYYYYYJ $ Code Receipt Description Full Name • House# greet Address City I Sate Zp Date[MM/DGYYYYYJ $ Code Receipt Description SCHEDULE!! IN-!4 ND CONTRI BU11 ONS AND VAWABLE T-II NGS MCI EVE) USE THIS SCH®ULETO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THI NGS DURING THE REPORTING PBIOD DETAI LED SUMMARY PAGE Rler Identification Number:I. 1. UNIT MIZDIN-KIND OONTRI3UT1ONSFECEIVED-VALUEOF$50.00 OR LMS PHRODNT IBUTOR TOTALfor the reporting period (1) $ 60.02 2. IN-KIND CONTFIBUTIONS RTIVED-VALUE OF$50.01'TO$250.00(FROM PAFTF) TOTALfor the reporting period (2) $ 401.79 3. IN-KIND CONTRIBUTION F VH}VALUEOVER$250.00(FROM PARTG). TOTALfor the reporting period (3) $ 0. TOTAL VAWEOF IN-KIND ClONTRIBUIICNSDUFINGTHISRHORTING $ PERIOD(Add and enter amount totals from boxes 1,2,and 3;also enter 461.81 on Page 1,Report Cbver Page, Item F) 9CH®ULEII PART F In-Kind Gbntributions Received VALUE OF$50.01 TO$250 Rler Identification Number: Full Name of Contributor Date[MM/DIY YYYY] $ JAMES&DEBORAH KUTZ 10/01/2021 53.24 House# S reet Address Date[M M/DLY YYYYJ $ 25 ARGALI LN. City Sate Zip Code Date[MM/DLYYYYYJ $ MECHANICSBURG PA 17055 Description of Contribution EVENT MATERIALS Full Name of Contributor Date[MM/DLYYYYYJ $ THOMAS KUTZ 10/02/2021 180 House# Sreet Address Date[MM/DCYYYYYJ $ 3207 DUNLAP LN.APT.A City Sate Zip Code Date[MM/DCYYYYY] $ MECHANICSBURG PA 17055 Description of Contribution EVENT MATERIALS Full Name of Contributor Date[M M/DD'YYYYJ $ LAUREN KUTZ 10/01/2021 50 House# reet Addresi Date[MM/DD/YYYYJ $ 1411 BENTON WAY City Sate Zip Code Date[MM/DCYYYYYJ $ MECHANICSBURG PA 17055 Description of Contribution EVENT MATERIALS Full Name of Contributor Date[MM/DD'YYYYJ $ House# Street Address Date[M M/DD'YYYYJ $ City Sate ZpCode Date[MM/DD'YYYYJ $ Description of Contribution Full Name of Contributor Date[MM/DO/YYYY] $ HOLUB# S reet Addresi Date[M M/DCY YYYYJ $ aty Sate Bp Code Date[M M/DD/YYYY] $ Description of Contribution 9Qi®ULE II PART F In-Kind Contributions Received VALUE OF$50.01 TO$250 Rier Identification Number: Full Name of Contributor Date[MM/DIYWWJ $ Thomas Kutz 68.55 11/6/2021 House# Greet Address 3207 Dunlap Ln Apt A Date[M M/DIYYYYY] $ aty Mechanicsburg sate PA Zp 03de 17055 Date[MM/DIYYYYY] $ Description of Contribution Website Full Name of Contributor Date[MM/DIY YYYYJ $ House# Sreet Address Date[MM/DIY YYYYJ $ City sate Zp Code Date[M M/DGY YYYYJ $ Description of Contribution Full Name of Contributor Date[M M/DIY YYY11 $ House# reet Addresi Date[MM/DD/MY] $ City Sate Zip Cbde Date[M M/DIY YYYYJ $ Description of Contribution Full Name of Contributor Date[MM/DQ'YYYYJ $ House# 3reetAddress Date[MM/DD/YYYYJ $ City Sate Zp Cbde Date[M M/DIY YYYYJ $ Description of Contribution Full Name of Gbntributor Date[MM/DGYYYYY] $ House# S reet Addresi Date[M M/DIY YYYY] $ City Sate Zp Oade Date[M M/DGYYYYY] $ Description of Contribution SZHEDULEIII Statement of Expenditures Rler Identification Number: To Whom Paid Date[MM/DD/YYYYJ $ REAM PRINTING368.43 10/01/2021 • House# 515 Street Address FARMBROOK LN. Destxiption of Expenditure City Lp YORK Sate PA 17405 PRINTING Code To Whom Paid Date[MM/DD(YYYY] $ HOSPITALITY MANAGEMENT CORP. 1,217.60 10/01/2021 House# Street Address Expenditure BOX 448 Description of aty Zp ABBOTSTOWN State PA 17301 EVENT COSTS Cbde To.Whom Paid Date[MM/DD/YYYYJ $ ALPHA GRAPHICS�� 21.20 10/01/2021 House# 4609 StreetAdd'e`iGETTYSBURGRD. Description of Expenditure City MECHANICSBURG I State PA Zde 17055 LAMINATING Cb To Whom Paid Date[MM/DD/YYYYJ $ PAYPAL 2.24 �IIII 09/15/2021 House# 2211 greet Mdre N. 1ST ST. Descxiption of Expenditure City SAN JOSE I Sate CA Bp 95131 PROCESSING FEES Cbcie To Whom Paid Date[MM/DD'YYYY] $ MEMBERS 1ST 2.00 FCU 10/01/2021 se Hou # 5000 greet Actdresi LOUISE DR. Description of Expenditure City MECHANICSBURG I State PA ZZipC1e 17055 CHECKS Cb To Whom Paid SIGNS BY TOMORROW Date[MM/DIY YYYY] $ 116.07 10/01/2021 House# 333 J9reetAddrefss S. FRONT ST. Desa'iption of Expenditure at WORMLEYSBURG State PA ZZippde 17043 EVENT MATERIALS To Whom Paid Date[M M/DD'YYYYJ $ US POSTAL SERVICE 72.00 dRVICE 06/16/2021 House# 10 Street Address' W.MAIN ST. Description of E enditure aty CAMP HILL State Zip PA 17011 P.O. BOX FEES Code To Whom Paid Date DAM/DD/YYYYJ $ Hoge# greet Addre IDescription of Expenditure aty Sate Zp Code 9CH®ULEIII Statement of Expenditures Rler Identification Number: • To Whom Paid Wix Date[MM/DIYYYYYJ $ 263.26 11/7/2021 House# Street Address1I500 Terry A Francois Boulevard Sixth Floor Description of Expenditure City San Francisco Sate CA Zp 94158 Website Code To Whom Paid Date[MM/DD/YYYY] $ • House# Street Address Description of Expenditure aty State Zip Cbde To Whom Paid Date[MM/DD/YYYY] $ House# 9reet Ackiressl Description of Expenditure City State Zp Code To Whom Paid Date[MM/DD/YYYYJ $ House# Street Address Description of Expenditure City I Sate Zp Cbde To Whom Paid Date[MM/DD/YYYYJ $ House# Street Addres1 Description of Expenditure aty I State Zp Code To Whom Paid Date[MM/DD✓YYYYJ $ House# Street Address Description of Expenditure City I State Zip Cbde To Whom Paid Date[MM/DD/YYYYJ $ House# Street Address Description of Expenditure • aty I Sate Zip Code To Whom Paid Date[MM/DD/YYYYJ $ House# Street Address Description of Expenditure City State Zp Code SCHEDULE IV Statement of Unpaid Debts Use this&dion to itemize all unpaid debts and obligations which are outstanding at the end of the reporting period. Rler Identification Number: Name of Creditor THOMAS H.KUTZ Outstanding Balance of Debt House# Sreet Addresi DATE DB31-INCURRED $ 3207 DUNLAP LN.APT.A NM/DO'YYYYJ City Zp MECHANICSBURG Sate PA Code 17055 14,620 Description of Debt LOAN TO CAMPAIGN Name of Creditor Outstanding Balance of Debt House# greet Adder DATE DEBT INCUR $ [M M/DQf YYYYJ City Sate Zp Ode Description of Debt Name of Creditor Outstanding Balance of Debt House# &reef Addr DATE DB3T lNCURFED $ [M M/DCY YYYYJ City Sate Zp Cbde Description of Debt Name of Creditor Outstanding Balance of Debt House# SreetAddress DATE DEBT INCURFED $ [M M/DCY.YYYYJ City Sate Zp Cade Description of Debt Name of Creditor Outstanding Balance of Debt House# Sreet Address DATE DB3T I NCURFiED $ [M M/DCYYYYYJ City Sate Zp Cade Description of Debt Name of Creditor Outstanding Balance of Debt House# greet Adder DATEDff INCURFED $ [M M/DD/YYYYJ City Sate Zp Cade Description of Debt