HomeMy WebLinkAboutFriends of Jean Foschi - 2021 Annual Report Pennsylvania Department of State
Bureau of Campaign Finance&Lobbying Disclosure
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500 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 unsworn
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.
Name of Filing Committee, Candidate, or Lobbyist
Friends of Jean Foschi
Reporting Cycle 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 Q Cycle 7 0 Cycle 8 ❑ Cycle 9
30 Day Post-Election Annual Report 2nd Friday Pre-Special Election 30 Day Post-Special Election
Part 1 — 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.
- � 01/24/2022
Signature • reasurer, Candidate, or Lobbyist Date (MM/DD/YYYY)
Sarah Ann Yerger Camp Hill, PA Cumberland/MS/4
Printed Name Location (City/State/Country)
DSEB-503S
Updated 1/5/2022
Pennsylvania Department of State
Bureau of Campaign Finance&Lobbying Disclosure
500 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4)
www.dos.pa.gov/campaignfinance • ra-stcampaignfinance@pa.gov
Part II - If this is submitted with a statement in lieu of full report by a Candidate's
Authorized Committee, candidate 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.
Z Ce Zee
Signature of Candidate Date (DD/MM/YYYY)
Jean Foschi Mechanicsburg, PA Cumberland it,L5/4-
Printed Name Location (City/State/Country)
DSEB-5035
Updated 1/5/2022
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 Illoo CANDIDATE I COMMITTEE y LOBBYIST
NUMBER ON BEHALF OF
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
Friends of Jean Foschi
STREET ADDRESS
2195 Brunswick Avenue
CITY STATE ZIP CODE
Mechanicsburg PA 17055 —
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO. DAY YEAR
6TH TUESDAY 1 -- -
PRE-PRIMARY FOR OFFICE USE ONLY
MO. I DAY YEAR MO. I DAY I YEAR
2ND FRIDAY 2. DATES OF
PRE-PRIMARY PREPORTING 09 14 21 T° 12 31 21 _ ..
30 DAY 3' C) h,
POST-PRIMARY e
CASH BALANCE AT END M IN4. OF REPORTING PERIOD: 1505.16 M , ,A
6TH TUESDAY
PRE-ELECTION =
TOTAL AMOUNT OF FILER'S
2ND FRIDAY 5. OUTSTANDING DEBTS OR LIABILITIES 0.00 •.1
AT THE END OF REPORTING PERIOD: $
PRE-ELECTION - Q
B. C Z
30 DAY 0 ,r.,
POST-ELECTION AMENDMENT YES NO X C ••REPORT? =
7.
ANNUAL
REPORT
XTERMINATION Y REPORTS YES NO
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 LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS(S250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS ��
411/ fir-'
DAY OF 20 SIG lititia^tRS IN SUBMITTING REPORT
Sarah erger
PRINTED NAME
SIGNATURE 717
MY COMMISSION EXPIRES 856-1388
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 POLITICta. E HAS .. VIOL TED ANY PRO .S OF THE ACT OF
JUNE 3, 1937(P.L. 1333,No.320)AS AMENDED.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
SIGNATUREL OF CANDIDATE
DAY OF 20_ Je Foschi
PRINTED NAME
SIGNATURE 717 571-3343
MY COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR.
Department of State • Bureau of Commissions,Elections and Legislation
LTSL`13-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280