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Home My WebLink AboutFriends of Rick Coplen - 2021 Annual Report 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 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 COalfaig' Nk3 Commit ee, Candidate,-ice Lobbyist Friends of Rick Coplen Re•ortin: - ❑ Cycle 1 ❑ Cycle 2 ❑ Cycle 3 ❑ Cycle 4 ❑ Cycle 5 6th Tuesday 2nd Friday 30 Day. 6th Tuesday 2nd Friday Pre-Primary Pre-Primary Post Primary Pre-Election Pre-Election ❑ Cycle 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. 2ifL 01 /27/2022 Signature of Treasurer, Candidate, or Lobbyist Date (DD/MM/YYYY) Roderick Frazier Carlisle, PA, USA Printed Name Location (City/State/Country) DSEB-503S Updated 1/22/2020 lePennsylvania 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 Part 11 - 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. 01/27/2022 ature o Candidate Date (DD/MM/YYYY) Rick Coplen Carlisle, PA, USA Printed Name Location.(City/State/Country) DSEB-503S Updated 1/22/2020 Reset Form t Print Form Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Filer Identification 20200165 Report Filed By Candidate Committee Lobbyist — Number (Mark X) Name of Filing Committee,Candidate or Lobbyist FRIENDS OF RICK COPLEN Street Address 806 ALEXANDER SPRING ROAD City 'Carlisle State PA • -Zip Code 1 701 5 Type of Report(Place x under report type) 1-6th Tuesday 2- 2nd Friday 3-30 Day Post 4-6"'Tuesday 5-2"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 11/02/2021 Year 2021 Amendment Termination (MM/DD/YYYY) 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 $ 121.50 • C) +` C to B.Total Monetary Contributions and Receipts $ 0.00 (From Schedule I) ii CO C.Total Funds Available $ 121.50 (Sum of Lines A and B) D.Total Expenditures $ 12.50 'Z �•.i (From Schedule III) t7 E.Ending Cash Balance $ 109.00 n S (Subtract Line D from Line C) iN F.Value of In-Kind Contributions ReceivedCrl $ 0 (From Schedule II) N G.Unpaid Debts and Obligations $ 0 (from Schedule IV) 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 of Person S g report Roderick Frazier Signature Printed Name 717 241-6677 My Commission expires 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 for 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 ture of Candidate Rick • Signature Printed Name 717 254-6448 My Commission expires MO. DAY YR. Area Code Daytime Telephone Number SCHEDULE Fit Statement of Expenditures Filer Identification Number: 20200165 To Whom Paid Act Blue ' Date IMM/DDI YYYY] $ '0.50 12/09/2021 House# 366 Street Address Summer Street Description of Expenditure City Somerville State MA Zip 01244 Service Charge Code To Whom Paid Truist Bank Date[MM/DD/YYYY] $ 12.00 12/21/2021 House# 330 Street Address York Road Description of Expenditure City Carlisle State PA Zip 17013 Service Charge Code To Whom Paid nothing follows Date[MM/DD/YYYY] $ 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[MM/DD/YYYY] $ 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[MM/DD/YYYY] $ 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