HomeMy WebLinkAboutTri-County FDW PAC - 2021 Annual Report jfPennsylvania 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 Reports
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 Reports. This form must be signed
by hand where a signature is required.
litaGailgalie Committee, Candidate, .w Lobbyist
Tri-County FDW PAC
Reporting
❑ Cycle 1 ❑ Cycle 2 ❑ Cycle 3 ❑ Cycle 4 ❑ Cycle 5
6th Tuesday 2'Friday 30 Day 6th Tuesday 2"d Friday
Pre-Primary Pre-Primary Post Primary Pre-Election
Pre-Election
❑ Cycle 6 B 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 Committee report, the treasurer must sign here. If
this form is submitted with a Candidate report, the candidate must sign here. If this report
is submitted with a 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 Report is true and correct.
•
i , I 10/01/2022
ign.ture of Tea rer, C. di,ate, or L• • • Date (DD/MM/YYYY)
Lisa Ann Budwig Lemoyne PA USA
Printed Name Location (City/State/Country)
DSEB-502R
Updated 1/22/2021
11111111! L Reset Form J Print Form I
Commonwealth of Pennsylvania-Campaign Finance Report
(Note:This report must be clear and legible.It should be typed)
Filer Identification 20180439 Report Filed By Candidate Committee \ / Lobbyist
Number (Mark X)
Name of Filing Committee,Candidate or Tri-County FDW PAC
Lobbyist
Street Address 285 Laurel Run Road(P.O.Box 212)
City Landisburg State PA Zip Code 17040-0000
Type of Report(Place x under report type)
1-6th Tuesday 2- 2n0 Friday 3-30 Day Post 4-6m Tuesday 5-2"d Friday 6-30 Day Post 7-Annual Special 2"0 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 S 1004.66
B.Total Monetary Contributions and Receipts S 734.00
(From Schedule I)
C.Total Funds Available 8 1738.66
(Sum of Lines A and B)
D.Total Expenditures S 8.46
(From Schedule III)
E.Ending Cash Balance S 1730.20
(Subtract Line D from Line C)
F.Value of In-Kind Contributions Received 8 0.00
(From Schedule II)
G.Unpaid Debts and Obligations S o.00
(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
10th day of January 20 22
Signature of Pe�ubmittin� -�,rt
Sign ,Y:Sti r is A Budwig
Printed Name
12/31/202 717 364-8774
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(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(Pt 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
SCHEDULE I
Contributions and Receipts
Detailed Summary Page
Filer Identification Number 20180439
1.Unitemized Contributions and Receipts-8 50.00 or Less per Contributor
Total for the reporting period (1) 8 0.00
I2.Contributions oil50.01 to 8 250.00(From
Part A and Part B)
Contributions Received from Political Committees(Part A) 8 0.00
All Other Contributions(Part B) S 734.00
Total for the reporting period (2) 8 734.00
I3.Contributions Over 8 250.00(From Part C and Part D)
Contributions Received from Political Committees(Part C) 8 0.00
All Other Contributions(Part D) 8 0.00
Total for the reporting period (3) 8
4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E)
Total for the reporting period (4) 8 o.00
Total Monetary Contributions and Receipts during this reporting period (Add and ' S
enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report 734.00
Cover Page,Item B)
PART A
Contributions Received From Political Committees
$50.01 TO 8250.00
Use this Part to itemize only contributions received from Political Committees
with an aggregate value from S 50.01 TO 8250.00 in the reporting period.
Filer Identification Number 20180439
Amount
Full Name of Contributing Date[MM/DD/YYYY] 8
Committee
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] S
Full Name of Contributing Date[MM/DD/YYYY] S
Committee
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Full Name of Contributing Date[MM/DD/YYYY] 8
Committee
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Full Name of Contributing Date[MM/DD/YYYY] 8
Committee
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Full Name of Contributing Date[MM/DD/YYYY] 8
Committee
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Full Name of Contributing Date[MM/DD/YYYY] 8
Committee
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
PART B
All Other Contributions
850.01 TO S 250
Use this Part to itemize all other contributions with an aggregate value from
850.01 TO 8 250 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Filer Identification Number. 20180439
Full Name of Contributor Megan Hull Date[MM/DD/YYYY] 8 100.00
10/19/2021
House# 2226 Street Address Hall Pl.NW Date[MM/DD/YYYY] 8
City Washington State DC Zip Code 20007 Date[MM/DD/YYYY] 8
Full Name of Contributor Ciera Dent Date[MM/DD/YYYY] 8 44.00
12/14/2021
House# 351 Street Address Swatara Street Date[MM/DD/YYYY] 8
City Steelton State PA Zip Code 17113 Date[MM/DD/YYYY] 8
Full Name of Contributor Jaime Johnsen Date[MM/DD/YYYY] 8 25.00
12/14/2021
House# 3219 Street Address N 6th St Date[MM/DD/YYYY] 8
City Harrisburg State PA Zip Code 17110 Date[MM/DD/YYYY] 8
Full Name of Contributor Rogette Harris Date[MM/DD/YYYY] 8 35.00
12/14/2021
House# B107 Street Address Springford Drive,Apt 01 Date[MM/DD/YYYY] 8
City Harrisburg State PA Zip Code 17111 Date[MM/DD/YYYY] 8
Full Name of Contributor Bridget Whitley Date[MM/DD/YYYY] 8 55.00
12/14/2021
House# 1525 Street Address N Front St,Unit 201 Date[MM/DD/YYYY] 8
City Harrisburg State PA Zip Code 17102-2563 Date[MM/DD/YYYY] 8
Full Name of Contributor Diane Bowman Date[MM/DD/YYYY] 8 1oo.00
12/14/2021
House# 285 Street Address Laurel Run Road(PO Box 212) Date[MM/DD/YYYY] 8
City Landisburg State PA Zip Code 17040-0000 Date[MM/DD/YYYY] 8
PART B
All Other Contributions
850.01 TO 8 250
Use this Part to itemize all other contributions with an aggregate value from
850.01 TO 8 250 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Filer identification Number: 20180439
Full Name of Contributor Jennifer Savino Date[MM/DD/YYYY] 8 15.00
12/17/2021
House# 6627 Street Address Terrace Way,Apt.B Date[MM/DD/YYYY] 8
City Harrisburg State PA Zip Code 17111 Date[MM/DD/YYYY] 8
Full Name of Contributor Fay K.George Date[MM/DD/YYYYJ 8 200.00
12/17/2021
House# 104 Street Address South Stoner Avenue Date[MM/DD/YYYY] S
City Shiremanstown State PA Zip Code 17011 Date[MM/DD/YYYY] S
Full Name of Contributor Barbara Pearce Date[MM/DD/YYYY] 8 25.00
12/20/2021
House# 171 Street Address Brindle Road Date[MM/DD/YYYY] S
City Mechanicsburg State PA Zip Code 17055-9515 Date[MM/DD/YYYY] 8
Full Name of Contributor Crystal M Karenchak Date[MM/DO/YYYY] 8 85.00
12/21/2021
House# 11 Street Address Richland Lane,Apt T2 Date[MM/DD/YYYY] 8
City Camp Hill State PA Zip Code 17011-2535AR. Date[MM/DD/YYYY] 8
Full Name of Contributor R.Ann Brunner Date[MM/DD/YYYY] S 50.00
12/23/2021
House# 197 Street Address South Main Street(PO Box 244) Date[MM/DD/YYYY] 8
City Berrysburg State PA Zip Code 17005 Date[MM/DD/YYYY] 8
Full Name of Contributor Date[MM/DD/YYYY] S
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
PART C
Contributions Received From Political Committees
Over 8250.00
Use this Part to itemize only contributions received from Political Committees
with an aggregate value over$250.00 in the reporting period.
Filer Identification Number: 20180439
Full Name of Date[MM/DD/YYYY] 8
Contributing Committee
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Full Name of Date[MM/DD/YYYY] 8
Contributing Committee
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Full Name of Date[MM/DD/YYYY] 8
Contributing Committee
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Full Name of Date[MM/DD/YYYY] 8
Contributing Committee
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Full Name of Date[MM/DD/YYYY] 8
Contributing Committee
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Full Name of Date[MM/DD/YYYY] 8
Contributing Committee
House# Street Address, Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
PART D
All Other Contributions
Over 8250.00
Use this Part to itemize all other contributions with an aggregate value over S 250.00 in the reporting period.
(Exclude contributions from political committees reported in Part C)
Filer Identification Number: 20180439
Full Name of Contributor Date[MM/DD/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Employer Name Occupation
Employer Mailing Address/
Principal Place of Business
Full Name of Contributor Date[MM/DD/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Employer Name Occupation
Employer Mailing Address/ •
Principal Place of Business
Full Name of Contributor Date[MM/DD/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Employer Name Occupation
Employer Mailing Address/
Principal Place of Business
Full'Name of Contributor Date[MM/DD/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Employer Name Occupation
Employer Mailing Address/
Principal Place of Business
PART E
Other Receipts
REFUNDS,INTEREST INCOME,RETURNED CHECKS, ETC.
Use this Part to report refunds received,interest earned,returned checks and prior expenditures that were returned to the filer.
Filer Identification Number: 20180439
Full Name
House# Street Address
City State Zip Date[MM/DD/YYYY] 8
Code
Receipt Description
Full Name
House# Street Address
City State Zip Date[MM/DD/YYYY] 8
Code
Receipt Description
Full Name
House# Street Address
City State Zip Date[MM/DD/YYYY] 8
Code
Receipt Description
Full Name
House# Street Address
City State Zip Date[MM/DD/YYYY] 8
Code
Receipt Description
Full Name
House# Street Address
City State Zip Date[MM/DD/YYYY] 8
Code
Receipt Description
Full Name
House# Street Address
City State Zip Date[MM/DD/YYYY] 8
Code
Receipt Description
SCHEDULE II
IN-KIND CONTRIBUTIONS AND VALUABLE THINGS RECEIVED
USE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS DURING THE REPORTING PERIOD
DETAILED SUMMARY PAGE
Filer Identification Number: 20180439
I1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF 850.00 OR LESS PER CONTRIBUTOR
TOTAL for the reporting period (1) S
I2. IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF 850.01 TO 8250.00(FROM PART F)
TOTAL for the reporting period (2) S
I3. IN-KIND CONTRIBUTION RECEIVED-VALUE OVER 8250.00(FROM PART G)
TOTAL for the reporting period (3) 8
TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING S
PERIOD(Add and enter amount totals from boxes 1,2,and 3;also enter
on Page 1,Report Cover Page,Item F)
SCHEDULE II
PART F
In-Kind Contributions Received
VALUE OF 8 50.01 TO 8 250
Filer Identification Number: 20180439
Full Name of Contributor Date[MM/DD/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Description of Contribution
Full Name of Contributor Date[MM/DD/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Description of Contribution
Full Name of Contributor Date[MM/DD/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Description of Contribution
Full Name of Contributor Date[MM/DD/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Description of Contribution
Full Name of Contributor Date[MM/DD/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Description of Contribution
SCHEDULE II
Part G
In-Kind Contributions Received
VALUE OVER$250
Filer Identification Number: 20180439
Full Name of Contributor Date[MM/DD/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Employer Name Occupation
Employer Mailing Address/Principal Description
Place of Business of
Contribution
Full Name of Contributor Date[MM/DO/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] S
Employer Name Occupation
Employer Mailing Address/Principal Description
Place of Business of
Contribution
Full Name of Contributor Date[MM/DD/YYYY] 8
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Employer Name Occupation
Employer Mailing Address/Principal Description
Place of Business of
Contribution
Full Name of Contributor Date[MM/DD/YYYY] S
House# Street Address Date[MM/DD/YYYY] 8
City State Zip Code Date[MM/DD/YYYY] 8
Employer Name Occupation
Employer Mailing Address/Principal Description
Place of Business of
Contribution
SCHEDULE III
Statement of Expenditures
Filer Identification Number: 20180439
To Whom Paid ActBlue Date[MM/DD/YYYY] S 3.00
11/0/2021
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid Vantic Ecommerce Date[MM/DD/YYYY] 8 4.96
11/09/2021
House#! Street Address Description of Expenditure
City State Zip
Code
To Whom Paid ActBlue Date[MM/DD/YYYY] 8 .50
12/09/2021
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid Date[MM/DD/YYYY] 8
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid Date[MM/DD/YYYY] S
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid Date[MM/DD/YYYY] 8
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid Date[MM/DD/YYYY] 8
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid Date[MM/DD/YYYY] 8
House# Street Address Description of Expenditure
City State Zip
Code
SCHEDULE IV
Statement of Unpaid Debts
Use this Section to itemize all unpaid debts and obligations which are outstanding at the end of the reporting period.
Filer Identification Number: 20180439
Name of Creditor Outstanding Balance of Debt
House# Street Address DATE DEBT INCURRED 8
[M M/DD/YYYY]
City State Zip
Code
Description of Debt
Name of Creditor Outstanding Balance of Debt
House# Street Address DATE DEBT INCURRED 8
[M M/DD/YYYY]
City State Zip
Code
Description of Debt
Name of Creditor Outstanding Balance of Debt
House# Street Address DATE DEBT INCURRED 8
[MM/DD/YYYY]
City State Zip
Code
Description of Debt
Name of Creditor Outstanding Balance of Debt
House# Street Address DATE DEBT INCURRED 8
[MM/DD/YYYY]
City State Zip
Code
Description of Debt
Name of Creditor Outstanding Balance of Debt
House# Street Address DATE DEBT INCURRED 8
[MM/DD/YYYY]
City State Zip
Code
Description of Debt
Name of Creditor Outstanding Balance of Debt
House# Street Address DATE DEBT INCURRED 8
[MM/DD/YYYY]
City State Zip
Code
Description of Debt