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Home My WebLink AboutColleen for PA - 2022 6th Tuesday Pre-Primary 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 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 Colleen for PA Reporting Cycle Name (1 Cycle 1 El 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 ❑ 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. ,3/ 31 /0202). Si nature of Treasurer, Candidate, or Lobbyist Date (MM/DD/YYYY) Colleen Gray Nguyen Ct,r Ott 1( , usik 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. 03r3 ( (z� Signature of Candidate Date (DD/MM/YYYY) Carp. Thornton -Mechanicsburg, PA, USA t.�'t' ( ( Printed Name Location (City/State/Country) DSEB-5035 Updated 1/5/2022 Commonwealth of Pennsylvania Campaign Finance Statement IIIIIIIII�IIIIIRIIII��nIl�Rlllllllllllll 3661966191 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 NUMBER: 20210153 REPORT FILED ON BEHALF OF: Committee NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST COLLEEN FOR PA STREET ADDRESS 1750 YORKSHIRE PLACE CITY ENOLA STATE PA ZIP CODE 17025-2745 TYPE OF REPORT 6th Tuesday Pre-Primary NAME OF OFFICE SOUGHT BY CANDIDATE REPRESENTATIVE IN THE GENERAL ASSEMBLY DISTRICT CODE PARTY CODE () DATE OF ELECTION 11/8/2022 DATES OF REPORTING PERIOD 1/3/2022 TO 3/28/2022 For Office Lile Only AMENDMENT REPORT? NO TERMINATION REPORT? NO rri -gyp CASH BALANCE AT THE END OF REPORTING 8,947.03 --- PERIOD: C") TOTAL AMOUNT OF FILER'S OUTSTANDING 0.00 C) DEBTS OR LIABILITIES AT THE END OF .. REPORTING PERIOD: CO AFFIDAVIT SECTION PART I- If statement is filed on behalf of a Political Committee or Candidate'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($250.00)AND THIS REPORT IS,TO THE BEST OF MY/KNOWLEDGE/ AND BELIEF,TRUE,CORRECT AND COMPLETE. SWORN TO AND SU CRIBED BEFORE ME THIS JCL r� day 2 f SIGNATURF,OFON SUBM NG REPORT AT [1w y C PRINTED NAME ' v MY COMMISION EXP 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 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 SIGNATURE OF PERSON SUBMITTING REPORT ATURE PRINTED NAME - 11-7 7-79 �3�q MY COMMISI IRES MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER Department of State.Bureau of Commissions,Elections and Legislation 3/30/2022 9:19:30 AM 210 North Office Building.Harrisburg,PA 17120-0020.(717)787-5280