The URL can be used to link to this page

Home My WebLink AboutFriends of Mercedes Evans - 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 Reports 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 Reports. This form must be signed by hand where a signature is required. Name of Filing Committee, Candidate, or Lobbyist Friends of Mercedes Evans Reporting Cycle Name Cycle 1 1 ! Cycle 2 0 Cycle 3 0 Cycle 4 0 Cycle 5 6th Tuesday 21'd Friday 30 Day 6th Tuesday 2nd Friday Pre-Primary Pre-Primary Post Primary Pre-Election Pre Election ❑ Cycle 6 0 Cycle 7 0 Cycle 8 0 Cycle 9 30 Day Post-Election Annual Report 2nd Friday Pre-Special Election 30 Day Post-Special Election Part l- 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. Signature of Treasurer, Candidate, or Lobbyist Date (MM/DD/YYYY) Patricia Smith Harrisburg, PA, USA Printed Name Location (City/State/Country) DSEB-502R Updated 1/5/2022 \i-ji . Pennsylvania Department of State Bureau of Campaign Finance&Civic Engagement 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 form is submitted with a report by a Candidate's Authorized Committee, the candidate 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 IfReidvi- 61d.5-Pd 1-- Signature of Treasurer, Candidate, or Lobbyist Date(MM/DD/YYYY) Mercedes Evans Camp Hill, PA USA Printed Name Location (City/State/Country) • i OSEB-502R Updated 1/5/2022 II11 _Reset Form--" ;__ Print Form--- Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Hier identification Report Filed By Candidate ` Committee InI m Lobbyist r( Number (Mark X) Name of Filing Committee,Candidate or Lobbyist Friends of Mercedes Evans Street Address P.O.Box 3213 City Camp Hill State PA Zip Code 17011 Type of Report(Place x under report type) i 1-6th Tuesday 2- 2nd Friday 3-30 Day Post 4-Bo'Tuesday 5-2nd Friday 6-30 Day Post 7-Annual Special 27'Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election x U Date Of Election Year Amendment Termination (MM/DD/YYYY) 05/17/2022 2022 J Report Report Summary of Receipts and From Date To Date For Office Use Only Expenditures 01/01/2022 03/28/2022 C) rL A.Amount Brought Forward From Last Report $ '— B.Total Monetary Contributions and Receipts $ '' 70 (From Schedule I) • .2a C.Total Funds Available $ I (Sum of Lines A and B) 3010.61 C rt D.Total Expenditures $ (From Schedule III) 347.20 'ti E.Ending Cash Balance $ C .L.— (Subtract Line D from line C) 2663.41 Z F.Value of In-Kind Contributions Received $ o � co (From Schedule II) G.Unpaid Debts and Obligations $ (From Schedule IV) 0 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 �e �—Li '-- Signature of Person Submitting report Patricia Smith Signature Printed Name My Commission expires 717 919-8585 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(P.L 1333,N0.320)as amended. Sworn to and subscribed before me this 40014171 //day of 20 Signature of Candidate Mercedes Evans Signature Printed Name My Commission expires 717 303-3932 MO. DAY YR. Area Code Daytime Telephone Number SCHEDULE I Contributions and Receipts Detailed Summary Page Filer tdentificationliumber I I I1:Unitemized Contributions and Receipts-!50.00 or Less per contributor . . I Total for the reporting period (1) $ 0 2.Coninbutions oft 50.01 to 1250.00(From Part A and Part B) Contributions Received from Political Committees(Part A) $ o AO Other Contributions(Part B) 8 o Total for the reporting period (2) t 0 3.Contributions Over i 250.00(From Part C and Part D) I 1 Contributions Received from Political Committees(Part C) 0 All Other Contributions(Part D) 1 o Total for the reporting period (3) t 0 I4.Other Receipts-Refunds,Interest'Earned,Returned Checks,ETC.(Prom Part Total for the reporting period (4) 8 .24 Total Monetary Contributions and Receipts during this reporting period(Add and $ enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report 24 Cover Page,Item B) 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. Full Name Members 1st Federal Credit Union House# Street Address P.O.Box 40 City State Zip Date[MM/DD/YYYYJ t Mechanicsburg PA Code 17055 .13 01l31/2022 Receipt bescription Dividend bull Name. Members 1st Federal Credit Union House# Street Address P.O.sox 40 City State Zip Date(MM/DD/YYYYJ ' a Mechanicsburg PA Code 17055 .11 02128l2022 Receipt Description Full Name Mouse# Street Address City State Zip Date[MM/DD/YYYYJ $ Code Receipt Description I Full Name House# Street Address' City State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address City State Zip Date(MM/DD/YYYY] t Code Receipt Description tall Name House#. Street Address! City State Zip Date[MM/DD/YYYY] _ Code Receipt Description d SCHEDULE Ill Statement of Expenditures 1 Fifer Identification Number: I To Whom Paid Cornerstone Coffeehouse Date[MM/DD/YYYY] Ii 03/06/2022 277.20 House# 2133 Street Address Market St Description of Expenditure City Camp Hill State PA Zip 17011 n-kind Refreshments lor Friends o1 Heather MacDonald Code To Whom Paid Date[MM/DD/YYYY] 8 70 USPS 03/16/2022 House# 1 o Street Address W.Main Street Description of Expenditure City Camp Hill State PA Zip 17011 P.O.Box Annual Fee 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 1 Date[MM/DD/YYYY] S House# Street Address Description of Expenditure City State Zip Code To Whom Paid Date[MM/DD/YYYY] i 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] E House# Street Address Description of Expenditure City State Zip Code 4