HomeMy WebLinkAboutHampden Twp. Democratic Club - 2022 6th Tuesday Pre-Primary Pennsylvania Department of State
Bureau of Campaign Finance&Lobbying Disclosure
t-C-17
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 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.
atEGOMIN3 Committee, Candidate,CQ Lobbyist
Hampden Township Democratic Club
Reporting
R Cycle 1 ❑ Cycle 2 0 Cycle 3 0 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 0 Cycle 7 0 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.
3/30/2022
Signature of Treasurer, Candidate, or Lobbyist Date (MM/DD/YYYY)
Carol E. Thornton, Treasurer Mechanicsburg, PA, USA
Printed Name Location (City/State/Country)
DSEB-502R
Updated 1/5/2022
.r.�.- 1
Commonwealth of Pennsylvania 111111I1MINMEM111110I11111111111
Campaign Finance Report 366186
(NOTE:This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification 20200298 I Report CANDIDATE COMMITTEE ✓ LOBBYIST
Number: Filed By :
Name of Filing Committee,Candidate or Lobbyist: HAMPDEN TOWNSHIP DEMOCRATIC CLUB
Street Address: 5412 LEGENE LANE
City: ENOLA State: PA Zip Code: 17025
TYPE OF 6TH TUESDAY 1.X 2ND FRIDAY PRE- 2. 30 DAY POST- 3. AMENDMENT Yes No
REPORT PRE-PRIMARY PRIMARY PRIMARY REPORT? ////
l 6TH TUESDAY 4. 2ND FRIDAY PRE- 5. 30 DAY POST- 6. TERMINATION Yes No
(pace X to PRE-ELECTION ELECTION ELECTION REPORT?
the right of - i
report type) ANNUAL REPORT 7. Year 2022 FILING METHOD PAPER 1 DISKETTE
( )CHECK ONE
OfficeCou
Name of Office Sought by Candidate: DATE OF ELECTION Numrber Code ict Party Code Code
MO DAY YEAR 99999 DEM 21
11 8 2022 (SEE INSTRUCTIONS FOR CODES)
Summary of Receipts and MO DAY YEAR MO DAY YEAR FOR OFFICE USE ONLY
Expenditures from: 1 3 2022 TO 3 28 2022
C) r...
A.Amount Brought Forward From Last Report $ 1,064.63 (-- ra
rr:3
B.Total Monetary Contributions And Receipts(From Schedule I) $ 1,555.00 C3"J
C7
C.Total Funds Available(Sum Of Lines A and B) $ 2,619.63 ��, I
.,--
D.Total Expenditures(From Schedule III) $ 120.09 '5
C) =
E.Ending Cash Balance(Subtract Line D From Line C) $ 2,499.54 0
F.Value Of In-Kind Contributions Received(From Schedule II) $ 0.00 Z
-G CD
G.Unpaid Debts And Obligations(From Schedule IV) $ 0.00
AFFIDAVIT SECTION
PART I--If this is a Committee report,treasurer sign here.If this is a Candidate report,candidate sign here. —� ___1
I swear(or affirm)that this report,including the attached schedul ed on paper or by electronic m !um,are t e best of my nowledge and true
correct an plete. y
Sworn to and subscr before me this Signature o Person Submitting— it Report
day o 20 _Oa i -Q , l - 7)/ 4---(d^.._-
�// PrintedN�ame,/l y�,,,
Signature C (,P , ► IiLI)rel C7 r1. G T elma bop(
My Commission E 7/ -7 Email L fi!'_7 3 /
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,
No 320)as amended.
Sworn to and subscribed before me this
Signature of Candidate
day of 20
Printed Name
Signature
My Commission Expires Email
MO DAY YR Area Code Daytime Telephone Number
3/30/2022 11:50:12 AM
SCHEDULE I
CONTRIBUTIONS AND RECEIPTS
Detailed Summary Page
Name of Filing Committee or Candidate Reporting Period
HAMPDEN TOWNSHIP DEMOCRATIC CLUB From: 1/3/2022 To: 3/28/2022
1.Unitemized Contributions Received-$50.00 or Less Per Contributor
TOTAL for the Reporting Period (1) $ 645.00
2.Contributions Received- $50.01 To$250.00(From Part A and Part B)
Contributions Received From Political Committees(Part A) $ 0.00
All Other Contributions (Part B) $ 910.00
TOTAL for the Reporting Period (2) $ 910.00
3.Contributions Received Over$250.00(From Part C and Part D)
Contributions Received From Political Committees(Part C) $ 0.00
All Other Contributions (Part D) $ 0.00
TOTAL for the Reporting Period (3) $ 0.00
4.Other Receipts,Refunds,Interest Earned,Returned Checks, Etc.(From Part E)
TOTAL for the Reporting Period (4) $ 0.00
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 Pagel,Report Cover Page,Item B.) $ 1,555.00
3/30/2022 11:50:12 AM
PART A
CONTRIBUTIONS RECEIVED FROM POLITICAL COMMITTEES
$50.01 TO $250.00
Use this Part to itemize only contributions received from political committees
with an aggregate value from $50.01 to $250.00 in the reporting period.
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributing Committee
MO DAY YEAR
Mailing Address
$ 0.00
City State Zip Code(Plus 4)
PAGE TOTAL
Enter Grand Total of Part A on Schedule I, Detailed Summary Page,Section 2. $ 0.00
3/30/2022 11:50:12 AM
PART B
ALL OTHER CONTRIBUTIONS
$50.01 TO $250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to $250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A)
Name of Filing Committee or Candidate Reporting Period
HAMPDEN TOWNSHIP DEMOCRATIC CLUB From: 1/3/2022 To: 3/28/2022
DATE AMOUNT
Full Name of Contributor
Vicki Mack MO DAY YEAR
Mailing Address 1120 West Powderhorn Road
$ 20.00
C; State Zip Code(Plus 4) 1 15 2022
�' Mechanicsburg
PA 17050
Full Name of Contributor
Vicki Mack MO DAY YEAR
Mailing Address 1120 West Powderhorn Road
$ 20.00
City Mechanicsburg
State Zip Code(Plus 4) 2 15 2022
PA 17050
Full Name of Contributor
MO DAY YEAR
Vicki Mack
Mailing Address 1120 West Powderhorn Road
$ 20.00
City Mechanicsburg
State Zip Code(Plus 4) 3 15 2022
PA 17050
Full Name of Contributor
John Maxton MO DAY YEAR
Mailing Address 440 St. John's Dr
$ 100.00
C; State Zip Code(Plus 4) 1 18 2022
ty Camp Hill
PA 17011
Full Name of Contributor
Ansel Gere MO DAY YEAR
Mailing Address 3815 Candle Light Dr
$ 250.00
C; State Zip Code(Plus 4) 1 6 2022
ty Camp Hill
PA 17011
3/30/2022 11:50:12 AM
�v� J
Full Name of Contributor ,I
Mary Gere MO DAY YEAR t!
Mailing Address 3815 Candle Light Dr
$ 250.00
City State Zip Code(Plus 4) 1 6 2022
Camp Hill
PA 17011
Full Name of Contributor T�1
Richard Sleboda MO DAY YEAR
Mailing Address 5 Donald Street
$ 250.00
City Mechanicsburg
State Zip Code(Plus 4) 1 8 2022
PA 17050
PAGE TOTAL
Enter Grand Total of Part A on Schedule I, Detailed Summary Page, Section 2. $ 910.00
3/30/2022 11:50:12 AM
PART C
Contributions Received From Political Committees
OVER $250.00
Use this Part to itemize only contributions received from Political committees
with an aggregate value from Over $250.00 in the reporting period.
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributing Committee
MO DAY YEAR
Mailing Address
$ 0.00
City State Zip Code(Plus 4)
PAGE TOTAL
Enter Grand Total of Part C on Schedule I, Detailed Summary Page, Section 3.
0.00
3/30/2022 11:50:12 AM
PART D
ALL OTHER CONTRIBUTIONS
OVER $250.00
Use this Part to itemize all other contributions with an aggregate value of
over $250.00 in the reporting period.
(Exclude contributions from political committees reported in Part C.)
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributor
MO DAY YEAR
Mailing
Address $ 0.00
City State Zip Code(Plus 4)
Employer Name Occupation
Employer Mailing Address/Principal Place of City State Zip Code(Plus 4)
Business
PAGE TOTAL
Enter Grand Total of Part C on Schedule I, Detailed Summary Page,Section 3.
$ 0.00
3/30/2022 11:50:12 AM
rv� V
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.
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name
MO DAY YEAR
Mailing Address $ 0.00
City State Zip Code(Plus 4)
Receipt Description
PAGE TOTAL
Enter Grand Total of Part E on Schedule I, Detailed Summary Page,Section 4.
$ 0.00
3/30/2022 11:50:12 AM
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
Name of Filing Committee or Candidate Reporting Period
HAMPDEN TOWNSHIP DEMOCRATIC CLUB From: 1/3/2022 To: 3/28/2022
1.UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR
TOTAL for the Reporting Period (1) $ 0.00
2.IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F)
TOTAL for the Reporting Period (2) $ 0.00
3.IN-KIND CONTRIBUTION RECIEVED-VALUE OVER$250.00(FROM PART G)
TOTAL for the Reporting Period (3) $ 0.00
TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING PERIOD(Add and enter $ 0.00
amount totals from Boxes 1,2,and 3;also enter on Page 1,Reports Cover Page,Item F.)
3/30/2022 11:50:12 AM
r v� 1V
SCHEDULE II
PART F
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OF $50.01 TO $250.00
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributor
MO DAY -YEAR
Mailing Address $ 0.00
City State Zip Code(Plus 4)
Description of Contribution:
Enter Grand Total of Part F on Schedule II,In-Kind Contributions Detailed Summary Page, PAGE TOTAL
Section 2.
$ 0.00
3/30/2022 11:50:12 AM
v� 11
SCHEDULE II
PART G
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OVER $250.00
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributor
i MO DAY YEAR.
Mailing Address
$ 0.00
City State Zip Code(Plus 4)
Employer of Contributor Occupation
Employer Mailing Address/Principal Place of City State Zip Code(Plus Description of Contribution
Business 4)
Enter Grand Total of Part G on Schedule II, In-Kind Contributions Detailed PAGE TOTAL
Summary Page, Section 3. 0.00
3/30/2022 11:50:12 AM
SCHEDULE III
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
HAMPDEN TOWNSHIP DEMOCRATIC CLUB From 1/3/2022 To: 3/28/2022
DATE AMOUNT
To Whom Paid
Vantiv, LLC MO DAY YEAR
Mailing Address 8500 Governors Hill Drive 3 9 2022
$ 4.61
State Zip Code(Plus 4)
City Symmes Twp Description of Expenditure
OH 45249 Merchant Processing Fee
To Whom Paid
Vantiv, LLC MO DAY YEAR
Mailing Address 8500 Governors Hill Drive 2 9 2022 $ 45.51
State Zip Code(Plus 4)
City Symmes Twp Description of Expenditure
OH 45249 Merchant Processing Fee
To Whom Paid
MO DAY YEAR
ActBlue
Mailing Address 366 Summer Street 1 5 2022
$ 2.10
City Somerville State Zip Code(Plus 4) Description of Expenditure
MA 02144 Service Fee
To Whom Paid
ActBlue MO DAY YEAR
Mailing Address 366 Summer Street 2 3 2022
22.28
City Somerville State Zip Code(Plus 4) Description of Expenditure
MA 02144 Service Fee
To Whom Paid
MO DAY YEAR
Vantiv, LLC
Mailing Address 8500 Governors Hill Drive 1 11 2022
7.44
City Symmes Twp State Zip Code(Plus 4) Description of Expenditure
OH 45249 Merchant Processing Fee
3/30/2022 11:50:12 AM
v� 1J
To Whom Paid
MO DAY YEAR
Zoom Video Communications, Inc
Mailing Address 55 Almaden Blvd., 6th Floor 1 20 2022
$ 15.89
City San Jose State Zip Code(Plus 4) Description of Expenditure
CA 95113 1 month subscription
To Whom Paid
Weis Markets MO DAY YEAR
$
Mailing Address 4525 Valley Road 3 26 2022 15.90
City Enola State Zip Code(Plus 4) Description of Expenditure
PA 17025 pizza for membership event
To Whom Paid
MO DAY YEAR
Weis Markets
$
Mailing Address 4525 Valley Road 3 26 2022 6.36
City Enola State Zip Code(Plus 4) Description of Expenditure
PA 17025 Pizza for membership event
PAGE TOTAL
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D.
$ 120.09
3/30/2022 11:50:12 AM