HomeMy WebLinkAboutFriends of Nate Silcox - 2022 2nd Friday Pre-Primary Pennsylvania Department of State
Bureau of Campaign Finance&Lobbying Disdosure
le
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.
Name of Filing Committee, Candidate, or Lobbyist
Friends of Nate Silcox
Reporting Cycle Name
❑ Cycle 1 B Cycle 2 0 Cycle 3 0 Cycle 4 0 Cycle 5
6th Tuesday 2nd Friday 30 Day 6th Tuesday 2"d 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 2"d 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.
CA474,60';' 5/6/22
Signature of Treasurer, Candidate, or Lobbyist Date (MM/DD/YYYY)
Craig Mellott Silver Spring Twp/PA
Printed Name Location (City/State/Country)
DSEB-502R
Updated 1/5/2022
Iirr
Pennsylvania Department of State
Bureau of Campaign Finance&Civic Engagement
500 North Office Building,Harrisburg,PA 17120 • 717.7875280{Option 4)
www.dos,pa.gov/campaignfinance • ra-stcampaignfinance@pa.gov
Part 11-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 correct.
he __ Th. .5- Ito ( zo27-
Signature of Treasurer,Candidate,or Lobbyist Date (MM/DD/YYYY)
i—nairi-112.-D P- S ►t.-c.. IA-ca rn c, -t-a was w , e p r�
Printed Name Location (City/State/Country)
DSEB-502R
Updated 1/5/2022
Commonwealth of Pennsylvania-Campaign Finance Report
(Note:This report must be clear and legible.it should be typed)
:Eller"identification;" 'Report"fl ... .SY:".": :Cat4data.";:;,;.': Tf.Oitittlliltea:' :"::':: r;hpbb�lst
, imlber:..;;is"": 20200372 :(Mar(..*') l
me.otPiing Committee,Candidate:or' • .
Friends of Nate Silcox
S feet Address:,`:.:: .., .
P.O.Box g82
:: -. :.::. Codti::;`;<-. 17 011
Camp H71 pA .:
Type of Report(Place x under report type)
•,1 6t".T! y 2-.2"°:Fr i '3-30"Da y-Post 4 5 b sday.:..S-'2"°;FrAdrel.;:.`.6?30''Day Post:• •:7 tual::=.:.SpoOlif Z.°..Friday;, ; 1:30:Day.::.:`::
:Prue-Primary. Pee-Primary, Primaryi Y<:. Pre;Election:. Prue-Election,':Becton::::" :: •Pie-flectfori :.Post 4*on
,.; ,::
n x n Li 0 1-----
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/2022 _ 2°22
'.:Year': AtnerldlpeM. E T
05 17 .•� '
.a.e,,„0.0,,,,,../. -:,. 0
port
•
::Summary of:Rp oeipts and :.::,• ;From Date'-;•.... To Dot
,..
For OAIce.l)se;0i>!ly:•:.":�:
Expenditures., _
o 2 12/31/21 s 0 2 -
A.Amn 1H4;4**,00.:FOrWard From Last Report " $
53
;;B.Total Monetary ConMbutions and"Receipts • $ ")
1 Sdiedule<Ij °
.C:Total Funds Avalable`,: `.::.":..:<,..; `::: :.`, $
(Sum of,ti".*Amid B 1,640.53 €€ I
(Fran+Schedule nl) `. . :.-::::. :,:= CJ�
:.E"Ending aashBalance' :M1:..• ;::'..;- $ 'M
1,640.53
F.Value,of Ni-Kind:Cont iibutions Re eived••..::..: $ ,�
•
;(FromSe lulaq).: • :: .•.' '.. •• :).. ° .-'
;G.tlnpaid"Debts'and:Obligations =: .. .. ' ., $ 0 -.< '-
'(From Sd adule�l0:-,;:... . .. :
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
Sig a Per Submitting report
Signature Printed Name Craig Mellott
My Commission expires 717 234-1430
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
days 20 7
...=-7-- "—.."— Signature of Candidate
+..) t-i"2,r7 P. 5i(r.GCJY
Signature Printed Name
•
My Commission expires "7 I"7 to LIg — ad --
MO. DAY YR. Area Code Daytime Telephone Number