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HomeMy WebLinkAboutFriends of David Fish - 2022 2nd Friday Pre-Primary Pennsylvania Department of State Bureau of Campaign Finance&Lobbying Disclosure 500 North Office Building,Harrisburg,PA 17120 • 717.7875280(Option 4) www.dos pa.gov/cantpaignfinance • r,stcarnpaignfrnanctLepa.guv 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 0SE6-502), Campaign Finance Statements in lieu of full reports (form DSEB-503), Non-Bid Contract Reporting Form (OSEB-504) and Independent Expenditure Reports(form 0SE8-505)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 r reds OF avf o" Reporting Cycle Name 0 Cycle 1 g Cycle 2 0 Cycle 3 0 Cycle 4 0 Cycle 5 bin Tuesday 24 Friday 30 Day 6th Tuesday 2"6 Friday Pre-C►xttion Pre-Primary Pre-Primary Post Primary Pre-Election 0 Cycle 7 0 Cycle 8 l� Cycle 9 ® Cycle 6 30 Day Post-Election Annual Report 2 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. 05/06/2022 Al' Signature of Treasurer, Candidate,or Lobbyist Date(MN1/DD/YYYY) Nicholas A. Sones Silver Spring Twp/PA/USA Printed Name Location (City/State/Country) DSFB-502tt Update-d 1/5/2022 1r Pennsylvania Department of State Bureau of Campaign Finance&Civic Engagement Soo North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option d} www.dos.pa.gpvicampraignf Ina nre • raa-s.rampai ninnance pa.gov Part it-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. DestiVa7/1 05/06/2022 Signature of reasurer,Candidate, or Lobbyist Date(MM/DD/YYYY) David J. Fish Hampden TwpIPA/USA Printed Name Location (City/State/Country) OSEB-SO2R Updated 1J5/7022 IN II Fteset'Forrn ! Print Form j 111 Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Filer Identification Report Filed By Candidate Committee [' Lobbyist Number (Mark X) 1 I� �I i!�, Name of Filing Committee,Candidate or Lobbyist Friends of David Fish Street Address 405 Lamp Post Ln. City J State (Zip Code Camp hill PA I 17011.1428 Type of Report(Place x under report type) Pre-Primary-Eit ua Tuesday "°2- Z'Friday-Fr ry 3-30 Day Post 4-EtTu�ay 5.a Friday 6-30 Day Post 7-Annual Special 2`' Friday Special 30 Day m Pre-Election Pre-Election Election Pre-Election Post-Election -1 : 11 L ri D- ! Date Of Election Year - ' Amendment Termination (MM/DD/YYYY) 2022 Report Report Summary of Receipts and From Date To Date For Office Use Only 1 Expenditures 01-01-2022 05-02.2022 A.Amount!Brought Forward From Last Report $ 1,601.48 h,B.Total Monetary Contributions and Receipts S 0 (From Schedule'I) C.Total Funds Available $ May , , 49-09`9, (Sum of Lines A and B) 1,601.d8 D.Total Expenditures $ S ' 31 Pre, 11 (From Schedule III) 250.00 E.Ending Cash Balance $ ! (Subtract Line D from Line C) 1,351.48 !II F.Value of In Kind Contributions Received $ (From Schedule II) G.Unpaid Debts and Obligations I $ (From Schedule IV( r Affidavit Section Part 1-II this is a Committee report,treasurer sign here.If this is a Candidate report,candidate sign here. r I swear(or affirm)that this report,including the attached schedules on paper,is to the best of my knowledge nd belief true,correct and complete. Sworn to and subscribed before me this " 3' �4/"T :? ` day of 20 ' Signature of Person Submitting report Nicholas A.Son es Signature Printed Name My Commission expires 71 753-0308 MO. DAY YR. Area Code Daytime Telephone Number Part 11.11 this is a report o1 a Candidate's Authorised 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 tune 3,1937(P.L.3333,NO.320)as amended, Sworn to and subscribed before mr,this ili a� ,1,,,i day of 20 11{l1] 1/Signature of Candidate David J.Fish Signature Printed Name • 717 737-66 35 My Commission expires—_ MO. DAY YR. Area Code Daytime Telephone Number SCHEDULE I Contributions and Receipts Detailed Summary Page Filer;Identification Number I {3 Uniternited Contributions and!Receipts-SS0.00 or Less per Contributor 11 - , Total for the reporting period (1) $ l 2.Contributions of 550.01 to $250.00(From Part A and Part 8) Contributions Received from Political Committees(Part A) 5 All Other Contributions(Part 8) $ Total for the reporting period (2) $ 1 3.Contributions Over$250.00(From Part C and Part D) 11 Contributions Received from Political Committees(Part C) 5 All Other Contributions(Part O) 5 Total for the reporting period (3) $ i - - IL 4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) - _ II Total for the reporting period (4) $ 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 Poge 1,Report Cover Page,Item 8) 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. Filer identification Number -�- Amount Full Name of Contributing Date[MM/DD/YYYY] $ - Committee House it • Street A - _ddress Date[MMf DD/YYYY] City State I Zip Code I Date[MM/DD/YYYY] $ Full Name of Contributing Date[MM/DD/YYYYJ $ Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code I Date[MM/DD/YYYY] S - - - Full Name of Contributing Date[NtM/DD/YYYY] $ Committee - House# Street Address. - Date[MM/DD/YYYY] $ City State Zip Code Date[MRfl/DD/YYYY] $ Full Name of Contributing Date[NMM/DD/YYYY] $ Committee House# Street address Date(MM/DD/YYYY] S City 1 State Zip Code Date[MM/DD/YYYY] $ Iw Full Name of Contributing Date[MiVI/DD/YYYY] $ Committee House# Street Address Date[MM/DD/YYYY] $ 'City State Zip Code Date[MM/DD/YYYY] $ ------- -- --- Full Name of Contributing Date[MM/DD/YYYY] $ Committee - House# Street Address Date[MM/DD/YYYY] $ City I State Zip Code Date'[MM/DD/YYYY] $ PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50-01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) Filer Identification Number: Fun Name of Contributor Date[MM/DD/YYYY) $ House it , Street Address Date(MM/DD/YYYY) $ City State Zip Code Date(MMfDDfYYYYJ $ Full Name of Contributor Date(MM/DD/YYYYJ $ House rt Street Address Date(MM/DD/YYYYJ $ City State I Zip Code Date(MM/DD/YYYYJ �$ Full Name of Contributor Date(MM/DD/YYYYJ $ l House n Street Address Date[MM/DD/YYYY) $ City State �Zip Code Date(MM/DD/YYYY) $ Felt Name of Contributor Date(MM/DD/YYYY) $ House tl Street Address Date(MM/DD/YYYYJ $� CitY State Zip Code Date[MM/DD/YYYY] $ ' - Date[NMM/DD/YYYY) $ Full Name of Contributor House St Street Address Date(MM/DD/YYYYI' $ City - State Zip Coin Date[MM/DD/YYYYJ $ - Full Name of Contributor Date 1MM/D©/YYYYJ $ -House If Street Address Date[MM/DD/YYYY) $ City I State Zip Code - Date(MMJDD/YYYYj $ 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 over$250.00 in the reporting period. Fikr Identification Number - -- --- �..�.� Full Name of Date(MM/DD/YYYYJ $ Contributing Committee - - Housed , Street Address Date[MM/DD/YYYYJ • City State ' I Zip Code Date[MM/DD/YYYYj $ Full Name of 6 Date[MM/DD/YYYYJ $ i Contributing Committee - House# Street Address Date[MM/DD/YYYYI ' City -_ State ` Zip Code Date[MM/DD/YYYYI $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee ~ Housed 'Street Address Date(MM/DD/YYYYJ $ 1 , city State Zip Code Date[MM/DD/YYYY} $ Full Name of Date[MM/OD/YYYY1 I S Contributing Committee House d Street Address Date'IMM/DD/YYYY) $ City � State Zip Code Date[MM/DDJYYYYJ $ - - 1 Full Name of - Date[MM/OD/YYYYJ $ Contributing Committee - Housed Street Address Date[MM/DD/YYYYI $ City State I Zip Code Date[MM/DD/YYYY) $ Full Name of Date(141M/DD/YYYYJ $ - Contributing Committee House It Street Address Date(MM/OD/YYYYJ $ City - State ~Zip Code Date(MM/DD/YYYYJ $ PART D AU Other Contributions Over$250.00 Use this Part to itemize all other contributions with an aggregate value over$250.00 in the reporting period. (Exclude contributions from political committees reported in Part C) - Filer Identification Number Futl Name of Contributor Date[MM/DD/YYYYJ $ House d Street Address Date[MM/DD/YYYY[ $ City State Zip Code Date(MM/DD/YYYY) $ Employer Name Occupation Employer Mailing Address/ Principal Place of Business Full Name of Contributor Date[MM/DD/YYYY) $ - - House Street Address Date[MM/DD/YYYY) City State Zip Code Date[MM/OD/YYYYJ Employer Name - Occupation ` Employer Mailing Address/ - - Principal Place of Business _ Full Name of Contributor Date[MM/DD/YYYYJ $ House# Street Address --- Date[MM/DD/YYYYJ $ City - - State -- Zip Code - Date[MM/DD/YYYYJ S - Employer Name - Occupation Employer Mailing Address I Principal Place of Business Full Name of Contributor Date[MM/DD/YYYYJ J $ House p Street Address Date[MM/DD/YYYYJ $ City State Zip Code Date(MM/DD/YYYY) $ 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. Filcr Idcntifii8tion Number: Full Name House# Street Address Gty State Zip Date[MM/DD/YYYYJ $ Code Receipt Description' Full Name House If Street Address City State Zip Date(MM/DDIYYYYJ Code Receipt Description I Full Name - House IS Street Address City State Zip - -Date IMM/DD/YYYYJ $ Code Receipt Description Full Name House# Street Address City, State Zip Date[MM/DD/YYYYJ $ Code Receipt Description ------ Full Name House+e Street Address City State Zip Date[MM/DD/YYYYJ $ Code Receipt Description Full Name - House# Street Address City - State Zip Date IMM/DD/YYYYJ $ -- Code Receipt Description SCHEDULE II IN-KIND CONTRIBUTIONS AND VALUABLE THINGS RECEIVED USE THIS SCHEDULE TO REPORT ALL IWKIND CONTRIBUTIONS OF VALUABLE THINGS DURING THE'REPORTING PERIOD DETAILED SUMMARY PAGE Filer Identification Number: fT -- - 1. IiNITEf,+112ED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR - TOTAL for the reporting period (1) $ I--Z. ON-KIND CO'NTRiBUTIONS RECEIVED-VALUl:OF$50:01T0 5250-00(PROP+"~PART F) TOTAL for the reporting period 42) $ 3. IN-KIND CONTRIBUTION'RECEIVED-VALUE OVER S250:00(FROM PART G) TOTAL for the reporting period - (3) $ TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING $ PERIOD(Add and enter amount totals from boxes 1,2,and 3;also enter on Page 1,Report Cover Page,Item F) f SCHEDULE ft PART F In-Kind Contributions Received VALUE OF$50.01 TO$250 Filer identification Number: Full Name of Contributor Date IMM/DD/YYYY) $ House#- Street Address Date[MM/DD/YYYY) City State Zip Code Date(MM/DD/YYYY1 $ Description of Contribution Full Name of Contributor Date[MM/DD/YYYY) $ House# Street Address Date(MM/DD/YYYY] II $ --F City State Zip Code Date[MM/DD/YYYY( I $ Description of Contribution - full Name of Contributor Date IMM/DD/YYYYI $ House# Street Address Date[MM/DD/YYY1 $ City -- State Zip Code Date IMM/DD/YYYY) $ Description of Contribution it li Full Name of Contributor Date[MM/DD/YYYY) $ House# Date[MM/DD/YYYY) $ Street Address Ills City - - - State Zip Code Date(MM/DD/YYYY[ $ Description of Contribution Full Name of Contributor Date(MIWI/DD/YYYY] $ House# Street Address Date(MM/DD/YYYY) $ City State Zip Code Date[IMM/DD/YYYY) $ Description of Contribution SCHEDULE II Part G In-Kind Contributions Received VALUE OVER$250 Filer identification Number: Full Name of Contributor Date[MM/DD/YYYY] $ House# - Street Address Date(MM/DD/YYYY) $ City State Zip Code Date(MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution Full Name of Contributor Date[MM/DD/YYYY] --$ House# Street Address Date(MM/DD/YYYY] $ i D YYY City State Zip Code Date(MM/ D/Y ] $ Employer Name Occupation I Employer'Mailing Address/Principal Description Place of Business 1 of Contribution Full Name of Contributor -Date(MM/DD/YYYY] $ House# Street Address Date IMM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY) ii I Employer Name Occupation I Employer Mailing Address/Principal Description - I Place of Business of Contribution I Full Name of Contributor - Date LMM/DD/YYYY] $ MM DD YYY Housed Street Address Date( / � ] $ City f State Zip Code Date jMM/DD/YYYY] $ -- Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution SCHEDULE III Statement of Expenditures Filer Identification Number: To Whom Paid Date[MM/DD/YYYYJ $ Mark Kelly Victory Fund 150.00 02/19/2022 House If Street Address Description of Expenditure 3014 E.Canielback Road y OW State ' Zip 1 Pliobnix AZ Code 165016 Donation To Whom Paid Date[MM/DD/YYYYI $ 1 Rick Coplen 100.00 04/04/2022 House P '623 West Penn Street Street Address' Description of Expenditure w Zip City Gerlislo `'State PA code 117013 'Donation II l To Whom Paid Date[MM/DD/YYYYJ $ i House tt Street Address I Description of Expenditure Gty State Zip Code 1 To Whom Paid Date[MM/DD/YYYYJ $ House ft Street Address Description of Expenditure 1 CityZip State I 1 Code r To Whom Paid 1 4 Date[MtM1/DDJYYYt'J $ House P I Street Address Description of Expenditure City State Zip Code r To Whom Paid Date IMJiM/DDJYYYYJ i $ House P Street Address Description of Expenditure City I State Zip Code To Whom Paid I Date tMM/DD/YYYY I $j House ft I Street Address Description of Expenditure City State 1 Zip Code To Whom Paid Date IMIM/OD/YYYY'J $ House* - Street Address Description of Expenditure City State I I 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. Filet 1rdentlonNurnber Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ (MM/DD/YYYY] II City State Zip Code Description of Debt 1 — Outstanding 1I''1 Name of Creditor Balance of Debt House it Street Address DATE DEBT INCURRED — S (MM/DD/Y!'YYJ I City State Zip Code Description of Debt - - - 1 Name of Creditor - Outstanding Balance of Debt 1 I House# Street Address DATE DEBT INCURRED $ (MM/DD/YYYi I City State Zip 1 Code• - Description of Debt h, Name of Creditor Outstanding Balance of Debt - House# Street Address DATE DEBT INCURRED $ 1 (MM/DD/YYYY1 City State Zip Code Description of Debt Name of Creditor Outstanding Balance of Debt Li House# Street Address DATE DEBT INCURRED $ (MM/DD/YYYYI Sty State Zip I I Code Description of Debt 1 Name of Creditor Outstanding Balance of Debt 1 House# treet Address DATE DEBT INCURRED $ (MM/DO/YYY'i) City - State I Zip 1 1 Code Description of Debt 1