HomeMy WebLinkAboutClancy, Eric - 2022 30-Day Post-Primary 714 Pennsylvania Department of State
Bureau of Campaign Finance& Lobbying Disclosure
500 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4)
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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, Lobbyist
Eric Clancy
Repotting Cyr Name
0 Cycle 1 0 Cycle 2 ® Cycle 3 ❑ Cycle 4 ❑ Cycle 5
6'h Tuesday 2""Friday 30 Day 6'h Tuesday 2"`'Friday
Pre-Primary Pre-Primary Post Primary Pre-Election
Pre-Election
0 Cycle 6
❑ Cycle 7 ❑ Cycle 8 ❑ Cycle 9
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.
June 16, 2022
Signatur r asurer, Candidate, or Lobbyist Date (MM/DD/YYYY)
Eric R Clancy East Pennsboro, PA
Printed Name Location (City/State/Country)
DSE3-502R
Updated 1/S/2022
PAGE )
Commonwealth of Pennsylvania IMII NIII IIIIIIiI11IM4IlIRIII
Campaign Finance Report 372098
(NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification 2022C0365 Report CANDIDATE 4s0, COMMITTEE LOBBYIST
Number: i Filed By :
Name of Filing Committee,Candidate or Lobbyist: CLANCY, ERIC R
Street Address: 53 EMLYN LANE
City: MECHANICSBURG State: PA Zip Code: 17055
TYPE OF 6TH TUESDAY 1. 72ND FRIDAY PRE- 2. 30 DAY POST- 3.X AMENDMENT Yes No
REPORT PRE-PRIMARY PRIMARY PRIMARY REPORT?
6TH TUESDAY 4. 2ND FRIDAY PRE- 5. 30 DAY POST- 6. TERMINATION Yes No VI
(place X to PRE-ELECTION ELECTION ELECTION REPORT?
the right of
report type) ANNUAL REPORT 7. Year 2022 FILING METHOD PAPER DISKETTE
( )CHECK ONE
_ _ n _
DATE OF ELECTION District Office Party Code County •
Name of Office Sought by Candidate: Number Code Code
MO DAY YEAR 87 STH ,REP 21
REPRESENTATIVE IN THE GENERAL ASSEMBLY '
11 8 2022 (SEE INSTRUCTIONS FOR CODES)
Summary of Receipts and MO DAY YEAR MO DAY YEAR FOR OFFICE USE ONLY
Expenditures from: 5 3 2022 TO 6 6 2022
A.Amount Brought Forward From Last Report $ (38,726.20) WOE B.Total Monetary Contributions And Receipts(From Schedule I) $ 0.00 J U JE Ito , apt
C.Total Funds Available(Sum Of Lines A and B) (38,726.20)C. AYVk
D.Total Expenditures(From Schedule III) $ 22,472.00
E.Ending Cash Balance(Subtract Line D From Line C) $ (61,198.20)
F.Value Of In-Kind Contributions Received(From Schedule II) $ 0.00
G.Unpaid Debts And Obligations(From Schedule IV) $$ 0.00
AFFIDAVIT SECTION
PART 1-If this is a Committee report,treasurer sign here.if this is a Candidate report,candidate sign here.
1 swear(or affirm)that this report,including the attached schedules filed on paper or by electronic medium,are to the best of my knowledge and belief,true
correct and complete. i—' `-
Sworn to and subscribed before me this i SI r}a/("'t'�ure of Person Submitting Report
day of 20 FCC 2-,V�- Y1l�.f!t, `Jl
`` 1\l P}rl,ted Name
/^J`�
Signature 6��li1 LV c b�\Cl`0 rs e �C.,6,
My Commission Expires (') , 1) -Li(-4 I -4'0;4ltiail
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.
1 swear(or affirm)that to the best of my knowledge and belief this political committee has not violated any provisions of the act of lime 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
Email
My Commission Expires
MO DAY YR Area Code Daytime Telephone Number
6/16/2022 9:51:44 AM
PAGE 2
SCHEDULE I
CONTRIBUTIONS AND RECEIPTS
Detailed Summary Page
Name of Filing Committee or Candidate Reporting Period
CLANCY, ERIC R From: 5/3/2022 To: 6/6/2022
1.Unitemized Contributions Received-$50.00 or Less Per Contributor
TOTAL for the Reporting Period (1) $ 0.00
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) $ 0.00
TOTAL for the Reporting Period (2) $ 0.00
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 $ 0.00
totals from Boxes 1,2,3 and 4;also enter this amount on Pagel, Report Cover Page,Item B.)
6/16/2022 9:51:44 AM
PAGE 3
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
6/16/2022 9:51:44 AM
PAGE 4
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
From: To:
DATE AMOUNT
Full Name of Contributor
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
6/16/2022 9:51:44 AM
PAGE 5
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. g 0.00
6/16/2022 9:51:44 AM
PAGE 6
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
6/16/2022 9:51:44 AM
PAGE 7
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
6/16/2022 9:51:44 AM
PAGE 8
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
CLANCY, ERIC R From: 5/3/2022 To: 6/6/2022
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.)
6/16/2022 9:51:44 AM
PAGE 9
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
6/16/2022 9:51:44 AM
PAGE 10
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
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
6/16/2022 9:51:44 AM
PAGE 11
SCHEDULE III
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
CLANCY, ERIC R From 5/3/2022 To: 6/6/2022
•
DATE AMOUNT
To Whom Paid
Clancy for Rep MO DAY YEAR
Mailing Address 225 Grandview Ave 5 12 2022
$ 15,000.00
City Camp Hill State Zip Code(Plus 4) Description of Expenditure
PA 17011 Loan to committee
To Whom Paid
Clancy for Rep MO DAY YEAR
Mailing Address 225 Grandview Ave 6 2 2022
S 7,472.00
State Zip Code(Plus 4) Description of Expenditure
City Camp Hill
PA 17011 Loan to committee
PAGE TOTAL
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D.
$ 22,472.00
•
6/16/2022 9:51:44 AM