HomeMy WebLinkAboutHampden Twp. Democratic Club - 2022 30-Day Post-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 Statements
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 Statements. This form must be
signed by hand where a signature is required.
G9DRG ME Commit ee,-Candida e, •
Hampden Township Democratic Club
Reporting
❑ Cycle 1 0 Cycle 2 ■ Cycle 3 0 Cycle 4 0 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 0 Cycle 9
30 Day Post-Election Annual Report 2nd Friday Pre-Special Election 30 Day Post-Special Election
Part 1 — If this form is submitted with a statement in lieu of full report by a political
committee, the treasurer must sign here. If this form is submitted with a statement in lieu
of a full report by a candidate, the candidate must sign here. If this form is submitted with
a statement in lieu of full 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 Statement is true and correct.
06/13/2022
Signature of Treasurer, Candidate, or Lobbyist Date (MM/DD/YYYY)
Carol E. Thornton Mechanicsburg, PA, USA
Printed Name Location (City/State/Country)
DSEB-5035
Updated 1/5/2022
Commonwealth of Pennsylvania IIIIIIII�IIInNINAIIICIflI�11I�INIINIINIII�
Campaign Finance Statement 371465
File this in lieu of a full report only if aggregate receipts, expenditures, or liabilities
incurred each did not exceed $250.00 during the reporting period.
FILER IDENTIFICATION NUMBER: 20200298 REPORT FILED ON BEHALF OF: Committee
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 REPORT 30-Day Post-Primary (-) w"•..
NAME OF OFFICE SOUGHT BY CANDIDATE =7,- ^~'.,
w C-..,
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DISTRICT CODE PARTY CODE DEM
DATE OF ELECTION 11/8/2022
DATES OF REPORTING PERIOD 5/3/2022 TO 6/6/2022 For Office 0e Only
AMENDMENT REPORT? NO TERMINATION REPORT? NO C.y' C.?
_ I IV
—C C.T1
CASH BALANCE AT THE END OF REPORTING 2,443.89
PERIOD:
TOTAL AMOUNT OF FILER'S OUTSTANDING 0.00
DEBTS OR LIABILITIES AT THE END OF
REPORTING PERIOD:
AFFIDAVIT SECTION
PART I-
If statement is filed on behalf of a Political Committee or Candidate's Committee,the Treasurer must sign here.
If statement is filed on behalf of a Candidate,the Candidate must sign here.
If statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID
NOT EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
day of 20 --•----
irit—IfrU _
SIGNATURE OF PERSON SUB TTTING REPORT
SIGN PRINTED NAME
7 11—c( tcc 7 3
MY COMMISION EX
MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
PART II-
If statement is filed on behalf of a Candidate's Authorized Committee,Candidate must 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.1333,No.320)AS AMENDED.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
day ,N ..........„...--1----
0
SIGNATURE OF PERSON SUBMITTING REPORT
IGNAT PRINTED NAME
MY COMMISION RES MO. DAY" YR. AREA CODE DAYTIME TELEPHONE NUMBER
Department of State.Bureau of Commissions,Elections and Legislation 6/12/2022 8:22:09 AM
210 North Office Building.Harrisburg,PA 17120-0020.(717)787-5280