HomeMy WebLinkAboutCross, Barbara - 2015 2nd Friday Pre-Primary COMMONWEALTH OF PENNSYLVANIA
CAMPAIGN FINANCE STATEMENT
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 REPOW FILED CANDIDATE. OOMMInEET 2. 1
LOBBYIST- 1
NUMBER ON BEHALF OF ,
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
STREET ADDRESS
�FfD 5PR(�I(yVl>;"lA) �D
CITY STATE ZIP CODE
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO, PARTY
(CHECK ONE) `Y�W�`l' � n /� MD, DAY YEAR:.
$TH TUESDAY 1. 'Y 1) 15
PRE-PRIMARY: FOR OFFICE USE
MO. DAY YEAR MO, pAV YEAR.
2ND FRIDAY 2 DATES,OF (} L
PRE-PRI Mi1RY REPORTING
x PERIOD OI PJ1 ( ✓ TO O J D `
30 DAY
POST-PRIMARY
CASH BALANCE AT END S�SSII� -
6TH TUESDAY : 4. OF REPORTING PERIOD: $ 0. OD -
PRE-ELECTION
TOTAL AMOUNT OF FILER'S - -
5. OUTSTANDING DEBTS OR LIABILITIES
ZRD FRIDAY AT THE END OF REPORTING PERIOD: $ w
PRE-ELECTION _
S
30 DAY
AMENDMENT
POST-ELECTION. REPORT?
YES NO
T
ANNUAL TERMINATION
REPORT REPI VES
AFFIDAVIT �CSECTION
PART I-
If statement is filed on behalf of a Political Committee or Candidates'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 KNOWLEO E AND- LIEF,TRUE, AND COMPLETE.
SWORN^TO AND SUBSCRIBED BEFORE ME THIS �_TICJ/\JZ>ti tt /Yt�
DAY OF 1� 20n SIGNATURE
OFF/.PyE�RSSOnN SUBMITTING REPORT
-11AU L PRINTED NAME
61SIGNATURE
MY COMMISSION EXPIRES
COMMONWEALTH OF PEhl&LVAMA DAY YR. AREA LODE DAYTIME TELEPHONE NUMBER
NOTARIAL tit
PART 1 - BETHANY SALZARULO
If state Ent is filed d+4br fth1I6f a Candidal 's Authorized Committee, Candidate must sign here.
CARLISLE BORO:,CUMBERLA
I LEDGE 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 MO. DAV AREA CODE DAYTIME TELEPHONE NUMBER
YR.
DSEB-503(12-99) -