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HomeMy WebLinkAboutSmith, Matt - 2015 2nd Friday Pre-Primary COMMONWEALTH OF PENNSYLVANIA CAMPAIGN FINANCE STATEMENT File this in lieu of a full report only ffaggregate receipts, expenditures, or liabilities incurred each did not exceed $250.00 during the reporting period. 1I1LERIDENI6ICATIOH REPORT FILE➢ - I I NUMBER ON HEHALF Of CANDIDATE \A CON -)" LOB9YWT NAME OF RUNG COMMITTEE,CANOIMn OR LOBBYIST �l -, a4 S STREET AODREss jo8 CRYDO CAM wl/ 'STATE p ZIPf/ — TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT RO,. PARTY (CNEDK ONE) MO; pAY YEAR �j�ce-t�4�c. G.0 o� Co•.L.n�h � b,c�.w 6TN YPESPAY 1. /'GAJ �'- I Y O.S q 7-0... PR&PRIM4RY FOR OFFICE USE ONLY MO. DAY YEAR NO. DAY YEAR 2M FMDALV Z. DATES OF FREPRIMARY X PERIOD REPORTNG O i Zd ZOIS TO o5 O'� Z01-45r 30 DAY S' POST-PRIMARY GASH BALANCE AT END 6TH TUESDAY. 4. OF REPORTING PERIOD: $_ -- PRE-BLEiDmoN TOTAL AMOUNT OF FILER'S 5. OUTSTANDING DEBTS OR LIABILITIES 2nD FRIDAY PRE-ELECTION AT THE END OF REPORTING PERIOD: $ S. 30 DAY AMENDMENTPOS'r+ELECTION REPORT? YES NO ANNUAL TERMINATION REPORT REPOM? YES NO AFFIDAVITB 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 SriFAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR UA&WTIES INCURRED WRING THE REPORTING PERIOD INDICATED ABOVE DID NOT EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE MST OF MY KNOW-EDGE AND BELIEF,TRUE,CORRECT AND COMPI;ETE. SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF jQ SIGNATURE OF PERSON SUBMITTING REPORT PRINTED NAME BWNATURE MY COMMISSION EXPIRES 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 ADT OT JUNE 3, 1937(P.L.1333,No.320)AS AMENDED. �J�/---'-��%� SWORN TO ND SSUUO�R)? I IgV A la-41-Z / SIGNATURE OF CANDIDATE J U 1 7n ( LC t-� D pF Joel 20_ rnN l r y o Harr' Ur to (Vf UpDIM PRINTED NAME MY COMMISSION E7CPIRES $y1 t9 .7✓ ) D� ��� �J� -5-7 ,31 AREA CODE DAYTIME TELEPHONE NUMBER MO.� DAY YR-. unylm m+em w ocnLe • oureeu ur L.Dnlmiss,Dns,raccoons ana Leglslaupn DSGB-503(12-9h) 210 North Office Building a Harrisburg,PA 17120.0029 • (717)787.5280 :vm_- . ------ _--_