HomeMy WebLinkAboutThomas, John - 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 ' REPORT FILED ' CANDIDATE WMMITTEE LOBBYIST
NUMBER ON BEHALF OF
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
✓✓ dM S
STREET ADDRESS
'TJO G✓ n/�� 1J 2.
CITY STATE
ZIP
JC
J i�Ct1 n/JcS U 70SO
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY
(CHECK ONE) �j�Gf,�J3 N//� �'o M�ttSSJn�/EC MO. DAY YEAR
8TH TUESDAY I- RS �Gz� �E P OS OJ3"
PRE-PRIMARY FOR OFFICE USE,ONLY
MO. DAT YEAR M0. DAY YEAR
2ND FRIDAY 2, / DATES OF
PRE-PRIMARY r/ REPORTING TOdLe
PERIOD O ! I? aer
30 DAY 3 J
POSTPRIMARY -
CASH BALANCE AT END
6TH TUESDAY [6.
OF REPORTING PERIOD: $
PRE-ELECTION
TOTAL AMOUNT OF FILER'S
2ND FRIDAY
OUTSTANDING DEBTS OR LIABILITIES
PRE-ELECTION a
AT THE END OF REPORTING PERIOD: $
30 DAY
POST-ELECTION AMENDMENT YES NOREPORT?
ANNUAL TERMINATION
REPORT REPORT? YES NO
AFFIDAVIT SECTION
S If state went is filed on behalf of a Political Committee or Candidates's Committee, the Treasurer must sign here.
IfAtgtg Mont
is filed on behalf of a Candidate, the Candidate must sign here.
If,$1 tM o nt is filed on behalf of a Contributing Lobb, the Lobbyist must sign here. b.�C-
Z f95� R AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
W q4 VO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
N E RN TO AND SUBSCRIBED BEFORE ME THIS
U
a s i DAY O 2O� SIGNATURE OF P rMNG REPORT
LL _ JDA/w/ ✓. �fJNENA S
Z
PRINTED NAME
E SIGNATURE
T _ gOMMISSIONEXPIRE ;7/7S O ��, �7 76J_ IYZ7
8 W MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
PART 11 -
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
JUNE 3, 1937(P.L. 1333,No.320)AS AMENDED.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
SIGNATURE OF CANDIDATE
DAY OF 2O
PRINTED NAME
SIGNATURE
MY COMMISSION EXPIRES MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
Department of State • Bureau of Commissions,Elections and Legislation
DSEB-503(12-99) 210 North Office Building 0 Harrisburg,PA 17120-0029 • (717)787.5280