HomeMy WebLinkAboutBurt, Dwayne - 2015 30-Day Post-Primary Commonwealth of Pennsylvania
PAGE 1 OF
.. CAMPAIGN FINANCE REPORT (COVER PAGE)
(NOTE: This report must be clear and legible. It may be typed or printed in 4
lue or black ink.)
Filer Identification000, Report , .CANDIDATE 1 COMMITTEE 2 LOBBYIST 3
Number: Filed By
Name of Filing Committee, candidate or Lobbyist:
Street Address:
/ .el
City' D State: Zip Code:
TYPE OF STH TUESDAY 1. 2ND FRIDAY 2. 30 DAY 113. AMENDMENT YES NO
REPORT PRE-PRIMARY PRE-PRIMARY POST PRIMARY : .'REPORT?
8TH TUESDAY 4. 2ND FRIDAY ` 5. 30 DAY. 6. TERMINATION
(place X to PRE-ELECTION PRE-ELECTION POST.ELECTION REPORT? YES NO
the right of ANNUAL 7. YEAR FILING METHOD
report type) REPORT `1 ) CHECK ONE-,, PAPER DISKETTE
Name of Office Sought by Candidate: r • • DistrictW(SEEICN
Party County
NumberCode Cotle
C,2 �j� MO.' DAY YEAR
UCTIONS FOR CODES)
FOR OFFICE USE. ONLY
Summary of Receipts Mo, DAY YEAR MO. DAY JJ YEAR
and Expenditures from: ► 161 J To
A. Amount Brought Forward From Last Report $ �!
B. Total Monetary Contributions and Receipts (From Schedule 1) $
C. Total Funds Available (Sum of Lines A and B) $
D. Total Expenditures (From Schedule III) S 3,
E. Ending Cash Balance (Subtract Line D from Line C) $
L
Value of In—Kind Contributions Received (From Schedule 11) S
Unpaid Debts and Obligations (From Schedule IV) $
AFFIDAVIT
PART I — If this is a Committee report treasurer sign here. If this is a .Candidate-report candidate sign here.
I swear (or affirm) that this report, including the attached schedules, on paper or computer diskette, are to the best of my knowledge and belief true,
correct and complete.
Sworn to and subscribed before me this
day of J� 20 V-�
ature of Person Submitting Report
BIAIADIhY E�I C, t �(/
Printed Name �y
AL R
M commissio BF7'FS W
Notary PubliVO. DA YR. Area Code Daytime Telephone Number
P — te'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 o1 June 3, 1937
(P.L. 1333, No. 320) as amended.
Sworn to and subscribed before me this
day of 20
Signature of Candidate
Signature Printed Name
My commission expires
MD. DAV YR. Area Code Daytime Telephone Number
Department of State • Bureau of Commissions, Elections and Legislation V
303 North Office Building • Harrisburg, PA 17120-0029 • (717) 787-5280
DSEB-502 (7-99)
PAGE OF
SCHEDULE III
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
From .5—Top >S
To Who Paid MO. DAVYEAR `-I mount
Mailing Address Description of Expenditure
City State I Zip Code (Plus
To Whom Pai� M0. 'DAY YEAR mount
L/� ,O
Mailing A dress Description of Expenditure
NQS ,2 E.r/VtZa d �14�
City]/C-y/J S are Zip Codde�(Plus
/41
//'i"-'/
To Whom Paid MO. DAY r.YEAR T: mount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid MO. '"DAY YEAR jAmount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid MO. DAY YEAR Amount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid <MO. I DAYYEAR '...jAmount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid ' MO. =DAYYEAR mount
"
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid --MO.. DAY YEafl '. mount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
PAGE TOTAL
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D. $ 73
DSEe-502 (7-99) s