HomeMy WebLinkAboutEakin, Jackie - 2015 30-Day Post-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.
PURR IDEMTFICATION REPORr FRED
CANDIDATE
NUMBER ` 001 BEHALF OF . I Y COMMDTEE:. 2 LOBBTTBT J.
HAMS OF FILING COMMITTEE,CANDIDATE OR LOS"Irr
SrREETADDms �n n
ell,
CITY / srATe n TIP CODE
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE OISTWCT NO• PARTY r
(CHECK ONE) 1. R;IDJ. 7yCR-
1 t
6TH TUESDAY-'
PRE-PRIMARY- : FOR OFFICE USE ONLY
MO. DAY TEAR MO. DAY YEAR
2ND FRIDAY Z' DATES OF
P. .Poh1ARY REFORNNG - - TO L-
PERIOD h -� L' /` .7
30 DAY - 3
POST-PRIMARY
CASH BALANCE AT END
6TH TUESDAY 4. OF REPORTING PERIOD: $
PRE-ELECTION
TOTAL AMOUNT OF FILER'S
S. OUTSTANDING DEBTS OR LIABILITIES
2ND FRIDAY AT THE END OF REPORTING PERIOD: $
PRE-ELECTION - - '
6
30 DAY: - AMENDMENTPOBT-ELECTION. .REPORT! YES NO
ANNUAL - TERMINATION YES NO
REPORT REPORT?
D • 0
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 DISBURSEMENT'S OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED T W UNDRED AND FIFTY DOLLARS($250.110 AND THIS REPORT IS,TO THE BEST OF MY KNOW ANDEF,TR�RREOT AND COMPLETE.
S SU CAUSED BEFORE E THIS „/\
A 0 SIGNA E OF PERSON SUBMITTING REPORT^ /
L -j6--
PRINTED NAME
CO MON LVA 7/ 7 . I /S
NOTARIAL SEAL M DA YR. AREA CODE DAYTIME TELEPHONE NUMBER
Win ard,Notary Public
ES,sI�, nsboro Twp.,CuMberiand Gmpty
�78��6bt�tlnhsion Expires May 11.208
MEM I minveharml 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 20,,,_
PRINTED NAME
SIMNATURE
MY COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR•
DSEB-503(12-99) -