HomeMy WebLinkAboutFittry, Dashell - 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.
RLER IDENDFICATION ' REPORT FILED , L
NUMBER ON BEHALF OF J. J.
CANDIDATE. COMMRTEE LOBBYIST
FID COMMI TEE,CANDIDATE OR LOBBDST
STREET ADDRESS
2ZG 2
CRY STATE ZIP CODE _
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY
(CHECK ONE) _ MO., DAY YEAR.
6Try TUESDAY. 1..
PRE-PRIMARY FOR OFFICE.USE..ONLY
MO. DAYYEAR MO. DAY YEAR
AY 2, DATES OF
PRE-PRIMARY REPORTING (� `� TO
PERIOD J l
30:DAY 3.
POST-PRIMARY /. ) n
( v I CASH BALANCE AT END
6TH TUESDAY 4' OF REPORTING PERIOD: $ -.
PRE-ELECTION
TOTAL AMOUNT OF FILER'S
5. OUTSTANDING DEBTS OR LIABILITIES
2ND FRIDAY
PREELECTION AT THE END OF REPORTING PERIOD: $
6.
30 DAY
,
POST-ELECTION AMENDMENT
REPORT,t YES NO
Z
ANNUAL TERMINATION
REPORT REPORT?- YES NO
AFFIDAVIT
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 URING THE REPORTING PERIOD INDI D ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE SES OF MY KNO E/QGEnA/NJ�'B LIEF, UE, ETA COMPLETE.
SWORN TQ AND SUBSCRIBED BEFORE ME THIS l /_J./n NI/� K
:21 DAY OF 20'If-, V V SIGNATURE PERSON SUBMITTING REPORT
FA-
PRINTED NAME
NATURE
wwA
NOTARIAL MO. D YR. AREA CODE DAYTIME TELEPHONE NUMBER
BETHANY SAL2ARUL0
Notary Public
PAit
11 -CARLISLE B0R0:,CUMBERLAND CNTY
If emWdeffWboiloorf Wbtt W151-Mridi te's Authorized Committee, Candidate must 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 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 AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR.
DSEB-503(12-99)