HomeMy WebLinkAboutGembusia, Denise - 2015 30-Day Post-Primary INIII�I Reset Form Print Form
If Commonwealth of Pennsylvania-Campaign Finance Report
(Note:This report must be clear and legible.It should be typed)
Filer Identification Report Filed By Candidate X Committee El I Lobbyist
Number I (Mark X)
Name of Filing Committee,Candidate or
Lobbyist Denise Gembusia
Street Address 1402 Bradley Drive Apt 211
Ory Carlisle Zip Code 17013
Type of Report(Place x under report type)
1-6"Tuesday 2- 2""Friday 3-30 Day Post 4.6'h Tuesday S-2n° Friday 6-30 Day Post 7-Annual Special 2 Friday Special 30 Day
Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election
E] 0 X 1:1 1:1 1:1 El
Date Of Election Year Amendment Termination ❑
(MM/DD/YYYY) 05/09/2015 2015 Report Report
Summary of Receipts and From Date To Date For Office Use Only
Expenditures
05/05/2015 06/08/2015
A.Amount Brought Forward From Last Report $ -3,349.18
B.Total Monetary Contributions and Receipts $ 0
(From Schedule 1)
C.Total Funds Available $
(Sum of Lines A and B) 0 -
D.Total Expenditures $ .
(From Schedule III) 4'25
E.Ending Cash Balance $ -3,353.a3
(Subtract Line D from Line C)
F.Value of In-Kind Contributions Received
(From Schedule 11) 0
G.Unpaid Debts and Obligations $ o
(From Schedule IV)
Affidavit Section
Part 1-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,is to the best of my knowledge and belief true,correct and complete.
Sworn to and subscri ed before me this
Fti day, 20
r Person Submitting report
l r�lse L71M �//s l�
I
ignature nted Name
Notary Public /- ���^349'2-
SOUTH MID ON B UNTY /, ,�/) )
My Commissi expi — '
016 A a Code Daytime Telephone Number
Part II-If this is a report of a Candidate's Authorized Committee,candidate shall sign here.
[swear(or affirm)that to the best of my knowledge and belief this political committee has not violated any provisions of the Act of lune 3,1937(P.L.1333,N0.320)as
amended.
Sworn to and subscribed before me this
day of 20 '
Signature of Candidate
Signature I Printed Name
My Commission expires
MO. DAY YR. Area Code Daytime Telephone Number
S
SCHEDULE III
Statement of Expenditures
Filer Identification Number:
To Whom Paid Date[MM/DD/YYYYj $
Cumberland County Election Bureau 05/14/2015 415
House# 1601 Ritner Highway,Suite 201 Street Address Description of Expenditure
City State Zip
Carlisle PA Code 17013 opies
To Whom Paid Date[MM/DD/YYYY] $
House# Street Address Description of Expenditure
CityState Zip
Code
To Whom Paid Date[MM/DD/YYYY] $
House# Street Address Description of Expenditure
city State —Tie
To Whom Paid Date[MM/DD/YYYY] $
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid Date[MM/DD/YYYY] $
House# Street Address Description of Expenditure
city State Zip
Code
To Whom Paid Date[MM/DD/YYYY] $
House# Street Address Description of Expenditure
city StateCp
ode
To Whom Paid Date[MM/DD/YYYY] $
House# Street Address Description of Expenditure
City State Zip
Code
To Whom Paid Date[MM/DD/YYYY]d $
House# Street Address Description of Expenditure
City State Zip
Code