Loading...
HomeMy WebLinkAboutCommitttee to Elect John Gross - 2015 2nd Friday Pre-Primary t Commonwealth of Pennsylvania �z PAGE 1 OF CAMPAIGN FINANCE REPORT (COVER PAGE) (NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.) 2. 3 Filer Identification pool , CANDIDATE 1 COMMITTEE x LOBBYIST Number: Filed By-. Name of Filing Committee, Candidate or Lobbyist: Comr„I'l'lcc ?o [IecL �n.14,J GR765 Tr�4ac..ft/' Street Address: I City: State: Zip Code: 'Bo;I INS pro —61!s- —}A 17007 - TYPE OF STH TUESDAY 1. .2ND FRIDAY 2. 30 DAY. 3. AMENDMENT YES NO X REPORT PRE-PRIMARY / PRE-PRIMARY -^ POSTPRIMARY. REPORT? BTH TUESDAY 4. 2ND FRIDAY. ` 5. 30 DAY.' 6. TERMINATION (place X to T PRE-ELECTION PRE-ELECTION POSELECTION REPORT? YES NO the right of ANNUAL- T YEAR FILING METHOD report type) REPORT i ) CHECK ONE Poo. PAPER X DISKETTE Name of Office Sought by Candidate: 1 u s • • District Office Party County %raw-cf,L,P jf MO: DAY '.' YEAR Number Code Code Code OT-H QcP I ai 5 i4f r�tl4 (SEE INSTRUCTIONS FOR CODES) FOR OFFICE USE ONLY Summary of Receipts Mo. DAY YEAR Mo. DAY viral: and Expenditures from: , I L av' j To 4 ' A. Amount Brought Forward From Last Report $ '00 B. Total Monetary Contributions and Receipts (From Schedule 0 $ $V 41!6, QD C. Total Funds Available (Sum of Lines A and B) $ 5 4 i;'. O7 D. Total Expenditures (From Schedule III) $ ags, 4p&, E. Ending Cash Balance (Subtract Line D from Line C) $ F. Value of In—Kind Contributions Received (From Schedule 10 S G. Unpaid Debts and Obligations (From Schedule IV) $ - 0Q AFFIDAVIT 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 or computer diskette, are to the best of my knowledge and belief true, correct and complete. Sworn to and subscribed befi re me this NOTARIAL SEAL ,y,}� O JENNIFER CEASE ' }S day of I11 NotaryPublic 20 l 5 ��� CARLISLE BORO., CUMBERLAND COUNTY Signature of Person Submitting Report bll�uo mission Expires May 12, 2016 (��ell Signature ) Printed Name My commission expires 5 12— ! 717 1 3 — y%s-,-- Mo. SMO. DAY YR. Area Code Daytime Telephone Number PART 11 — If this is a report of a Candidate's Authorized Committee, candidate shall 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 IP.L. 1333, No. 320) as amended. Sworn to and subscribed! before re this NOTARIAL SEAL JENNIFER CEASE 0 day of / 141 Notary Publirio �_C]_ BERLA14[ t1N Signature of andidate ommission Expires May 12, 2016 7&d4a ^ �12os S Signature II J Printed Named/p 7 My commission expires S /Z / IQ 71a—I {--7 /a2-2 MO. DAY YR. Area Code Daytime Telephone Number Department of State • Bureau of Commissions, Elections and Legislation 303 North Office Building • Harrisburg, PA 17120-0029 • (717) 787-5280 DSEB-502 (7-99) SCHEDULE I PAGE 2 OF �e2 CONTRIBUTIONS AND RECEIPTS Detailed Summary Page Name of Filing ff Committee or Candidate COMrhlTec I o Reporting Period ei� From �t 61 Y �-,57 1. UNITEMIZED CONTRIBUTIONS AND RECEIPTS - $50.00 OR LESS PER CONTRIBUTOR TOTAL for the Reporting Period $ 2. CONTRIBUTIONS $50.01 TO $250.00 (FROM PART A AND PART B) Contributions Received from Political Committees (Part A) $ .Z$O, OD All Other Contributions (Part B) $ t� 0O w TOTAL for the Reporting Period (2) $ 2{ 850. pp 3. CONTRIBUTIONS OVER $250.00 (FROM PART C AND PART D) Contributions Received from Political Committees (Part C) $ ao All Other Contributions (Part D) $ S--eo- Co TOTAL for the Reporting Period (3) $ S06 of-, 4. OTHER RECEIPTS - REFUNDS, INTEREST EARNED, RETURNED CHECKS, ETC. (FROM PART E) TOTAL for the Reporting Period (4) $ a a TOTAL MONETARY CONTRIBUTIONS AND RECEIPTS DURING THIS REPORTING PERIOD (Add and enter amount totals from Boxes 1 , 2, 3 and 4; also enter this amount on Page 1 , Report Cover Page, Item B.) DSEB-502 (]-99) PAGE 3 OF /2 PART A CONTRIBUTIONS RECEIVED FROM POLITICAL COMMITTEES $50.01 TO $250.00 Use this Part to itemize only contributions received from political committees with an aggregate value from $50.01 to $250.00 in the reporting period. Name of Filing Committee or LCandidate Reporting Period LOMAr1�4 ^)—a F �a.�7 T�HJ �yQSS From /-I -;Pois To '4 DATE DATE AMOUNT Full Name of ContributingCommittee 'MO. DAY YEAR OO C)'tezr...5 f-r mr�e �ca�a y .7 apes $ /Jr. Mailing Address MO. DAY YEAR iii Ore o..P $ City State Zip Code Plus 41 MO. DAY YEAR "Zi 1145 wr9 R? /7oeq — $ Full Name of Contrib tin Committee MO. .DAY YEAR pore. it �;d FCccoP y k. I 'i $ r a s ailing Address MO: DAY YEAR 30y �(. aL76 Sr �o fur -p7a $ City State Zip Code lPlus 41 MO. DAY YEAR C4mP / 1i11 17oie - $ Full Name of Contributing Committee -MO: DAY YEAR y s $ Mailing Address 'M . DAY YEAR City State Zip Code Plus MO. DAY YEAR. Full Name of Contributing Committee "MO. DAY YEAR $ Mailing Address MO. DAY YEAR $ City Stete Zip Code Plus 4 MO. DAY YEAR Full Name of Contributing Committee MD, DAY YEAR $ Mailing Address MO.' DAY YEAR $ City State Zip Code Plus 4 MO. DAY YEAR Full Name of Contributing Committee MO. DAY YEAR $ Mailing Address 'MO. DAY YEAR $ City State Zip Code Plus 4 MO. DAY YEAR $ Full Name of Contributing Committee -MO. DAY YEAR $ Mailing Address 'MO. DAY YEAR $ City State Zip Code Plus 4 MO. DAY YEAR $ Full Name of Contributing Committee Mo DAY YEAR $ Mailing Address 'MO. DAY YEAR $ City State Zip Code Plus 4 MO. DAY YEAR $ PAGE TOTAL Enter Grand Total of Part A on Schedule I, Detailed Summary Page, Section 2. $ GYM DSES-502 (7-99) PART B PAGE Y CF 1;L ALL OTHER CONTRIBUTIONS $50.01 TO $250.00 Use this Part to itemize all other contributions with an aggregate value from $50.01 to $250.00 in the reporting period. (Exclude contributions from political committees reported in Part A.) Name of Filing Committee or Candidate Reporting Period Ce/nrwl�lec To Elm 70tio QrocS From /— t_ ys To ,5- N aa1S DATE AMOUNT Full Name of Contribut r MO:. ` DAY YEAR 3r�cc a.rc. 3 s is $ aO"' Mailing Address MO. DAY" .YEAR City AA r1�5 State Zip Code Plus 4 -.MO: DAY YEAR . /YI iOt JlfCb 1 10'% /7o6s - $ Full Naml�e f Contributor MO. DAY - YEAR f. . WC.1Lti .3 do /s $ / OO.ao Mailing Addre�s1s --.Mo> DAY .YEAR $ (e7 (�/u tdef City State. Zip Code Plus 41 MO:. DAY _ -YEAR- CC..rllcic. PO4 Full Name of Contributor MO. DAY YEAR $ Tom < aee ie 3 1'I IT Mailing Address MO. 'DAY YEAR $ City State Zip Code Plus 4 MO. DAY t YEAR C 4 rl E'% 194 1701l— — $ Full Na e o f,Contributor MO. DAY YEAR rllwn m:F2c Gress 3 47 1S $ /e25• o� Mailing Address ":MO. DAY YEAR $ lao Spr1 �5 u1Cw �..at City 1 CState Zip Code Plus 4 'MO. DAY I YEAR G �fIt IC 1taW /?oil' — $ Full Name of Contributor MO. DAY YEAR Ta C. Swts�el 31 1S $ lo7S•"� Mailing Address MO. DAY YEAR $ 33S 1°�,rK �r�c City State Zip Code Plus 4 MO. DAY YEAR Full Na a of Contributor Mo YEAR $ Mailing Address Mo. DAY YEAR I -ell 14)wlfC.] $ City State Zip Code Rus 4 MD. DAY YEAR PA - $ Fulli a of Contributor MO. DAY. YEAR osc 3 31 1S' $ / Mailing Address -MO. DAY ts //.W- DSEB-502 ayo r1. 3grrt s-Lii City , JI State Zip Code Plus 4 `MO. DAY aea o }I � I-), ,( - Full Name of Cp ntributo 'Mo. DAY S-t rpC" � OI ctw31 Mailing Address 11MO. DAY961, dkta"Lwat /City 5 ate ip Code Plus 4 M . DAY gas► _Enter Grand Total of Part B on Schedule I, Detailed Summary Page, SectionEB-502 (7-99) PART B PAGE� OF /pZ ALL OTHER CONTRIBUTIONS $50.01 TO $250.00 Use this Part to itemize all other contributions with an aggregate value from $50.01 to $250.00 in the reporting period. (Exclude contributions from political committees reported in Part A.) Name of Filing Committee or Candidate Reporting Period Contnttlw T eleA -'oNJ Gro6S From t -!-c7yf� To Z4 y - oda IS DATE AMOUNT Full Name of Contributor MO.. DAY I YEAR -J � 6. Tr y , aip,s $ Mailing Addres�s7 +MD. DAY - YEAR - !� (,-ifcle $ City State Zip Code Plus 4 "MO. DAY< YEAR Full Name of Contributor ,,td -.MO. - DAY. YEAR / r�LNJi {. • /„1 /l6r 1 '201s, $ Mailing AddressY MO. DAY'.' .YEAR a crr� b-�•� c:r�d $ City �1 L Ste te. Zip Cod. Plus 4 MO. DAY YEAR- / !7011 — `�/rte $ Full N e of Contnin or MO: DAY YEAR Mailing Address 'MO. -''.DAY YEAR /So J�w✓ --t $ City State Zip Code Plus 4 MO. .DAY: YEAR �rllsbarq 'j ! 1 17219 - I $ Full Nam¢ of C tributor MO. DAY YEAR �/ti PG 5 g• mewcly y $ So• Mailing Address MO. DAY YEAR a8�+1 u,4-6Q. C:r�lr $ City CS to Zip Code Plus 4 `MO- DAY YEAR�0 Full Name of Contributor MO. DAY YEAR ?rarn,c C . Geor y 3 aa5- $ 50, ao Mailing /GaAddress MO. DAY YEAR $ a City State Zip Code Plus d MO. DAY YEAR La.rlrsle- ?d r�o� - $ Full Nam of ContributorDAY YEAR C.f. leo,4eerol -D. /-lwrdtf, �^ y 3 9oN $ aSo. uo Mailing Address MD. DAY YEAR of Zone'l.lt.1 �r,oc $ City 'r5- I State Zip Code Plus 4 MO. DAY YEAR Ce.r c PR 11013 - 1765 $ Full Name of Contributor MO. DAY YEAR 7"er, C . '�, ar y .3 ,2oif $ il"W pO Mailing Address Of' s („J, /✓I alta Strider- MO. DAY YEAP $ City State Zip Code Plus 4 MO. 'DAY YEAR Mcdk6wo'esbvr5 IAA -L230 $ Full Nam of Contributor Mo. DAY YEAR OV rj. Z"#rf vrtrll��, Tr T- 3 50r5- $ a6o. Mailing Address `,D _MO. .DAY' YEAR ?l . 0, 2O)e S1 $ City n State Zip Code Plus 4 M . DAY YEAR `ur�tS'e 'TA /'7013 - $ PAGE TOTAL Enter Grand Total of Part B on Schedule I, Detailed Summary Page, Section 2. $ DSEe-502 (7-99) PART B PAGE L OF /Z ALL OTHER CONTRIBUTIONS $50.01 TO $250.00 Use this Part to itemize all other contributions with an aggregate value from $50.01 to $250.00 in the reporting period. (Exclude contributions from political committees reported in Part A.) Name of YY Filing ,,Committee or Candidate /Y Reporting Period C..aprM r7t�c Td eleA —X—)4A C�/OSS From /`1.-ol0i5 To Z-11 -07046- DATE AMOUNT Full Nage pf ConiAbutor 1 MO. DAY YEAR $ F4,1 Ca (�rthmiW ` !o e5atS /o oo Mailing Address // -MD. DAY' YEAR . sa aa • (j,(s�� � +c App. y y $ City State Zip Code Plus 4 'MO. DAY. YEAR /Itcc��dlcs b,�r9 mid /�aS'S' -lo Liv $ Fullg of FonttibutoZr'L ` :MO. 6AY.. YEAR V, S $ Mailing Address "Mo, DAY YEAR Sa4L ST¢ATN monk' Dr $ City LL JL IA Sttaa�te. Zip Code Plus 4 'MO: DAY " YEAR McAdel CStJGtr�I )7o*> — $ Full Name of Contributor MO. DAY. YEAR /a'+k � 4 /aNwc Am4rd�ad L4 F( 2w5 $ d>" Mailing Address MO. DAY. YEAR $ is ala S, p;* Sf City State Zip Code Plus 4 MO. DAY YEAR. C4rl e PA / ;0I3 - $ Full Name of Contributor MO. DAY YEAH C . Qdy 4. 54,54.) l,✓•GI�A) a/ 5r oarIY $ Mailing Address ..M0.' DAY YEAR CoIGO '28,614idwlc Lir` $ city I State Zip Code Plus 4 MO- DAY YEAR $ Full Name of Comir,le P•or MO: DAV YEAR �J Ilr�.w �Powa Jo ,1Dts $ l a' Mailing Address Mo. DAY I YEAR _?L4 Z AyrbtrG 7]c $ City State Zip Code Plus 41 Mo.. DAY YEAR C4.rIi-SL �A /7oIS -Q2S`I $ Full Name of Contribu-iyo�r NLQ. DAY YEAR J`Q./h CS L. �6 4./' 4/ ld 267s $ Mailing Atldress MO. DAV YEAR $ W. Mala Sf City State Zip Code Plus 4 MD. I DAY I YEAR Full Name of Contributor Mo. DAY YEAR $ Mailing Address MO. DAY YEAR SG Z.rb,A.rc Zr $ City State Zip Code (Plus 4 MO. '.DAY YEAR C4,rl14 Full Name of 1Contributorrn MO. DAV " YEAR t du.$ T- V r' /'r'l: JD r3 Iia t 3 $ Jac. m Mailing AtldressMO. DAY YEAR $ �f Yf)ar�4r�� City State Zip Code Plus 4 Mo. .DAY YEAR r�cc�14 )to6bwl�j PA $ PAGE TOTAL Enter Grand Total of Part B on Schedule 1, Detailed Summary Page, Section 2. $ /376, DSEB-5n2 (7-99) PART B PAGE '/ OF oZ ALL OTHER CONTRIBUTIONS $50.01 TO $250.00 Use this Part to itemize all other contributions with an aggregate value from $50.01 to $250.00 in the reporting period. (Exclude contributions from political committees reported in Part A.) Name of Filing Committee or Candidate Reporting Period C4mm� 1 cc T� Oe.� J oNd Gfo6S From �siS Ta •S DATE AMOUNT Full Njme of Contributor MO. . DAY YEAR CG �Vzw r� • ` Sc. +.f fro f Sh r�rc/ y G Jo iS $ Mailing Address MO. DAY YEAR D11oS ��j�4s ?Ir $ City State Zip Code Plus 4 -.'MO. 'DAY ' `. NEAR C4.PIt4IC Rj t7ot3 - $ Full Name of Contrib for `MO. - DAY,' .YEAR Tmrny � . .'tors $ Oar— Mailing `Mailing Address MO. DAY - YEAR 1111 "Wiv +rkya GN• $ City State. Zip Code iPlus 4 MO. DAY YEAR /A ca ha.)t Isla w/"'1 174$0 - $ Full Name of Conutor MO. DAY: YEAR 7kh.Mtrib'?. arc s y 1G abjs $ / ai o0 Mailing AddressMO. DAY .YEAR j�tu6.�S� t rC Q44re $ City ,,fi�� L State �Zip Code Plus 4 MO. DAY'. YEAR Ae G k 4..r LC5 Full Name off Contributo�rJ M .DAY YEAR $ .TG.cr.:e- 64,r./ 076 j:* Ids. Mailing Atld1.S� MO. . DAY YEAR 3 c Ic $ City State Zip Code Plus 4f MO. .DAY YEAR All4J 6 C pA 1-7 46,> — $ Full Name ofontributor M0: DAY YEAR . o EL Y ao a',s $ 1� Mailing Address M0. DAY YEAR ill Wtirb Oink 0rde, $ City stat Zip Code Plus 4 MO. DAY YEAR 1�1 t. fl.l�� SPn ��s I7oGS - $ Full Name of ContribuRRr d DAY YEAR 144TH19Nt r. S% 01 7015 $ Mailing Address M0. DAY YEAR City State Zip Code Plus 4 MO. DAY YEAR 1;4 111 4.)101 "rj PA nafo — $ Full Name of Contributor Mo. DAY YEAR f'liiii 4 owtsw G aw �►c.tl y Stl a4f5 $ loo. Mailing Address Mo. DAY YEAR o . Cdr a�3 $ City State Zip Code Plus 4 MO. DAY YEAR CwM t1f �� A Full Name of Contributor MO. DAY YEAR $ Mailing Address MO: DAY YEAR $ City State Zip Code Plus 4 M .DAY YEAR $ PAGE TOTAL p Enter Grand Total of Part B on Schedule I, Detailed Summary Page, Section 2. $ 9 � ' DSEB-502 l7 991 PART D PAGE p OF 1 a ALL OTHER CONTRIBUTIONS OVER $250.00 Use this Part to itemize all other contributions with an aggregate value of over $250.00 in the reporting period. (Exclude contributions from political committees reported in Part C.) Name of Filing Committee or Candidate Reporting Period COMM �- To �� Tof/J �oS.s From To DATE AMOUNT Full Name of Contributo1r IINin. DAY YEAR Guf Erche�gef y a yt�f gcao. " Mailing Address t!DO(o S. Arc 3L. DAY YEAR $ CityI LL State Zip Code (Plus 4) Mo. DAY YEAR Mei,+w , e$Vwr9 r7azS -`{ZIr $ Employer Name Occupation Caw.7I. o'r �ra,M O[/� I4.� Ci04.uL'1 L-OWAII.SSfo47C� Employer /^1 Mailing Address/Principal a ress/Principal Place of Business I C•w41,OL S4ue/ t C Lr1t1,1 �?A 1-70(3 Full Name of Contributor MO, DAY YEAR $ Mailing Address MO. DAY YEAR $ City State Zip Code (Plus 4) MO. DAY YEAR $ Employer Name Occupation Employer Mailing AddresslPrincipal Place of Business Full Name of Contributor MO. DAY YEAR $ Mailing Address MO, DAY YEAR $ City State Zip Code (Plus 4) MO. DAY YEAR $ Employer Name Occupation Employer Mailing Address/Principal Place of Business Full Name of Contributor MO. DAY YEAR $ Mailing Address MO. DAY YEAR $ City State Zip Code (Plus 4) Mo, DAY YEAR $ Employer Name Occupation Employer Mailing AddresslPrincipal Place of Business Full Name of Contributor M0. DAY YEAR $ Mailing Address MO. DAY YEAR $ City State Zip Code (Plus 4) Mo. DAY YEAR $ Employer Name Occupation Employer Mailing Address/Principal Place of Business PAGE TOTAL Enter Grand Total of Part D on Schedule 1, Detailed Summary Page, Section 3. $ jOC. to DSEB-502 17-99) PART E PAGE [ OF OTHER RECEIPTS REFUNDS, INTEREST INCOME, RETURNED CHECKS, ETC. Use this Part to report refunds received, interest earned, returned checks and prior expenditures that were returned to the filer. Name of Filing Committee or Candidate Reporting Period Comm i-N4 To Ural- From r�-ob To Full Name Mailing Address City State Zip Code (Plus 4) MO: DAY YEAR ' moue Receipt Description Is Full Name Mailing Address City State Zip Code (Plus 4) MO. .DAY -:YEAR Amount Receipt Description Full Name Mailing Address City State Zip Code (Plus 4) Amount Receipt Description Full Name Mailing Address City State Zip Code (Plus 4) Mo. .DAY YEAR Amount Receipt Description Full Name Mailing Address City State Zip Code (Plus 4) MO. DAY- I YEAR Amount Receipt Description Full Name Mailing Address City State Zip Code (Plus 4) "MO. DAY YEAR Amount $ Receipt Description PAGE TOTAL Enter Grand Total of Part E on Schedule I, Detailed Summary Page, Section 4. $ • O0 DSEB-502 (7-99) SCHEDULE II PAGE /0 OF IN-KIND CONTRIBUTIONS AND VALUABLE THINGS RECEIVED USE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS DURING THE REPORTING PERIOD. Detailed Summary Page Name of Filing Committee or Candidate /� Reporting Period Comm'-R eG TD 'oN.0 &PleC-1 O055 From To S-4-aorS 1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED - VALUE OF $50.00 OR LESS PER CONTRIBUTOR TOTAL for the Reporting Period (1) $ 00 2. IN-KIND CONTRIBUTIONS RECEIVED - VALUE OF $50.01 TO $250.00 (FROM PART F) TOTAL for the Reporting Period (2) $ . 00 3. IN-KIND CONTRIBUTION RECEIVED VALUE OVER $250.00 (FROM PART G) TOTAL for the Reporting Period (3) $ pp TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING PERIOD (Add and enter amount totals from Boxes 1 , 2, $ and 3; also enter on Page 1 , Report Cover Page, Item F.) . 00::::o OSEB-507 (7-99) PAGE r1 OF /- SCHEDULE III STATEMENT OF EXPENDITURES Name of Filing Committee orr Candidate Reporting Period Comm, -4-c 1v F J Offl�l Grp S 7 From 004s To 54 A0 To Who Pai O M�r MO: -0AY- YEAR mOu � Mailing Address // ,,�J1,,�� Description of Expenditure II City State Zip Code (Plus 4) C,%Ats)c A 11.7013 - To Why�[J� Paitl 1\D4k Ir11�T� S� '-MO. o:DAY VEAfl: mount Li I• sols 8't3.3Sr Mailing Address Description of Expenditure iso �• H 1�� 5-�ru-E ►°r,N e,,,,, � a r+'1�.;�I s City S,tpate ZiCode (Plus 4) i a, I tz 1,e- p 17d 1 Zi () Ton Whop" Ppid Q 2(MO. - -DAY YEAR''' m0 t C /Ir'i �u i� fcc�rJ� J !C� I'liuiN7GJ (8Iy- - c� Mailing Address Description o Expe iture Ev�.r� ^ I i, two c City State Zip Code (Plus 4) FwN (41 To Whom Paid LL `:MO. DAY I YEAR mount $11Gt/rrA.lperLlfiN S eGrall<ItS , ILC 5 / ebls X707. 31 Mailing Address Description of Expenditure /Vol E r St �.lr�t�.l Sr Ns City St a T Zip Code (Plus 41 CaPkir Ie r"p 11013 - To Whom Paitl ,MO. :DAY YEAH: mount '; Mailing Address Description of Expenditure City State Zip Code (Plus 4) To Whom Paid --SMO. -.DAY YEAP rC. mount Mailing Address Description of Expenditure City State Zip Code (Plus 4) To Whom Paid '--MO:. . DAY. YEAR mount Mailing Address Description of Expenditure City State Zip Code (Plus 4) To Whom Paid 'MO. DAY 1 YEM mount Mailing Address Description of Expenditura City State Zip Code (Plus 4) PAGE TOTAL Enter Grand Total of Expenditures on Page t, Report Cover Page, Item D. $ p���g. too DSEB-502 (7-99) • PAGE OF SCHEDULE IV STATEMENT OF UNPAID DEBTS Use this Section to itemize all unpaid debts and obligations which are outstanding at the and of the reporting period. Name of Filing 1Committee or Candidate Reporting Period C_OYhMtTtec �)rrT �'otla f'Ibss From 1-1-c7611 To S-V '126f5 Name of Creditor Outstanding Balance Of Dert Mailing Address DATE MO. DAY, I YEAR DEBT INCURRED City State Zip Code (Plus 41 Description of Debt Name of creditor Outstanding Balance of Debt Mailing Address DATE ;MO. DAY , YEAR DEBT INCURRED City State Zip Code (Plus 4) Description of Debt Name of Creditor outstanding Balance of Dert Mailing Address DATE IMO. DAY YEAR DEBT INCURRED City State Zip Code (Plus 4) Description of Debt Name of Creditor Outstanding Balance of Dert Mailing Address DATE 1 MO. DAY 'YEAR DEBT INCURRED City State Zip Code (Plus 41 Description of Debt Name of creditor Outstanding Balance of Debt Mailing Address DATE rMO, DAY,, YEAR--- DEBT EAR TDEBT INCURRED City State Zip Code (Plus 4)) Description of Debt Name of Creditor Outstanding Balance of Debt Mailing Address DATE £MO. DAY YEAR DEBT INCURRED City State Zip Code (Plus 4) Description of Debt PAGE TOTAL Enter Grand Total of Unpaid Debts on Page 1, Report Cover Page, Item G. $ pa DSEB-502 17-99)