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HomeMy WebLinkAboutCross for Cumberland - 2015 2nd Friday Pre-Primary 1 III III Reset Form Print Form Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Filey Identification 1c�I r, n Report Filed By, Candidate Committee / Lobbyist Number L V v) s'L (Mark X) Name of Filing Committee,Candidate or Lobbyist I.rUS� m Street Address d- TUU City Stater ZiP.Code I�D� Type of Report(Place x under report type) t-6°h Tuesday 2- 2"d.Friday 3-30 Day Post 4.6th Tuesday 5-2nd Friday 6.30 Day Post. -7-Annual Special 2" Friday Special 30 Day Pre-1Primary Pre-Primary.. Primary Pre-Election Pre-Election Election Pre-Election Post-Election L' Ellj F-1 11 1:1 El D El EJ Dat�ection Year Amendment Termination (MM/DD/YYYY) Report Report ❑ Summary of Receipts and From Date To Datg. For Office Use Only Expenditures 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) p-b.�+�o' r`y =D D.Total Expenditures $ I' 2 (From Schedule III) Vx��� '7 E.Ending Cash Balance $ /1 7> p L r (Subtract Line D from Line C) /' >A* F.Value of In-Kind Contributions Received $ (From Schedule II) r G.Unpaid Debts and Obligations $ (From Schedule IV) v• V v 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 knowge and belief true,correct and complete. Sw,ppytp and subscribed before me this ''KK Wdayof 20�_ I _ Sign�tyr�q(Per ng report r— Lel ('[Printed Name N ARI SEAL I �t FCAFIL�J�SLE ommisIM soSFe�N sY SALZARULO ' BORO;,C ERLANLRYITN Y ol Area Code Daytime Telephone Number 017 rt 11- or Committee,candidate shall sign here. I swear atfirm)that to the best of my knowledge and belief this political committee has not violated any provisions of the Act of lune 3,1937 IP.L.1333,NO.320)as amended. ��}} SwqtP and subscribed before me this ( � day of ' 20 i W .(L i n t r_u.a of Canr/jQate�` C q k} (1129 i� Sig a ure I � Printed Nam/e/ My Commission expires 7/ r -e 9— 267/7 COMAONVyEl—F PEN V Area Code Daytime Telephone Number NOTARIAL SEAL AFTHANY SALZARULO Notary PublicMBE CARLISLE BORCommission CUMBs Oct 7,RLAND 0r17 My Commissiop Expires OcV,2017 SCHEDULEI Contributions and Receipts Detailed Summary Page Filer Identification Number (J rn ��✓-t^5� �� tti�rnhel�G.UC� 1.Unitemized Contributions and Receipts-$50,00 or Less per Contributor Total for the reporting period (1) JtJ 2. Contributions o 50.01 to 250.0 From Part A and Part B) Contributions Received from Political Committees(Part A) $ All Other Contributions(Part B) $ Total for the reporting period (2) $ 3.Contributions Over$250.00(From Part C and Part D) ill Contributions Received from Political Committees(Part C) $ All Other Contributions(Part D) Total for the reporting period (3) $ a DDD 4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) Total for the reporting period (4) $ �. Total Monetary Contributions and Receipts during this reporting period(Add and $ enter amount totals from Boxes I,2,3 and 4,also enter this amount on Page 1,Report V t t ' Cover Page,Item 8) Y/ "L 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. Filer Identification Number Amount Full Name of Contributing DateMM DO/YYYY] Committee ( / $ House# Street Address Date[MM/DD/YYYY] $ Z[ de Date[MM/DD/YYYY] $ Full Name of Contdbuti Committey� ��,�-I Date[MMS/1DD/YYYY] $ e. ........ �f t/wtcff,C� House If - Street Address Date[MM/DD/YYYY] $ City � � Date.[MM/DD/YYYY] $ l` W� Full Name of Contributing (� Date[MM/DO/YYYY] $ Committee ft �^XK� yMA Lf J}��[� [ House# Street Address PK Date([MM/DD/YYYY] $ I'0 City , State 1 Zip Code Date[MM/DD/YYYY] $ Full Name of Contribu inij Date[MM/DD/YYYY] $ Committee House It !Street Address Date[MM/DD/YYYY] $. City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date[MM/DD/YYYY] $ city State Zip Code Date[MM/DD/YYYY] $ PART 8 All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) Filer identification Number: Cao 55 �V, Full Name of Contributor Date[;MM/DD/YYYYI $ Gqu- w 6 tF l00- r1D House# Street Address p Date I.MM/DD/YYYY] $ v� �9Y�CVLW.1 lit city 1, 5� � h State pp( Zlp Code IJoL Date[MM/DD/YYYY] $ Full Name of Contributor �C Date[MM/DD/YYYY] $ 0 � �b-(t-5 [60-� House# Street Address Date[MM/DD/YYYY] $. city �` State Zip Code I Date[MM/DD/YYYY] $ Full Name olVf_CCtontributor 1, Date[MM/DD/YYYY] $ PName!kContributorI Date MM DD 64, �!Street Address � � t {Y�] $ State Zip Code Date[MM/DD/YYYY]Date IMM/DD/YYYY] $ P-avr� VO4, ;;,(u I6� House# Street Address Date IMM/DD/YYYY] $ City I I state Zip Coder Dace[MM(DD/YYYY] $ Full Name of Contributor V Date[MM/DD/YYYY] $ ud�l -,� I ti'l ,, 11)o- G� House# Street Address 'Date[MM/DD/YYYY] $ City 1 _ State 21p.Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YYYY] $ gml"'An-5 7v[[11iI; tap _ Isa House# Street Address Date[MM/DD/YYYY] $ ao(3 b City r� State �� Zip Code Date[MM/DD/YYYY] $ PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) Filer Identification Number. Full Name of Contributor n1,LV, Date[MM/DD/YYYYj $ House# Street Address :':Date[MM/DD/YYYYj $. City r state Zip Code Date[MM/DD/YYYYj $ dam �-hll Full Name of ContributorDate IMM/DD/YYYYj $ Wald I� �u 11e�v� 55i�, IS lav House# Street Address Date IMM/DD/YYYYj $ . City (, State (� Zip Code Date[MM/DD/YYYYj $ MP 9 Full Name of Contributor Date[MM/DD/YYYYj $ xoerl �rzer Pie -?,)It�rt(5 too— House# Street Address Date jMM/DD/YYYYj $ 70 YIA �V?LLU rt w') city State .Zip Code .Date[MM/DD/YYYYj $ Full Name of Contributor -Date[MM/DD/YYYYj $ House# Street Address �0 Date[MM/DD/YYYYj $ city h` State ,G Zip Lode Date[MM/OD/YYYYj $ Full Name of Contributor h - Date[MM/DD/YYYYj S House# Street Address Date[MM/DD7. j $ IRo�5 1 1 1 J � U . City M(.UkW C State pn Zip Code Date jMM/DD/YYYYj $ Full Name of Contributor K Date[MM/DD/YYYY] $ House# Street Address Date.[MM/DD/YYYYj , $ State. .Zip Code ' Date[MM/DD/YYM $ IF IK' l� PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) Filer Identification Number: Full Name of Contributor Date[MM/DD/YYYY] $. T iv� �Y j ]-Y. L (3 116 2- D [House# Street Address DatejMM/DD/YYYYjrD35y State Zip Code Date{MM/DD/YYYYj $ Full Name of Contributor -Date[MM/DD/YYYYj $ S �- (y/� Mm Lt [3 1 L6 too — LHouse# Street Addres Date[MM/DD/YYYYj $ city State Zip Code Date[MM/DD/YYYY] $ ern Ak �k l Lf3 Full Name of Contributor 'Date[MM/DD/YYYYI $ Tows �vhL kDD- House# Street AddressDate[MM(DD/YYYY) $ �DM64 . city State- Zip Code Date[MM/DD/YYYY] $ Y w P� 111t1 Full Name of Contributor 1 -1 Date[MM/DD/YYYY] $ 'NWA i vo- House# Street Address Date.[MM/DD/YYYyj $ city State.,. Zip Code Date[MM/DD/YYYYJ. . $. Full Name of Contributor Date.[MM/DD/yYYY) $ L se# HouStreet Address /7 ,I Date.:[MM/DD/YYYY) $ d `J C'" State. Zip lode I Date jMM/OD/YYYYj $. Full Name of Contributor Date[MM/DD/YYYY).. $ House# Street Address Date.[ M/DD/YYYY) $: City State' �� Zfp Code �l Date[MM/DD/YYYY] $. PART 8 All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) Filer IdentRiCation Number: ^ ('I n m 4 Full Name of Contributor l /\j'[!),r/ ' {�•,, Date[MM/DD/YYYY] $ �SCh� �uA/dilrt, h 'r XLtS ��o, House# Street Address Date[MM/DD/YYYY] $ City .State Zip Code Date IIMM/DD/YYYY] $ �lX GAP pr� i 1 ,5 Full Name of Contributor Date[MM/DD/YM] $ Ann Luc, — House# Street Address Date[MM/OD/YYYY] $ city (� State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YYYY] $ QA0 G C-*WL, tors— IHouse# Street Address Date[MM/DD/YYYY].. $ l l �� me, e City state Zip Code Date[MM/DD/YYYY] $ 1NQ fi�nl lV ALWI I I lqD-, t Itc?U Full Name of Contributor Date[MM/DD/YYYY] $ Dw ne,W" V 3-Z t t lad House# Street Address Date[MM/DD/YYYY] $ City State aip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ U-1% City State ,Zip Code Date[MM/DD/YYYY] $ n\ i h& l (I Full Name of Contributor Date[MM/DD/YYYY] $ _ U r1A ZtImLL!�- h House# Street Address Date(MM/DD/YYYY] $ City State Zip Code lip I Date[MM/DD/YYYY] $ PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. [Exclude contributions from political committees reported in Part A.) Filer ldemdication Number: �, C� 1ti�S /inti l �xmE�r;6�G;i,Gti Full Name of ContributorDate[MM/DD/YYYY] $ n�� ksc C • �ti Cal i'l lx3�163 101; -- House# Street Address �—y^y Date[MM/DD/YYYY] $ City ,State Zip Cade Date[MM/DD/YYYY] $ C�nlI 1161�v�ll Full Name of Contributor Date[MM/DD/YYYY] $ C-aw`� RC2 qw- Yor- House# Street Address Date[MM/DD/YYYY] $ CityStaee Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor 0Date[MM/DD/YYYY] $ 1 YU4 � —TU htf4 V V House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YM] $ I-0io House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ 1AMl ii? v� & L?I)L 3 Full Name of Contrib or Date[MM/DD/YYYY] $ prOM5 W *61(4 1, House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DO/YYYY] $ Full Name of Contributor Date[MM/DD/YYYY] $. House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ rr[�r�lrud Pik l PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) Filer Identification Number: Full Name of Contributor p � Dat�e7[MM/DD/YYYYj 5 fjlA� �j7✓[S� PiZYZe, I���[-t.{/1ti1� "l. . �[D� [9I/ House NStreet Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YYYY] $ 9mvi wk q1 m 114 a5D House p Street Address Date jMM/OD/YYYYj $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YYYYj $ House p Street Address Date[MM/DD/YYYY] $ city State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YYYYj $ House K // Street Add ss n m Date[MM/DD ] $ City i State Zip Code Date[MM/DD/YYYYj $ Full Name of Contributor Date MM/DD/YYYY] $ )nQ �r a 23<<, [Ub— HouseN Street Address n_ Date[MM/DD/YYYYI $ City State Zip Code Date[MM/DD/YYYVj $ C4mc p� i�o�� Full Name of Contributor Date[MM/DD/YYYY] $ House a Street Address l Date[MM/DD/YYYY] $ city n ]l State.: Zlp Cade Date[MM/DD/rml $ L-4 PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) Filer Identification Number: full Name of Contributor Date[MM/DD/YYYY] $ 9W, qO� I(r) �nb� House If Street Address Date[MM/DD/YYYY] $ `))o— 5 _ fv City State 21p Code , Date[MM/DD/YYYY] $ Full Name of Contributor Date IMM/DD/YM] $ X63« [bb House# Street Address Date[MM/ODYYY]/Y $ city State21p Code Date[MM/DD/YYYY] $ �� Pty t,)Mk Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ �11� LA,uCQ��GI'Ikt,�tiuw. City �40t6( State Zip Code Date[MM/DD/YYYY] $ PGk ll�G lh Full Name of Contributor I Date[MM/DD/YYYY] -$ Pao/llr A (,v[rot q I'w [ House# Street Address Date[MM/DD ] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $. City State Zip Code Date[MM/DD/YYYY] $ Prl i X16( Full Name of Contributor Date[MM/DD/YM] $. Lfj +p([- loo— Hous e# Street Addres I Date[MM/DD/YYYY] $ City State Zip Code Date IMM/DD/YYYY] S �q Pa )/hu PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) Filer Identification Number: ,\ C/ Mk I t G Full Name of Contributor Date[MM/DD/YYYY] /� $ House# Street Address :Date[MM/DD/YYYY] $ V tJ���' •`c� City - state Date[MM/DD/YYYY] $ Full Name of Contributor ,l'�.• ',,l Date[MM/DD/YYYY] $ House# street Address Date.[MM/DD/YYYY]. $ City State Zip Code Date.[MM/DD/YYYY] . $ Full Name of Contributor Date[MM/DD/YYYY] $ '�larre� �V�J1✓� y ,yq House# �� Street Addresst DatejMM/DD/YYYY] $' City State Zip Code Date.[MM/DD/YYYY] Full Name of Contribut Date[MM/DD/YYYYj $ House# Street Address Q�, Date[MM/DD/YYYY] $ City Stater Zip Code Date IMM/DD/YYYY] $ Full Name of Contributor 0 Date[MM/DD/YYYY] $ [ `dv House# Street Address a Date[MM/DD/YYYY] $ City State`" -Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date'[MM/DD/YYYY] $ House# Street Address Date.[MM/DD/YYYYj., $. City State Zip Code Date{MM/DD/YYYY]>. $ PART C Contributions Received From Political Committees Over$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value over$250.00 in the reporting period. Filer ldentifir tion Number: Full Name of IN Contributing Committee" V k '1„^^ V"r✓q ", 1� ] $ House# ISIM7 YC. 'L` �V�'�✓ �o plc gag City: kvft6b ��«� $ Full Name-W----..Wr Contributing Committe VVU� V �rfL, �A.r®0 � tr0b � Ho Street Vv lllc h w If�ti Date[ l •df� City Full Name o y' Date[MM/DD/YYYY] $ Contributing Committ '1 it 1 i p/br/r [y„r ;11�t'� �n House# Street iAdVdrrerlQl^j9 Date[(MM/DD/YYYY] $_ City f �� Date[MM(DD/YYYY, 5 T Full Name of ` Date[MM/DD/YYYY] $ Contributing Committee k House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Date.[MM/DD/YYYY] $ Contributing Committee House# Street Address Date[MM/DD/YYYY] $ City State I _ Zip Code I Date[MM/DD/YYYY] $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee House# Street Address Date(MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ PART C Contributions Received From Political Committees Over$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value over$250.00 in the reporting period. Filer Identification Number: r Full Name of Date[MM/DD/YYYY] $„ Contributing Committee y�1 y I„ ©� qtn v�.n,✓ PAP House# Street Address ` Date[MM/DD/ "oY/ [�Ot) nit eek 8� cityEdiDate[MM/DD/YYYY) $ IM �Q�P�. �1�. - lDl.l&� Full Name of Date[MM/DD/YYYY] $ Contributing Committee �� House# Street Address ffN����1 pvW�r x/111 t rW�l Date(MM/DD/YYYY] $ I�7 City State Zip Code Date[MM/DD/YYYY] $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee House# Street Address Date(MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee EHouse# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Date(MM/DD/YYYY] $ Contributing Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ PART D All Other Contributions Over$250.00 Use this Part to itemize all other contributions with an aggregate value over$250.00 in the reporting period. (Exclude contributions from political committees reported in Part C) Filer Identification Number: t �1fi�S ' r mb Full Name of Contributor $ Mouse It ;Street Address City $ illil) .� ' t P IlkLj Employer Name Employer Mailing Address/Principal Place of Business Full Name of Contributor 1 House# eet _ au2-6 dalz�ri�C. city de Date[MM/DD/YYYY] $ auk. -- Employer Name ' Occupation Employer Mailing Address/ Principal Place of Business Full Name of Contributor Date(MMJDD/YYYY] $ FStreHouse et Date[MM/DD/yYyy] $ cityPik $ -- Employer Name r .,n Employer Mailing Address J Principal Place of Business Full Name of Contributor Date(MMJDD/yy $ Cel,�l. l� m.aat , fir. ---- ---- �— House# Street Address Date[MM/DDJYYYYJ $ Tlwp 0✓�P3(vvVUl City Date Employer. OccupatiQA - - - 4Ld6^r _ Employer Mailing Address J _ Principal Place of Business PART D All Other Contributions Over$250.00 Use this Part to itemize all other contributions with an aggregate value over$250.00 in the reporting period. (Exclude contributions from political committees reported in Part C) Filer Identi8 Full Name of Contributor p/yyyy) b(c5CcS ,rte, House If $ City hne�� c�b, Employer Name - Employer Mailing Address/ - " Principal Place of Business Full Name of Contributor ��* L. `� � �lao lcs moo" House# Ll dre ;; $ city $ �`,. nr�ttib2e+�� h �� 1�oty Employer Name �n Employer Mailing Address( /Jnr Principal Place of Business Full Name of Contributor House# Street Address City - State Employer Name Employer Mailing Address/ - Principal Place of Business Full Name of Contributor T""` $ House# Street Address TState F-7ode -Date[MM/DD/riri] $ 7 Employer Name Occupation Employer Mailing Address Principal Place of Business SCHEDULE III Statement of Expenditures Filer Identification Number; hms VIr ( uv M "k To Whom Paid Date[MM/DD/YYYY] $ � � `PYvMa �w t (�k House# Street Address Description of Expenditure City ( w td State Zip Vr Code' ��b D To Whom Paid Date IMM/DD/YY) $ �u eI t L5- House ��t�i 27 # ) 'Street Address 1 _ 1 l Description of Expenditure City rn � S to Zip �� Co l� l�fi<< 47„' ""' Code ��. Vn `� To Whom Paid House Ifn ( Street Address b ]I �- II 11 Description of Exppe"lnditur/e. City l Nvq 1� u fe P� Cde l �l J To Whom Paid '1 �` � n �F,o `` Date[MnM/DD/YYYYJ $ It',1V(Zh l ,IhJ Wtn.J ll '"j-pl,(_ t'l ?4 s-q House# r Street Address I n Description of ExpenditureAliiV/ City catn I/L [�U ke FMS Code --roll i v � m(1 ) To Whom Paid l ) Date[MM/DD/YYYY] $ �btl l �gjnGMS � 5 �� House# � of13)2Street Address Description of Expenditure �• City Zip isa sS� f A[ Code To Whom Paid p / Date�M� DD/YVYY] House# 1n�) tree Address (k/ Description of Expenditure Ci 5 to Zi Code To Whom Paid . Date[ JDD/YYYY] $ House# ��) Street Address 6N Description orffEExppenditure City staid �n Code Towhom Paid I( �� Dat - [6 ] House# � Street Address Description of Expenditure ,y{' CityM Code SCHEDULE III Statement of Expenditures Filer identification Number: To Whom Paid 1 Date[MM/DD/YYYY] $ ���r�-tl � � � q• (Gj 200 House#I )Oil Street AddressTstle � Descriptiion of Expenditure Zip Citykit p Code �' WMjm ( ejs To Whom Paid f Date MM/DD/YYYYJ $ House# IStreet Address .Description of Expenditure CityIIl+tV�wV�t�J State y� Zip wWwJ �K . Code To Whom Paid Date IMM/DD/YYYY] $ �lC�atP� �I u� � t Lot AA( House# 'Street Address Description of Expenditure City S ate n Zip Code L1 l.bi, � l.'{ "�l Wq-- -u]' To Whom Paid Date[M /D /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 Cade 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 IMM/DD/YYYYI $ House# lstreet Address Description of Expenditure City State Zip Code PAGE OF SCHEDULE IV STATEMENT OF UNPAID DEBTS Use this Section to Itemize all unpaid debts and obligations which are outstanding at the end of the reporting period. Name of Filing Committee or Candid ate ,1,,"-, '' ReF'orting Period ` I CIV S k(Df �u'wt1��d1(,.�61. F•om 1 1 I To 5 � l�J 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 Debt Mei{ing Address DATE L'.MO. DAY YEAR.: DEBT INCURRED City Sta<e Zip Code (Plus 4) Description of Debt Name of Creditor jutstandrig Balance of e t Meiling Address DATE Ni O. DAY YEAR DEBT INCURRED City State Zlp Code (Plus 41 Dc,imption of Debt Namo of Credito, Outstanding Balance of Debt Mailing Address DATE -r MO. DAY YEAR DEBT INCURRED City $tete yip Cotic (Plus 4) Description of Debt Nn.. of Creditor Outstanding Balance of Debt Mailing Address DATE "MO, DAY YEAR DEBT INCURRED city State Zip Code (Plus 4) Description of Debt �J Name of Creditor Outstanding Balance of Debt Mailing Address DATE MD. DAY J.,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. $ O. DSEB�501 (7-941 '„ ulY w. -11ku,An. 1"�if�'�4'l+�i'illilllAi"�'�MII�:�sHllrlt .IIVflY11)t�ll '2 ;,18A d!) _,ui,dP�Yfl lkflFlNli ll'bmRml .. i, gin:. CROSS FOR CUMBERLAND PO BOX 300 CARLISLE, PA 17013 May 4, 2015 This letter is written to acknowledge that Michael and Barbara personally forgive the debt from CROSS FOR CUMBERLAND for the 2011 Cycle in the amount of$44,500.00. Sincerely, ��.��r� Barbara Crossvk-�ia '/�I < ' �7 ,ir_ Michael Cross V V c SC TT WY H h"IW S10 SCHEDULE IV Statement of Unpaid Debts Use this Section to itemize all unpaid debts and obligations which are outstanding at the end of the reporting period. 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