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HomeMy WebLinkAboutEast Pennsboro Republican Association - 2015 30-Day Post-Primary III III Reset Form Print Form Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible. It should be typed) Filer Identification Report Filed By Candidate ❑ Committee Lobbyist Number (Mark X) Name of Filing Committee,Callcliclate or �t p / �s -�7 p Lobbyist r-A / ' fA J"U / W�, 9v A 1 Street Address �` 3 city 1Q 14 State Zip Coder-- Type of Report(Place x under report type) V 7 1-6`h Tuesday 2- 2"°Friday 3-30 Day Post 4-6'h Tuesday 5-2"d Friday 6-3ODay Post 7-Annual Special 2" Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election E] E] 1:1 11 Date Of Election Year Amendment ❑ Termination (MM/DD/YYYY) J—lq 45 , '1� y- Report Report ❑ Summary of Receipts and From Date To Data J Tor Office Use Only Expenditures A.Amount Brought Forward From Last Report $ ., B.Total Monetary Contributions and Receipts $ p l (From Schedule 1) Jr©,t�• ®0 ( - C.Total Funds Available $ 2 rt [/ (Sum of Lines A and 8) -�- �p I5r5 D.Total Expenditures $ ��II c1 ,,,, (From Schedule III) - ®q,�p r.":� Zj E.Ending Cash Balance $ r (Subtract Line D from Line C) Q F.Value of In-Kind Contributions Received (From Schedule II) G.Unpaid Debts and Obligations $ (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 subscribed before me this 5day of JUrJE- 20 IS Sig uure of P¢rson SubmItttin e oy( Z p Xv �- lav K 2 rC (�' �T` Signature o17/ 7 Printed Name /y My Commission expires Oq 15- aCA a /`y/ 7 7-5r), 0 - �I M0. DAY YR. Area Code Daytime Telephone Number Part II-If this is a report of a Candidate's Authorized Committee,candidate shall sign here. r(or affirm)that to the best of my knowledge and belief thi 'ical committee has not violated any provisions of the Act of June 3,1937 . .1333,NC.320)as amende Sworn to and subs ed before me this day of 20 Sig ofC idate Signature Ped Name My Commission expires MO. DAY YR. Area a Daytime Telephone Number p""ONWEALTH OF PENNSYL ANIA NOTARIAL SEAL - C.3rly R.Ambrose,Notary Public Hampden Twp.,Cumberland County My Commission Expires April 15,2018 JAEN8f R, PENNSYLVANIA ASSOCIATION OF NOTARIES SCHEDULEI Contributions and Receipts Detailed Summary Page Filer Identification Number 1.Unitemized Contributions and Receipts-$50.00 or Less per Contributor Total for the reporting period (1) $ 2.Contributions o 50.01 to $250.00 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) Contributions Received from Political Committees(Part C) $ SO v U All Other Contributions(Part D) $ Total for the reporting period (3) $ 4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) Total for the reporting period (4) $ .VE 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) •J 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: Full Name of pp, " � Date[MM/DD/YYYY] $ Contributing Committee House# Street Address (� Dat [MM/ D[YYYY] $ P 6, �� /r City State Zip Code Date[MM/DD/YYYY] $ /7v 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 House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee 4House# Street Address Date[MM/DD/YYYY] $State Zip Code Date[MM/DD/YYYY] $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee LHouse# Street Address Date[MM/DD/YYYY] $ State Zip Code 'Date.[MM/DD/YYYY] $ PART E Other Receipts REFUNDS, INTREST INCOME, RETURNED CHECKS, ETC. Use this Part to report refunds received, interest earned, returned checks and prior expenditures that were returned to the filer. Filer Identification Number: Full Name // 6A „„'' House# --., Street Address City IIAqq hn ))A��p /nr ''State. Zip Date[MM/DD/YYYY] $ I�NI KI(L v k& PA I Code Receipt Description J 7£ s T e x I D Full Name House# Street Address city State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address city State Zip I Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address city State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address City State Zip 'Date.[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address City State Zip'" Date[MM/DD/YYYY] $ Code' Receipt Description SCHEDULE III Statement of Expenditures Filer Identification Number: To Whom Paid Date[MM/DD/YYYY] $ House# Street Address Desc iptionof Expenditure City {1 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] 77 House# IStreet 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] 77 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] 77 House# Street Address Description of Expenditure City StateZip Code To Whom Paid Date[MM/DD/YYYY] $ House It Street Address Description of Expenditure City State Zip Code