HomeMy WebLinkAboutResponsible Citizens for Silver Spring - 2015 2nd Friday Pre-Primary Commonwealth of Pennsylvania
CAMPAIGN FINANCE REPORT PAGE , OF
(COVER PAGE)
(NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification001" Report , CANDIDATE 1 COMMITTEE 2 LOBBYIST 3
Number: Filed By X
Name of Filing Committee, Candidate or Lobbyist:
PG ;'
Street Address:
11
City. State: Zip Code:
- 00
TYPE OF STH TUESDAY J7.
2ND FRIDAY ?'/ 30 DAY 3. AMENDMENT YES NO
REPORT PRE-PRIMARYPRE-PRIMARY 'C POST PRIMARY REPORT?
6TH TUESDAY 2ND FRIDAY 5',.. 30.DAY E .TERMINATION
(place X to PRE-ELECTIONPRE-ELECTION POST ELECTION REPORT? YES NO
the right of ANNUAL YEAR FILING METHOD
report type) REPORT 1 ) CHECK ONE , . PAPER ` DISKETTE
Name of Office Sought by Candidate: e • 0:11:[Pitilojil District Office Party County
'MO.. DAY YEAR Number Code Code Code
T-uwr�sfllP < ;U?ev-vlsuR , �ILvCZ SPRItic� rj'rH ?,C- 1 21
I dl ( ! (SEE INSTRUCTIONS FOR CODES(
FOR OFFICE USE ONLY
MO.. DAY. YEAR ' MD.. DAY YEAR
Summary of Receipts
and Expenditures from: , t73 110 I 2U1Z2 To o5 k 2G f,
A. Amount Brought Forward From Last Report 11
B. Total Monetary Contributions and Receipts (From Schedule 1) $ I 1 b,1J
C. Total Funds Available (Sum of Lines A and B) $ I I UO
D. Total Expenditures (From Schedule III) S o♦C4
E. Ending Cash Balance (Subtract Line D from Line C) $
F. Value of In—Kind Contributions Received (From Schedule 11) $
G. Unpaid Debts and Obligations (From Schedule M $ (X
AFFIDAVIT
PART I — 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, ie()P#0(igifAE1ft41®f pENN *_VAN[Aaper or computer diskette, are to the best of my knowledge and belief true,
correct and complete. Notarial Seal
Sworn to and subscribed before r a this Marissa Hiester,Notary Public
Sliver Spring Twp.,Cumberland ou ty
day of My Commission Expires Fek 7
ME BER,PENNSYLVAN ASSOCIATION-UrNOTARIES i�o .Signature of Pe son Submitting Report
� I,I.CZrn e �
Signature // �/ �7 Printed Name
My commission expires Feb ir t 217 l 1 1 242.1- $303
MO. DAY YR. Area Code Daytime Telephone Number
PART 11 — If this is a report fttee, candidate shall sign.here..
I swear for affirm) that to the be of m)f`fBfIS R4R§tl9n�d�r'itl,�ll�poI ti ` I committee has not violated any provisions of the Act of June 3, 1937
tP.L. 1333, No. 320) as amended. Silver Spring Twp.,Cumtledand County
Sworn to and subscribed before Commission Expires Feb.5,2017
MEMBER,PENNSYLVANIA ASSOCIATION OF tWAR1
to Day of 1" 1 20 �tJ _.dJ �
Signature of Canditlate
r.(, rer
y //ignature ///� ���777 '''777 Prin�t�°+N�e
My commission expires r`/J pG(J/7 J J -7— /NQ
MO. DAY YR. rea Code Daytime Teleppphone 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)
Commonwealth of Pennsylvania 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.)
Filer Identification ► Report , .CANDIDATE 1 .COMMITTEE 2 LOBBYIST3
Number: Filed By
Name of Filing Committee, Candidate or Lobbyist:
Street Address:
City: State: Zip Code:
TYPE OF 8TH TUESDAY j
2NO FRIDAY- 2. 30 DAY 3' AMENDMENT YES ±NQ
REPORT PRE-PRIMARYPRE-PRIMARY POSTPRIMARass"Y REPORT?
STH TUESDAY 2ND FRIDAY 5. 30 DAY' - 5' TERMINATION
PRE-ELECTIONPRE-ELECTION POST-ELECTION REPORT? YES r
(place X to
the right of ANNUAL YEAR FILING .METHOD
report type) REPORT ( ) CHECK ONE , PAPER DISKETTE
Name of Office Sought by Candidate: '
e E District Office Party County
Number Cod¢ Code Code
MO. "DAY YEAR
61E. INSTRUCTIONS FOR CODES)
` `-
MO. DAY , YEA ft MO: 'DAY YEAR USE ONLY
FOR.OFFICE
Summary of Receipts
and Expenditures from: ► To
A. Amount Brought Forward From Last Report $
B. Total Monetary Contributions and Receipts (From Schedule 0 $
C. Total Funds Available (Sum of Lines A and B) $
D. Total Expenditures (From Schedule III) $
E. Ending Cash Balance (Subtract Line D from Line C) $
F. Value of In—Kind Contributions Received (From Schedule IO $
G. Unpaid Debts and Obligations (From Schedule IV) $
AFFIDAVIT
PART I - If this is a Committee;report, treasurersign. 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 before me this
day of 20
Signature of Person Submitting Report
Signature Printed Name
My commission expires
MO. DAY YR. Area Cade 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
(P.L. 1333, No. 320) as amended.
Sworn to and subscribed before me this 7
day of 20 ° Bj,,,,�
_ '7 Signature of Candidate
'Ci Lf "' / ( �T'(
COYMUI MTN. Fk9h §AMA Printed Name
My co mission expvWu �;q C> — -7��
Ujo tCNTY
YR. Area Code Daytime Telephone Number
o ary u rc
CARLISLE BORO;,CUMBERLANOMy Commission rWf9rRM9n • Bureau of Commissions, Elections and Legislation
UUJ or ing • Harrisburg, PA 17120-0029 • (717) 787-5280
DSEB-502 17-99)
SCHEDULE I PAGE 2 OF
CONTRIBUTIONS AND RECEIPTS
Detailed Summary Page
Name of Filing Committee or Candidate Reporting Period
r �Ji^ From�2 ��� Y' {_ To "l
.,iLVzC �.! r ' moi b� U_
E
UNITEMIZED CONTRIBUTIONS AND RECEIPTS - $50.00 OR LESS PER CONTRIBUTOR
TOTAL for the Reporting Period (1) $ ( (,
2. CONTRIBUTIONS $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) $ � �
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) $
TOTAL MONETARY CONTRIBUTIONS AND RECEIPTS DURING
THIS REPORTING PERIOD (add and enter amount totals from $ l,
Boxes 1 , 2, 3 and 4; also enter this amount on Page 1 , Report
Cover Page, Item B. )
DSEB-502 17-99)
PART A PAGE OF
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/Candidate Reporting Period _
9C5 P6 51�(r �1 I I Zr� S of �SIVC�Z �a�14�I C From 3C 1� To2 ,i
DATE AMOUNT
Full Name of Contributing Committee Mo. DAY YEAR
Hbul )U',u�6R� r » C . 1. of 1 ^-(Ll �;li" ,.,z•_ �,Y ' Oi $ Z �i
Mailing Address MO. DAY YEAR
City State Zip Code Plus 4 MO. DAY YEAR
i1t11�1Z�s���•'�C - $
Full Name of Contributing Committee MD. DAY YEAR
Mailing Address MO, DAY YEAR
$
City State Zip Code lPll 4 MO. DAY YEAR
$
Full Name of Contributing Committee MO. DAY YEAR
$
Mailing Address M . 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
$
Full Name of Contributing Committee Mo. DAY YEAR $
Maung 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 1, Detailed Summary Page, Section 2. $ ,
DSES-502 (7-99)
PAGE OF
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.
Name of Filing Committee or CandidateReporting Period
�'Si b�,,�.• • Gl l l :Pi (5r Sn-=i`(Z- (7DV?i W 6/ From' 2( ' To
DATE AMOUNT
Full Name of Contributin Committee MO. DAY YEAR q
9 ')'`.l C S-�
'I k' :11 (r "�IS'l3V'' Ca "w�.l - Oti e' f ,%` .; 4 .2 = '- $
Mailing Address MO. DAY YEAR
L ELL,1-4 �R yVV -Sv o c i $
City State Zip Code Plus 4 M0. DAY YEAR
Full Name of Contributing Committee MO. DAY YEAR
$
Mailing Address MO. DAY YEAR $
City State ip Code Plus MO. DAV YEAR
$
Full Name of Contributing Committee MO. DAY YEAR $
Mailing Address M0. DAY YEAR
$
City State Zip Code Plus 4 MO. DAY YEAR
Full Name of Contributing Committee M0. 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 lPlus 4r MO. DAY YEAR
Full Name of Contributing Committee 44) M0.
DAY YEAR $
Mailing Address DAY YEAR
$
City State LZipCode DAY YEAR $Full Name of Contributing Committee 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 iPlus 4 MO. DAY I YEAR
$
PAGE TOTAL
Enter Grand Total of Part C on Schedule I, Detailed Summary Page, Section 3. $
DSEB-502 (7-99)
� SCHEDULE III PAGE OF
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
t i 6)vStj r cIn 2l A a (3� �(IVC� : RANG) From tl2_— To 2C�1
To Wnom Paid Mo. DAv' ".YEAft mount
Ki w 1�� �i-ii.l Lac cw
Mailing Address Description of Expenditure
VA;-iiia� -
City State Zip Code (Plus 4)
To Whom Paid S- MO. DAY 'YEAR mount
�L�E� LL a X015
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
TES�1l l c �A 1c( j�C- -f rpt rA Gf1f US
To Whom Paid r' Mo. :DAV .YEAR.--' mount
Mailing Address Description of Expenditure
City State Zip Code (Plus 61
To Whom Paid MO. "DAY ` YEAp" mount
Mailing Address Description of Expenditure
City State Zip Code (Plus 41
To Whom Paid MD. -DAY YEARmount
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 Lode (Plus 4)
To Whom Paid '.'Mo.. -DAYYEAR mount
Mailing Address Description oS Expenditure
City State Zip Code (Plus 4)
To Whom Paid :-MO. f:DAY YE 9RJ mount
Mailing Address Description of Expenditure
City State F=I
PAGE TOTAL
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D. $ w�-
DSES-502 (7-99)