HomeMy WebLinkAboutResponsible Citizens for SIlver Spring - 2015 30-Day Post-Primary 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 LOBBYIST 3
Number. Filed By. ► i�(
Name of Filing Committee, Candidate or Lobbyi ('�
S SI LC ITTZ�st: �flVe�L 5 '1106
Street Address:
I-7 ?HCASAwr ST
City: State: Zip Code:
f� C+�AN(G53 0-1 1 loSct - 3i LtS
TYPE OF 6TH TUESDAY 1. 2ND FRIDAY 2. 30 DAY 3. AMENDMENT YES NO
REPORT PRE-PRIMARY PREPRIMARY POST PRIMARY X REPORT? X
6TH TUESDAY 4' 2ND FRIDAY 5' 30 DAY 6' TERMINATION
PRE-ELECTION PREELECTION PAST ELECTION REPORT? YES NO
(place X to
the right of ANNUAL 7. YEAR FILING METHOD
report type) REPORT I 1 CHECK ONE ` PAPER X DISKETTE
Name of Office Sought by Candidate:
�I ("� Ut t,F1V� aY YAR•
District Office Party County
MODNumber Code Code Code
��S'�(r
((�
6 5 i-1 �(-' I ?SEESEE INSTRUCTIONS FOR CODES)
FOR OFFICE USE ONLY
MO. DAY YEAR . MO. DAY -.YEAR
Summary of Receipts ► bSV5 2615 To �a G$ 2G1�
and Expenditures from:
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) S
D. Total Expenditures (From Schedule 111) $ 3
E. Ending Cash Balance (Subtract Line D from Line C) $ CJ
F. Value of In-Kind Contributions Received (From Schedule 10 S
G. Unpaid Debts and Obligations (From Schedule IV) $
MENOMINEE
AFFIDAVIT a
PART I - If this is a Cpmmitte - If.this is a Candidate report, candidate.sign .here.
I swear (or affirm) that this report, including the aNftlid lSediedules, on paper or computer diskette, are to the best of my knowledge and belief true,
correct and complete. Marissa Hlester,Notary Public
Sworn to and subscribed before
Silver Spring Twp. Cumberland County
m thi�,Commission Expires Feb.5 20 7
day of t Lwo
MEMBER,PENNSYLVM'IA ASSOCI.A�N OT�olr /A
Signature of Par on SSuurb`miit-ttiing Report
rvl�
Signature *-•I �I Printed Name
My commission expires &b 217 {I f Z'�I—T 3 Q
Mo. DAY YR. Area Code Daytime Telephone Number
PART II - If this is a report of , candidate shall sign here.
I swear for affirm) that to the best of my knomNig 19( is hi rp�I�tical c lmmittee has not violated any provisions of the Act of June 3, 1937
(P.L. 1333, No. 3: as amended. Silver Spring Twp.,Cumberland County
Sworn to and subscribed before met is My Commission Expires Feb.5,2017
MEMBER,PENNSYLVANIA ASSOCIA OF RIE.
day of _ 20= /
(� Signatur of Ca dila 7�
I �f'-L'� (tlatl'nl.� �t58E1�) J �1TBvl'O
�
tura Printetl Name
My commission expires TZ �Aa
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 III PAGE OF
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
1SS
Q� ���XJe, G l) c6NS From CYC- 1b ToOC>-C16' z615—
To Whom Paitl MO. ' DAY YEAR mount
Mailing Address Description of Expenditure
Io O US PlrC— INS
City State Zip Code (Plus 41
�Ct1A CS`d�RG ?q
To Whom Paitl iMO. iDA Y YEAR I Amount
��5 os zas
Mailing Address Description of Expenditure
X650 LkSLL LVE
City State Zip Code (Plus 4)
MC \CS(3CS�Ca i 'IbSD -
To Whom Paitl 1MO. DAY YEAR mount
t 2 06
Mailing Address Description of Expenditure
1460 cfae - 'dLVD w f* V I u
CityState Zip Code (Plus 4)
i IaSU- @ -SH CeT2
To Whom Paid MO. rr=DAY I YEAR mOunt
'.
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid -MO. I DAY I YEAR.:". 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. dDAY , (YEAR . mount
Mailing Address Description of Expenditure
City State Zip Code (Plus 4)
To Whom Paid MD.: DAY. YEAR Amount
Mailing Address Description of ......iture
City State Zip Code (Plus 4)
PAGE TOTAL
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D. $ 3$ 6O
DSES-502 (7-99)