HomeMy WebLinkAboutDay, Susan - 2015 2nd Friday Pre-Election 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 Identification , Report , CANDIDATE 1 COMMITTEE 2 LOBBYIST 3
Number: Filed By
Name of Filin mmittee, Canditlate r Lobb ist:
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Street Address:
s H-. �
City: State: Zip Co
Y� (% 3a -
TYPE OF STH TUESDAY 1. 2ND FRIDAY 2. 30 PAY 3. AMENDMENT YES NO
REPORT PRE-PRIMARY PRE-PRIMARY POST PRIMARY REPORT?
STH TUESDAY a' 2ND FRIDAY 30 DAV 0' TERMINATION YES NO
(place X t0 PRE-ELECTION PRE-ELECTION i POST ELECTION REPORT]
the right of ANNUAL 7. YEAR FILING METHOD
report type) REPORT { ) CHECK ONE ® PAPER DISKETTE
Name of Office Sought by Candidate: s a a District Office Party I County
Number Code Code Code
/�/�/f/�J1��1q /' / p �/` /1 f / MO. (DAY YEAR
/ IaG(S / ( 1 J t( ' /l LJ L r� (SEE INSTRUCTIONS FOR CODES)
FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY . YEAR
Summary of Receipts � <
and Expenditures from: To ld c a
A. Amount Brought Forward From Last Report $ cn
403 O
B. Total Monetary Contributions and Receipts (From Schedule 1) $ C'1:1
4 C'2
75 —i
IV
C. Total Funds Available (Sum of Lines A and B) $ Dt tV
r_
D. Total Expenditures (From Schedule III) $ LD Z
E. Ending Cash Balance (Subtract Line D from Line C) $ C pp
F. Value of In-Kind Contributions Received (From Schedule 10 $ Cn
CD
G. Unpaid Debts and Obligations (From Schedule IV) $ a
AFFIDAVIT a
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, including the attached schedules, on paper or comput 'skette, are to the best of my nowledge a d belief true,
correct and complete.
Sworn t a ubscribed before me this
c � ''L✓`
r day of 20 1�-J
_�d t Signature of Pe on S b it i eport n
COMMONj rt
;M�� ZjjDAY
r _ Print Na0e
BE —r`--�/�—
My ommission ex
VR. Area Cotle Daytime T¢lephone Numb¢r
PART II -Mf QPRS' 's Authorized Committee, candidate shall sign here.
I swear lot 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
day of 20
Signature of Candidate
Signature Printed Name
My commission expires
M0. DAV 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)