HomeMy WebLinkAboutFreed, David - 2015 2nd Friday Pre-Election COMMONWEALTH OF PENNSYLVANIA
CAMPAIGN FINANCE STATEMENT
File this in lieu of a full report only if aggregate receipts, expenditures, or
liabilities incurred each did not exceed $250.00 during the reporting period.
FILER IDENTIFICATION REPORT FILED CANDIDATE
NUMBER ON BEHALF OF COMMITTEE LOBBYIST
NAME OF FILING COMMITTEE, CANDIDATE OR LOBBYIST
D� 1
STREET ADDRESS
CITY STATE ZIP CODE
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY
(CHECK ONE) MO.F •OAT •YEAR
6TH TUESDAY
PRE-PRIMARY ❑ FOR OFFICE USE ONLY
MO. DAY YEAR MO. OAY YEAR
2ND FRIDAY
2 DATES OF
PRE-PRIMARY ❑ REPORTING �"1 Tg �„f TO lO 1p 201
PERIOD 1 l
30 a
3 ZD
POST-PRIMARY n b
CASH BALANCE AT END
6TH TUESDAY 4' OF REPORTING PERIOD: $
PRE-ELECTION C5
TOTAL AMOUNT OF FILER'S n
B. OUTSTANDING DEBTS OR LIABILITIES aa
2ND FRIDAY V
PRE-ELECTION AT THE ENO OF REPORTING PERIOD: $
s. a�
30 DAY C y�
POST-ELECTION ❑ REPOFIT A END NT YES "NO
7. CANNUAL TERMINATION VES REPORT REPORTS rV
SECTIONAFFIDAVIT
PART I-
If statement is filed on behalf of a Political Committee orCandidates's Committee, the Treasurer must sign here.
If statement is filed on behalf of a Candidate,the Candidate must sign here.
If statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
I SWEAR (OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS ($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
DAY OF V Vf 20 SIGNATURE OF PERSON SUBMITTING REPORT
4�GtGt CSI. n� : d TEC
PRINTED NAME
COMMOWWEai TLt OF 1
MY COMMISS%jX RRJ CEAL I v lYC/� T, 2Z.c�
Sonia E.M,e. s Notaj;%bltc AY YR. AREA CODE DAYTIME TELEPHONE NUMBER
Carlisle Boa Raberland County
PART Il MyoiaQiisp,, Pres Jul 31 016
If State date's Authorized Committee, Candidate must 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(RL. 1333, No. 320)AS AMENDED.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
SIGNATURE OF CANDIDATE
DAY OF 20_
PRINTED NAME
SIGNATURE
MV COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR.
Department of State • Bureau of Commissions,Elections and Legislation
DSEB-503 (12-99) 303 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280