HomeMy WebLinkAboutNegley, Marlin - 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
NUMBER
ON BEHALF OF ' CANDIDATE COMMITTEE LORRYIST
NAME OF FILING OOMM r CANORI OR LORB
A,l /�
STREET ADDRESS r/
ZI
N
Al `�oU /DD>�� ��
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY I
(CHECK ONE) " M0. DAY YEAR
6TH TUESDAY 1.
PRE-PRIMARY FOR OFFICE.USE:ONLY
MO.' DAY "YEAR MO. DAY YFAR
TND FRIDAY 2' DATER
REPORTING `_ Q /L� To /
PRE•PmMARY PERIOD III
V
30 DAY 3. O
POST-PRIMARY .m• Gn
CASH BALANCE AT END
6TH.TUESDAY 4' OF REPORTING PERIOD: $ O on n
PRE-ELECTION
TOTAL AMOUNT OF FILER'S Iv
2ND FRIDAY. s_ OUTSTANDING DEBTS OR LIABILITIES
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ O i -•p
6. 0
30 DAV AMENDMENT • C iV
POST-ELECTION YES NO r1
' REPORT?
W
ANNUAL TERMINATION �(
REPORT REPORT? YES NO 1
AFFIDAVIT SECTION
PART I-
If statement is filed on behalf of a Political Committee or Candidates'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
44N �r 20 - 6NATU E��N S MDTn EPO
RT
DAV OF _
(/�•, �'G� Al L J IV /lie v le y
eAL Li LI/ l 17 6 /1' NA � ,^
MY COMM[ SION EXPIRES ORRIS 7 7(O - 3 %,'17
Not"PBMIC DAY COUNTY YR. AREA LODE DAYTIME TELEPHONE NUMBER
PART II - MY Commission Ealtiva Jan 14,2015
If statement is filed on behalf of a Candidate'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(P.L. 1333,No.320)AS AMENDED.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
SIGNATURE OF CANDIDATE
DAY OF 20_
PRINTED NAME
SIGNATURE
MY COMMISSION EXPIRES MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
DSEB-503(12-99)