HomeMy WebLinkAboutDawber, Richard - 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.
FlLER NEMIFICATION REPORT FILED CANDIDATE. I COMNRTEE. LOBBYIST J,
NUMBER ON BEHALF OF ,
NAME OF RUNG COMMITTEE,CAN DATE OR LOBBYIST n
5 ADDRESS
CITY / STATE � ZIP COOO�D
TYPE OF REPORT NAME OF OFFlCE SOUGH BY CANDIDATE DIS RICT NO. PA TYP
F
(CHECK ONE) �'� I /'l S��'n C MO. DAY YEAR..
6n+TuesOnr 1' O'' v ` � „/ �l Q•.7� dD%
PRE-PRIMARY FOR OFFICE USE:ONLY
MO. DAY YEAR MO. DAV YEAR.
2ND FRIDAY 2' DATES OF rt _
PRE-PRIMARY REPORTING `- v) /S TO
PERIOD
30 DAY 3.
POST-PRIMARY : C
CASH BALANCE AT END
6TH TUESDAY 4' OF REPORTING PERIOD: $ Cu CTT
Q
PRE-ELECTION rr3
TOTAL AMOUNT OF FILER'S
2ND FRIDAY 5. OUTSTANDING DEBTS OR LIABILITIES r
.PRE-ELECTION AT THE END OF REPORTING PERIOD: $
30 DAY
6.
POST-ELECTION AMENDMENT ',. YES NO
REPORT? G' 1V
ANNUAL TERMINATION
REPORT REPORT?. YES NO -< Co
AFFIDAVIT •
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.
SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCU REPORTING P R D INDIC TED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BES F MY KNOWLE AND EF RUE,CORRE AND COMPLETE.
SWORNi TO AND SUBSCRIBED BEFORE ME THIS//
DAY OF `��� � 20SIGNATURE OF PERSON SUBMITTING REPORT
�y�Jpc` 7 PRINTED NAME
Y COMMISSION
7HWLS M. �
/7// /�� 5 3��
Notary Public
DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
C1INLISLE 6
PART I - My Commission Expires Oct T,2017
If state a andidate'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) ,y