HomeMy WebLinkAboutFriends of Robin Guido - 2015 30-Day Post Election lulllnll ' Reset Form -Print Form
IAI IIIA Commonwealth of Pennsylvania-Campaign Finance Report
(Nate:This report must be clear and legible.It should be typed)
Filer Identification Report Filed By Candidate . Committeelobbyist
Number (Mark)f)
Name of Filing Committee,Candidate or ,/
Lobbyist Frf 2►td4 bpv"
Street Address 52 5 . 't 7V�--
Ciry State Zip Code I D/
Type of Report(Place x under report type)
1-6" Tuesday Z- 2n°Friday 3.30 Day Post 4 6th Tuesday 5-Z"°Friday 6-30 Day Post 7-Annual Special 2 Friday Special 30 Day
Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election
Date Of Election // Year L Amendment Termination-
(MM/DD/YYYY) /n3 I 2�IJ . Report Report ❑
Summary of Receipts and From Date To Date For Office Use Only
Expenditures
A.Amount Brought Forward From Last Report $ 1
B.Total Monetary Contributions and Receipts $ /
eA N
(From Schedule l)
C.Total Funds Available $ m
(Sum of tines A and B) I,7 3. zg in o
D.Total Expenditures $ ^7 -.=
r— N
(From Schedule III) 49
_y>
E.Ending Cash Balance $ p
(Subtract Line D from Line C) y03 •b
-D
F.Value of In-Kind Contributions Received $ O 3
(From Schedule ll) C fV
O
G.Unpaid Debts and Obligations $ J
(From Schedule IV) yl
Affidavit Section
Part 1-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,Is to the best of my knowledge and Wief true,correct and complete.
Sworn t d subscribe before mee(,,t�h�is'�
dayof. III '20
5 r fr on S, raittj_rlg %S�
L A f I rn_,nr,h]o_ +
6 cJG
cowamftmoF NNSYIVANIA Print d Name
M ommission eoo�OTARIAL SEAL
Nota uolic AY YR. Area Code Daytime Telephone Number
Pa II-IftM 160dA'NMI zed mmittee,candidate shall sign here.
Ills ballet this political commIttee has not violet any provisions of the Act of June 3,1937(P.L 1333,NO.320)as
amended.
Sworn to and subscribed before me this
QN day of
natyre of didat
Slgnaturk /J Printed Name
COUMIONKIEAITN Of P61110MANIA _�
M ommissio �yy
iFf
BETNAI ALZAfl �0 YR. Area Daytime Telephone Number
Notary Public
CARLI$
My Commission Expires Oct 7.-20'17
SCHEDULE
Contributions and Receipts
Detailed Summary Page
Filer Identification Number
1.Unitemized Contributions and Receipts-$50.00 or Less per Contributor
Total for the reporting period (1)2. $
S �
Contributions o $S0.01 to From
Part A and Part B)
Contributions Received from Political Committees(Part A) $
All Other Contributions(Part B) $ ,m
vv•
Total for the reporting period (2) $
3.Contributions Over$250.00(From Part C and Part D)
Contributions Received from Political Committees(Part C) $
All Other Contributions(Part D) $
Total for the reporting period (3) $
4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E)
Total for the reporting period (4) $
Total Monetary Contributions and Receipts during this reporting period(Add and $
enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report
Cover Page,Item B)
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PART A
Contributions Received From Political Committees
$50.01 TO$250.00
Use this Part to itemize only contributions received from Political Committees
with an aggregate value from$50.01 TO$250.00 in the reporting period.
Filer Identiflution Number
Amount
Full Name of Contributing Date[MM/DD/YYYY] $
Committee
JC,ouse#
�StreetAddress Date[MM/DD/YYYY] $
State Zip Code Date[MM/DD/YYYY] $
Full Name of Contributing Date[MM/DD/YYYY] $
Committee
House q Street Address Date[MM/DD/YYYY] $
Qty State Zip Code Date[MM/DD/YYYY]
Full Name of Contributing Date[MM/DD/YYYY] $
Committee
jHou,e# Street Address Date[MM/DD/YYYY] $
State Zip Code Date[MM/DD/YYYY]
Full Name of Contributing Date[MM/DD/YYYY] $
Committee
L
eStreet AddresDate[MM/DD/YYYY] $
State Zip Code - Date[MM/DD/YYYY] $
Full Name of Contributing Date[MM/DD/YYYY] $
Committee
House N Street Address Date[MM/DD/YYYY] $
Qty State Zip Code Date[MM/DD/YYYY] $
Full Name of Contributing . Date[MM/DD/YYYY] S
Committee
House N Street Address Date[MM/DD/YYYY] $
Qty State Zip Code Date[MM/DD/YYYY] $
PART B
All Other Contributions
$50.01 TO$250
Use this Part to itemize all other contributions with an aggregate value from
$50.01 TO$250 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Filer Identification Number:
Full Name of Contributor Date[MM/DD/YYYY] $
House# Street Address Date[MM/DD/YYYY]_ $
D � �iee
city State Zip Code Date[MM/DD/YYYY]- $
r 17013 70/3
Full Name of ContributeIDate[MM/DD/YYYY] $
House# Street Address [Date[MM/DD $
I
Qty State FZip Code - Date-IMM/61) I— $
i
Full Name of Contributor L,Date[MM/DD/YYYY] $
I
House# Street Address Date(MM/DD/Y" $
I
I
Qty State iZip Code - Date[MM/DD/YYYY]- $
Full Name of Contributor Date[MM/DD/YYYY] $
I
House# Street Addres Date[MMD $
I I
I
Qty State Zip Code Date[MM/DD/YYYY]- $
I
Full Name of Contributor Date[MM/DD/YYYY] $
I �
House# Street Address ate[MM/DD/YYYY] $
� I I
Q [Zip Code I Date[MM/DD/YYYY]- $
I
Full Name of Contributor ; Date[MM/DD/YYYY]_ $
jouse,1 Street Address Date[MM/DD/YYYY] $
State -Zip Code Date[MM/DD/YYYY] . $
SCHEDULE III
Statement of Expenditures
Filer Identification Number.
To Whom Paid �. Date[MM/DD/yYYYj $ I
ZSY K
House# Street Address Descriptio of Expenditure - -
53 7 �Lc rvl M i�" VQ, i nn
City I e, �f �/� State (�. Mode '7013 /CQd wgA4 " S40m —MLu lif
To Whom Paid ' 1 i Date[MM/DD/YYYYI 1 $
House# treet Address' I Description of Expenditure
I
city I!.-
State I F Zip
Code
To Whom Paid I_Date[MM/DD/YYPYj_ $
House# street Address Dewrlptionof Expenditure
City State Zip
Code
To Whom Paid I Date[MM/DD/YYYYj 11
$
House# Street Addressl)esaiptfon of Expenditure
City state Zip
Code
To Whom Paid Date IMM/DD/MM $
I
House# Street Address 1 Description of Expenditure - -- -
City i State Zip--
Code
To Whom Paid I Date[MM/DD/Y" $
i
House# Description of Expenditure
City State 1 Zip
Code
To Whom Paid Date[MM/DD/YYYY] $
House# Street Address Description of Expenditure
City -3i4
te C�Zo
Code
To Whom Paid I Date IMM/DD/TM]_ $
House# Street Address Description of Expenditure
City StateZe-
INSTRUCTIONS FOR FILING THE CAMPAIGN FINANCE STATEMENT
I. You may file this statement in lieu of a full report when the amount of contributions(including in-kind contributions)
received,the amount of money expended and the liabilities incurred each did not exceed$250.00 during the reporting
period.
2. File this statement in the office where the nomination petitions,nomination certificate or nomination papers of the
candidate(s)supported were filed.
3. A candidate must file a statement or report that is separate from one filed by herlhis authorized committee.
4. Each statement shall be subscribed and sworn to by the candidate(if it is the candidate's personal report)or the
treasurer of the political committee,acknowledging the accuracy of the report. In addition,those reports filed on
behalf of a candidate's political committee,authorized by a candidate and created solely for the purpose of influencing
an election on behalf of that candidate,shall be subscribed and sworn to by that candidate.
5. Reports must be filed according to the following schedule. For specific dates,consult the Election Calendar.
Fust report deadline: Sixth Tuesday Pre-Primary. Reporting period closes 50 days prior to the election-
Cycle I (Required only by statewide candidates on the ballot and political committees supporting
statewide candidates.)
Second report deadline: Second Friday Pre-Primary. Reporting period closes 15 days prior to the election.
Cycle 2 (Required by all candidates on the ballot and committees supporting such candidates.)
Third report deadline: 30 days Post-Primary. Reporting period closes 20 days after the election.
Cycle 3 (Required by all candidates on the ballot and committees supporting such candidates.)
Fourth report deadline: 6°i Tuesday Pre-Election. Reporting period closes 50 days prior to the election.
Cycle 4 (Required only by statewide candidates on the ballot and political committees supporting
statewide candidates.)
Fifth report deadline: Zed Friday Pre-Election. Reporting period closes 15 days prior to the election.
Cycle 5 (Required by all candidates on the ballot and committees supporting such candidates.)
Sixth report deadline: 30 days Post-Election. Reporting period closes 20 days after the election.
Cycle 6 (Required by all candidates on the ballot and committees supporting such candidates.)
Annual report deadline: January 31'of the following year. Statement must be complete as of December 31.
Cycle 7
6. Political committees that are required to file pre-election reports are also required to file at all subsequent reporting
deadlines for that election.
7. Retain copies of all records for a period of 3 years. Although no detailed campaign expense report is filed,you are
required to keep a record of the names and addresses of each person from whom a contribution of over$10.00 has
been received and a record of all other information required to be reported pursuant to the Campaign Expense
Reporting Law.
LATE FILING PENALTY
A penalty of$10.00 for each day or part of the day(excluding Saturdays,Sundays and holidays)that the statement is overdue,
plus an additional fee of$10.00 for each of the first six days that a statement is overdue,will be assessed.
In addition,any candidate or treasurer of a political committee,or person acting as such treasurer,who shall fail to file an
account of primary or election expenses,as required by the Law,shall be guilty of a misdemeanor and,upon conviction
thereof,shall be sentenced to pay a fine not exceeding$5,000(five thousand dollars)or to undergo an imprisonment of not less
than one(1)month nor more than two(2)years,or both,in the discretion of the court.
Further penalties are provided by law.
Postmarks are acceptable asRroof of timely filing where report is sent by first class mail and postmarked by the United States
Postal Service,no later than the day prior to the filing deadline