HomeMy WebLinkAboutDay, Susan - 2015 30-Day Post Election Commonwealth of Pennsylvania
PAGE 1 OF
3- CAMPAIGN FINANCE REPORT (COVER PAGE)
(NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.)
[of
dentification ► Report 01111,
1. 2. - 3.
r: Filed By. CANDIDATE COMMITTEE LOBBYIST
Filing Com ' ffe, Candidate or Lobbyist:
U /
ddress: _
34S
f0 r _ State: lip Code: ^ /
PE OF STH TUESDAY 1. 2ND FRIDAY 2. 30 DAY 3. AMIENNDMMENTNTJJ(7/ YES NO X
PORT PRE-PRIMARY PRE-PRIMARY_ POST PRIMARY REPORT? .
STH TUESDAY a. 2ND FRIDAY 5. 30 DAY S' TERMINATION
PRE-ELECTION PRE-ELECTION POST ELECTION REPORT? YES NO
(place X to - -
right of ANNUAL 7. YEAR FILING METHOD
ort type) REPORT ( ) CHECK ONE , PAPER DISKETTE
f Off ie¢ Sought by Candidate: r a a Distriof Office PartyCounty
Number Code Cod. Code
� ,/` /'�/ / MO. DAY YEAR
` ra l�r� VW H �3 ISEE INSTRUCTIONS FOR CODES)
FOR OFFICE USE ONLY.ary of Receipts MO. DAV YEAR MO. DAV YEAR
and Expenditures from: , 1/0 3 To GI � � n
c o
A. Amount Brought Forward From Last Report $ m �'
CO t�
B. Total Monetary Contributions and Receipts (From Schedule 0 $ m n
7D
C. Total Funds Available (Sum of Lines A and B) $ I
L N
D. Total Expenditures (From Schedule III) $ 3�
LGUnpaid
nding Cash Balance (Subtract Line D from Line C) $ O pp
C
F
E
—Kind Contributions Received (From Schedule IO $ N
ts and Obligations (From Schedule IV) S
AFFIDAVIT
PART I — If this is a Committee report treasurer sign here. If this is a Candidate report candidate sign here. '
I swear lot affirm) that this report, including the attached schedules, on paper or ca pate diskette, ere to the best of my know dge and belief true,
correct and complete.
Sworn to and subscribed before me this /
day of /� e, (�j�t� 20 �J
Signature o son S ' ting Report
CIS - r�vi4� A cf . Su a
CO TIIOFP IRMANY Printed e
My commission expir s NOTARU SEAL, 9—
MO. ic YR. Area Code Daytime Telephone Number
PART 11 — If this is re 4g®IR11s ize Committee, candidate shall 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 emended.
Sworn to and subscribed before me this
day of 20
Signature of Candidate
Signature Printed Name
My commission expires
MO. DAV V0.. Arca Code Daytime Telephone Number
Department of State • Bureau of Commissions, Elections and Legislation l n
303 North Office Building • Harrisburg, PA 17120-0029 • 1717) 787-5280 `_�\1(ty�
DSEB-502 (7-99) `�