HomeMy WebLinkAboutThomas, John - 2015 30-Day Post 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 IOENTIRCATIOM REPORT FLED ' CANDIDATE m
CONMEE LOBBYIST �.
NUMBER m BEHALF OF
NAME OF FILING COMMRTEE,CANDIDATE OR LOBBYIST
STREET ADDRESS
A 0 7
COY STATE ZIP CODE
N/FC N All C A l 7Dfp
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE TDISTRTCTNO. PARTY(CHECK ONE) TO t.•WI✓S H�/1 CD/✓/l7/S S /O/✓�� M0., DAY YEAR
LITH TUESDAY 1. / AS 7E - N H CFI7LE l 5
PRE-PRIMARY FOR OFFICE USE ONLY
M.O. DAY YEAR MD. DAY YFJJI
2ND FRIDAY 2' DATES OF
PPE-PRIMARY REPORTING TO
PERIOD /O O OJ- �Ia3 DLJ
30 DAY 3.
POST-PRIMARY C C
CASH BALANCE AT END � CD
6TH TUESDAY A' OF REPORTING PERIOD: $ _m rrl
PRE-ELECTION l7
TOTAL AMOUNT OF FILER'S A
2No FRIDAY s' OUTSTANDING DEBTS OR LIABILITIES
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ y
C') 3
e. O
30 DAY / AMENDMENTC
POST-ELECTION REPORT? YES NO vl� w
7.
ANNUAL TERMINATION
REPORT REPORT? YES :i
NO ✓
AFFIDAVIT SECTION
S If stat nt is filed on behalf of a Political Committee orCandidates's Committee,the Treasurer must sign here.
d' If Rid nt is filed on behalf of a Candidate,the Candidate must sign here.
If nt is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
Z
Z l AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
LM q HUNDRED AND FIFTY DOLLARS(S250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND COMPLETE.
O q g X�
mN TO AND SU SCRIBED BEFORE ME THIS
J Z� 3 C a DAY F 20_15� -SIGNATURE OF PERSON SUBMITTING REPORT
E Jel/Nn/ V 71�Ow7A_S
£ q rA�TURE ''7 PRINTED NAME
AT MM SI PIRES �1� i7� �� 7 ) 7
F MO. DAY M. AREA CODE DAYTIME TELEPHONE NUMBER
E
PARTII-
If statement is filed on behalf of a Candidate's Authorized Committee,Candidate must sign here.
1 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 M0. DAY AREA CODE DAYTIME TELEPHONE NUMBER
YR.
Department of State • Bureau of Commissions,Elections and Legislation
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 111 (717)787-5280