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Commonwealth of Pennsylvania-Campaign Finance Report
(Note:This report must be clear and legible.It should be typed)
Filer Identification qq 19 Report Filed By Candidate Committee Lobbyist
Number ac f (Mark X)
Name of Filing Committee,Candidate or t I
Lobbyist •e{��1^a Cu m berigo d N�OCYa7 5
Street Addressq,y r �r
6 Gn /e
city k I ecka' 1 t es b cr I– State Ip,4 Zip Code
Type of Report(Place x under report type) /
1-6' Tuesday 2- 2n Friday 3-30 Day Post 4 6'a Tuesday 5-2"d 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
El
Date Of ElectionYear Amendment Termination
(MM/DD/YYYY) 11 l7 3 C20If Report Report ❑
Summary of Receipts and From Date To Date _ For Office Use Only -
Expenditures
101111155- fa 31115-
A.
/SA.Amount Brought Forward From Last Report $
B.Total Monetary Contributions and Receipts $
(From Schedule 1) C
C.Total Funds Available $ o rn
(Sum of Lines A and B) c•-
z7 x`
D.Total Expenditures $ :;u :r
(From Schedule III) 0 F" —
E.Ending Cash Balance $ .�
tD
(Subtract Line D from Line C) q 95%76
F.Value of In-Kind Contributions Received $
(From Schedule 11) G
G.Unpaid Debts and Obligations- $ "...{{
(From Schedule IV) –G 'v
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 belief true,correct and complete. _
Swo t and subscribed before me this
day of 20 - `?r �r/WL. /T/ r'J/L'�✓� ""_
�3Si nature of Person 5y b"mitting/eport
gr�iara A/ / /2r /oarYl
Printed Name
NOT IAL SEAL 0 �1
My ommission e,�MANY SALZARULO (7/ 7 �09�r` �C L' 7
Nolft_Irblle DAY YR. Area Code Daytime Telephone Number
CARLISLE BORO:.CUMBERLAND CNTY
PartI-If th s a mitt",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
amended.
Sworn to and subscribed before me this
day of 20
Signature of Candidate
Signature Printed Name
My Commission expires
M0. DAY YR. Area Code Daytime Telephone Number