HomeMy WebLinkAboutGembusia for State Representative - 2015 Annual Report Commonwealth of Pennsylvania lluu � ul'�wlll�ull� �lu
Campaign Finance Statement 153556
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 IDENTIFICATION NUMBER: 20140082 REPORT FILED ON BEHALF OF: Committee
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST GEMBUSIA FOR STATE REPRESENTATIVE
STREET ADDRESS PO BOX 1
CITY MOUNT HOLLY SPRINGS STATE PA ZIP CODE 17065
TYPE OF REPORT Annual
NAME OF OFFICE SOUGHT BY CANDIDATE REPRESENTATIVE IN THE GENERAL
ASSEMBLY
DISTRICT CODE Statewide PARTY CODE REP
DATE OF ELECTION 11/4/2014 C o
DATES OF REPORTING PERIOD 1/1/2014 TO 12/31/2015 For O(Jae Us'p',Only
f'47- .r'TT•
AMENDMENT REPORT? NO TERMINATION REPORT? NO W
� 1
CASH BALANCE AT THE END OF REPORTING 412.73
PERIOD:
TOTAL AMOUNT OF FILER'S OUTSTANDING 0.00 C f V
DEBTS OR LIABILITIES AT THE END OF C
REPORTING PERIOD: Cil
AFFIDAVIT a
PART I-
If statement is filed on behalf of a Political Committee or Candidate'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.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID
NOT EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BE Cf 0 LE G�EELIEF,TRUE,CORRECT AND COMPLETE.
SWORN T9 AND SUBSCRIBED BEFORE ME THIS
day of 20 V-
SIGNATURE
�2 PER(S�'7N4SUpB�M�ITTING REPORT
19 1LTH i@IM PRINTED NAME
NOTARIAL SEAL �7 . �Q I, fop
MYC MMISID E'PBESHANY$ALZ DA
NDlary Public YR. AREA CODE DAYTIME TELEPHONE NUMBER
CARLISLE Br)Rn
PAR - Y ommission Expires Oct 7,2 17
If statemen is i Auth rized 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 T.DD,4pD SUBSCRIBED BEFORE ME THIS
-/�- " z r)a�zf�zcl
day ofT� 20 1
jQ, ecNATURE OF PERS.0 SUBM NGREPOR3
SIGNATURE / PRINTED NAME
COMMONWEALTH OF PENNSYLVANIA - 37
COMMISION EXPW RIAL SEAL M0. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
BETHANY SALZARULO
CARLIB►EIROBliluA MBIRbWONNildau ol Commissions,Elections and Legislation 2/1/2016 10:57:29 AM
My CdhUl1lbW011E4WmeOBURflIMA7.Harr sburg,PA 17120-0020. (717)787-5280