HomeMy WebLinkAboutTravis, Michael Scott - 2016 6th Tuesday Pre-Primary • I
Commonwealth of Pennsylvania-Campaign Finance Report
(Note: This report must be clear and legible. It should be typed)
Filer Identification Report Filed By Candidate ❑ Committee T IF L _
Number 2016 C0572 ( e,
Number x � A+ k ni i
Name of Filing Committee,Candidate or
Lobbyist Michael Scott Travis
- _
Street Address 3904 Trindle Road
city - Camp" Rill State I PAZip Code" -
rk}r, 17011
Type o1 Report(Place x under report type)
t.Bin Tuesday 2- 2'd Fridayj 3.30 Day Post 4-6'h Tuesday 5-211 Friday 6-30 Day Post 7•Annual ' ',,Special 2 :=F d y "Sp�i,a,l .1f _
Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre Election. ,p s,El
pipit.
Date Of Election Year w
i
.:; erf,Pi,a[IfY
(h1M/DD/YYYY) ) 11 /8/16 2016 sRepoI iii -
rf ❑
Summary of Receipts and From Date To DateFor OfficeUse'0 :I
Expenditures. s'�=- -
1 /24/16 3/7/16
A.Amount Brought Forward From Last Report 3
0.00
B.Total Monetary ContributionsandReceipts S . .,
(From Schedule I) 184.28 t
C.Total Funds Available - S
(Sum of Lines A and B) 84.28 w;`' ?
D.Total Expenditures S "•° - "`T
(From Schedule III) 184.28 ,
E.Ending Cash Balance
(Subtract Line D from Line C) ::i 0.00 _
F.Value of In-Kind Contributions Received S P'
(From Schedule II)
3 200 00
G.Unpaid Debts and Obligations
(From Schedule IV) 3,384.28 "j
Affidavit Section
Part 1-If tnis 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.
Sworn to and subscribed before me this -
day of - 20
Signature of Person Submitting report
COMMON LTH OF PEN _
SignatureNotarial Seal Printed Name -
Leslie A.Jones,Notary 731-9509
My Commission expires - Franklin Twp.,York C _
Mo. DAY YR My Commission Expires Feb.Zir:f19de Daytime Telephone Number -
MEMBER,GEN NSYI VANIA ASSOCIATION OF NOTARIES
Part II-If this is a report of a Candidate's Authorized 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( . .1333,N0.320)as
amended.
Sworn to and subscribed before me this `
i J
_ i I
dayof i 20
Signature of Candidate
` Mi,hast 4rvhtt TYAVia
Signature Printed Name "
My Commission expires 717 731-9509
M0. DAY YR. Area Code Daytime Telephone Number
COMMONWEALTH OF PENN6�'4,..
Notarial Seal
Leslie A.Jones, Notary Puhro
Franklin Twp.,York Count,
CommISSlon Expires Feb"2, &: : , I
MEMBER,PENNSYLVANIA ASS(N;tATION OF�O'pRIES
SCHEDULEI
Contributions and Receipts
Detailed Summary Pane
-:erre ravonnunecX
' 2016 C 072
1.0 Iemlzed Connhutions-and Receipts450.00 or Less per Cc-'•,.,_ter
_erlad (1 i 3
to t HO.Uj(ramIve`
-----,. s9eCehe, from ?Clltital Comm'tees '>a.". :. '13
I
=_I ="er Corannutions(Part 8) 3 184.28
i
?otal for. �e .___., -,;,-clod (2.+ S
T. .. .torsOvert 250.()0(From Part C and cart D;
Pclitic2i Con.- t tees
tPaC D)
I
Total for the ?,-clod (31 s
. . •Peselp's-Refunds,Interest Earned, Retumed C`ecl s EC. ,From Part E) a°-
..-Y.;?..rta.!
otal 'o't:'e re.,_„ _ oerjcd Id) 8
S'ee-'zry Centnoutiens and F.ereiots during this re?crtmng s_.._d !HGd and S
totals tram Boxes 1, 23 arc d;a;so en'ar, !his a7Pzoe i,Peocrl
-?a;e Item B) - 184.28
SCHEDULE11
IN-KIND CONTRIBUTIONS AND VALUABLE THINGS RECIEVED
USE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS DURING THE REPORTING PERIOD
DETAILED SUMMARY PAGE
fMUM
2016 C 0572
41: UNITEWZED,N-,INDCONTRIBUTIONSRECEIVED-VALUE OFI E0.000PLESS N1RIB UIOR--;; •r,xi �: ^,�wu.
..amu. ..,t..a,�s h.�r �rw<•w?�i..Ts "���k���p�.
TOTAL for the reporting period (1) 19 LL
2_�tN-KIND.CO,N
11
tOS�o00C(fP011 "'T i)
°>u `s' rt?cti:,v x.Y ...»r
TOTAL for the reporting period (2) 1
CONIRIBUTiONRECEIVED-VALU E.OVER:250 v0(FnOr1PkFT
wail.=`wY�rxe�iYst vs..vi aaukv'rn .`
TOTAL for the reporting period (3) 3,200.00
TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORT INC 8
PERIOD(Add and enter amount totals from boxes 1,2, and 3; also enter r 3 200.00
on Page 1,Report Cover Page,Item F} i
i
SCHEDULE II
Part G
In-Kind Contributions Received
VALUE OVER 3250
:Eller.ldentlf ca on: umber.
2016 C 0572
Full Name of Contra utoLet
Date(M M/DD/YYYY]��w aS
Travis Law office 3/7/16 a': 43,200.00
ouse 3904 KorQes Trindle Road Pate:INI W.P.PWWW'.a.£�
Camp Hill PA 17011
_ t.l
Employer ame Occupatiop`
Candidate / Principal A-N r attornev
Employer a 48A [os'TRcnc.pal Des0,nD tOltra} legal services valu
Place of6.Gilness same ?Co�'tfi uttQn ;, 1 /24-3/7/16
Full. ams of CIoadnbbtor ;Data'[ . /DD ]s '" " „
-;t
Ho se# traetAd'dtess Date(MM/DD/YYYY]
GtY $tyre- Zip Coe Date'[MM/DP( jji4
mp 0 er a Occupation �
�mployerMa n A dress"/'Pt ecipal -, Descppt ptl
Plage of flusiness
cogtrt2utiaD:"
Full Name.of Coll litor� ^1)ate]MM[DD/YYYY]?s.:! i*.
Houle `eat+Address s4ate. �,�
0
-city spite",, Zip Ca a Date(M M/D.D/. It—A.
a
mployer .amt Oocupation
Employer—MaiMad liq AR O Pr n p_t= P�
Plaee W.Bolness ipOf,
Full Name ofContObutgJ 'Date[MM/DWYYYY]tyY'f
�y
h_
11.104e $treelAddress Date[MM/]7DyYYYYlrjv ,i=
ti
City sState: :Zip,CodeiDate.( M/RD . • •i 3
:EMP[Qye[ - — ccUpatio]t
Etnp pYertglaU qg:A dress/Principal t 0escript ons
P(aCeoft3LainaCS' at^ •
_� 'ConJRbutippal;
SCHEDULE III
Statement of Expenditures
2016 C 0572
To Whom Paid - Date,[MM/DD{YYYY]„?;4i,yy
Department of Stated
1 /24/16 _µms; .20.00
House#,. Street Address' Description ofExpen tturez „�' 5
T4 x �
City State Zip
Harrisburg PA Code voter list not cashed
To Whom Paid l Date[MM/DD/YYYY].'.r,
Department of State 1 /29/16 20.00
House..F, StreetAddress. Description of Expen, iture
City State _ —— p — online e vo e- list did not
Harrisburg FA Co, = _
arrive �ely
To WhomPaid:.: Date(MM/DD/YYYY].rj8; _
Harrisburg Parkingfcbx2/12/1 ; & 4.00
House 1
223 StreetAddressiWalnutStreet DescnptionofExpenditwurC�-, ������`;
City - State i Zip
Hb9 o Cade _ng
To Whom Paid ; Date ';�+
l ..61M/DDlYYYY
1 .,. 4
Staples 2/14/10 5.29
House[#I SttreettAddrei Description of Expenditure x*'
5850 __ " Carlisle Pke , VINA
City .State.. 'i Zip �
f- Ntechanic.sburcl PA occe - _5 e col
To Whom PaiIRAId—'
Date,[Mfd/DD�YYYYJ-„� ;
„Sy
Commonwealth of P= 2 15 I y= -,0C.-0
House# Street ddress Description of Expenditure M^ .J- �
210 = N Office _15F 'i.
City; State iZip
Hbg PA Code 1 /'� 20 f i 1;ng fee nom 3e
7o Who m. al ”" Date:[MM(DOlYY.YY];S�uitp
g s•
is=r^ t CVS -
`-+' .. .e.
2/15/16
Houser@. S'RM
tldies3 Description of Expenditurew ,r 14
105 s= N Sportinq Hill Sd
Cir lip �
Mech _ s. �,Code,;...� 7055 monev order fee
roWho ' aid Date: MM'/DD/Y,l';Y;.
[ ,.. . . Y3�'�f
Harrisburg Parking 2/16/16 9.00
ous' e diesi. DescnptranofExpenditt)re� v,- ” .
1201 : 7th Street s: ,r` yw I_ t
`State- L_Lp is
Harrisbur ; 1?PP. Code aarkinc
M'1DDf•YT e
Harrisburg Parking 3/4/16 25.00
Depoofxpen f r
r1201 7th Street fi a tzA t sem,.+r,•, �
Statda Zip -
',Code ,,,,,
i Darkinq ob' nom hearin
SCHEDULE IV
Statement of Unpaid Debts
Use this Section to itemize all unpaid debts and obligations which are outstanding at the end of the reporting period.
2016 C 0572
Travis Law office c icla e MOM
-'g: 51; 'C`yof;D�t3
3904 Trindle Road s IM1ttt/oD/YYTYT: .,s;; a.,
1 /24-3/7/16 $3,384.28
Stator:
Camp HIll, ( ;; : PA Godes 1701 1
same as in-kind and statement of expenses(loan to campaign)
Qtttsta HifttCBa[Mbe"ot:Detitl' +'"
rens DATE DEBT
•`[MM/[jb1YYYYJM� ",�'
C -State, Zlp
�ars�t�v rcCo.
I Qdtstading Balancedt D'eM H
x- �"'" a,; DATE:DEBTINCURREO:S�i+ty,�;_r
x
State i
4
ipi�2-�
' tl xuOitista1ltlili¢'Balanbe'dt�DetitA'�?�
M1 oU" eu DATE,DEBT INCURRED:
� Y,_:
"i
St
p a. ➢ u
s p
� _£
in g BatanCe of OKbtt�.i
DATE-0E8T9NCURREDsbN riA
'X
„Stat@:_r
T;t
a -:OutsUhdingBalaiideofrDebt ,,
,,DATE DEBT INCURRED�n' �Y
PAPi B
All Other Contributions
S 50,01 TO S 250
Use this Part to itemize all other contributions with an aggregate value from
S 50.01 TO S 250 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
'F
2016 c 0572
Date[MM7DD/YYYY]-.= d�
1 /24/16 20.00
.reetAd res: Date[MM/DD/YYYY],gg'j
1 /29/16 k 20.00
-- - � .--_ _ "ate[MM/DD,/YYYYjr,;;"8f
---' 2/12/16 4.00
1 Date(MMFpD/YY17 ! ;
_ � - --_--� 2/14/16 f 5.29
reetAddrzs< _ _ Date=(M_y,OD1YY.Y,.YJ $
2/15/16 100.99
Date[MM/.DD/.YYY-Y.3f�w.;
2 416-416 9.00
Date[Mlvt/DD/YYYYI,} 8
3/4/16 $ ' 25.00
` � S,�ee�f4d`dr is' Date[M D •
cac
90 ,yl rd_ ? 1
— - State C.'e Date'[ ✓DD/YYYY,u�1A
-Full,t7ame'o ConMbu o :Datei[MMYD47gYYtY;,NJ ' - -
ROuse 4., Street ddr
State 21pCcde
i
Full Name'o dntribiri6. 1
.. -. s Dat`e;(,MMFDD YyYYYjt "$
House#+� Str'l ctclress! ,/_DDI s
"1.. h. -A.14.it .
3M
C State I Zip Code,;,
NOW
.ess ;tt`Da`t �':' t
g t 'zipbtle
h
Commonwealth of Pennsylvania-Campaign Finance Report
(Note:This report must be clear and legible.It should be typed)
'FIAF`- 8 ;Rep'ortlFledsBy ~4:CCandldatW0, pr ffi'itt Lr6
e 2016cO572 x 'q
N t�
Michael Scott Travis
Str�etfA 3904 Trindle Road
D~ ft111 aSt9te; ZipG')"
C-amP ;a%r>a PA 17011
Type of Report(Place x underreport type)
1.60 Tuesday' 2 po°FriAay V%3 Day Post 14.6th Tuesday 5.2 Friday 6.30 Day Post '7 Annuals �5pe�clatr�.:�Fittla'y`xr�S�'8resa1.�30 Day
Pre-Primary PrePnmary Prijlmary�ll Pre-Election Pre-Election Election q t -Pfe-Elecfio� (;post ctio'
X
Date Of Eiecbon � :} 11 /8 Year Amendment
2016
Termiiia2fd0 ""
(MM/DD/YY 11
Report .❑ t�eprt. _
;SSuumon dfR€tHM Ei bf F orii'Dat ROOM, ,r'
Expe �fi '!0. Y
_.
1/24/16 3/7/16 ..`.x.>: „.
;A'Ambl[MC _Stfil ,tDht'� 36 sport S
+La-
.,nna,:
;BToral? 6fIAt3t!7a On IR€E21pts =
184.28
s�
(FromSlhe :,
.CaTotatIBriddsstAVatlablA ` = 184.28 '='rT7 "T
. . - k(Sumo - '� .r- .tea
a0'Tot btT ItUfes = 184.28 u1{�S
CD ut
t fiHRtTf BaiaS
R yi 0 :; CCD
7
cz-
'F ValBe'u I rt I' b'rlf: ece a yc'- 1 $3,200.00o
OR
G C.ItN
IG UhpasdD`bt5`an '. gato x 3 0 vr�
4_ I 1
Affidavit Section
Part I-If this is a Caroni 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 tote best of my knowledge belief true,correct and complete.
Sworn to and subscribed before me this _ ,✓
-/Vr�'_dayof �J J�_f '�- 20 !
� Signature of Person Submitting report
Michael Scott Travis
�- Signature i Printed Name
My Commission.expires J J�/' / (�— 717 - 731-9509
M0: DAY YR. Area Code Daytime Telephone Number
Part 11-If this is a report of a Candidate's Authorized Committee,candidate shall sign here.
-' 1 swear loraffirm)thatto the best of my knowledge and belief this political committee has not violated any provisionsof the Act of June 3,1937 F.L.1333,NO.320)as
amended.
Sworn to and subscribed before me this
_ d
Y � /
ayol. )i:-G'i:�71 20
Signature of Candidat
`ti /O" iJi i ' Mature
Scot Travis
.Signatures I Printed Name
My Commisslon expires� 717 - - 731-9509
MO.. DAY YR. - Area Code Daytime Telephone Number
COMMONWEALTH OF PENNSYLVAilw, _ COMMONWEALTH OF PENNSYLVANIA
Notarial Seal Notarial Seal
:L.eslie A.]ones,Notary Public I Leslie A.Jones,Notary Public -
Franklin Twp.,York County Franklin Twp.,York County`ommisslon Expires Feb.23,203 My Commission Expires Feb.21,2017
MEMBER,PENNSYLVANIA ASSOCIATJON OFNOTARIES MEMBER,PENNSYLVANIA ASSOaAT10N OF NOTARIES
SCHEDULEI
Contributions and Receipts
Detailed Summary Page
Fler IdehfifiEaU6IFNum
2016 C 0572
LUmtem¢ed Contnbutlons and ReceiptsS 50.00 or Less per Contributor
Total for the reporting period (1) S
2.Contributions of 150.01 to (From
�d Part
Contdbutions Received from Political Committees(Part A) S
All Other Contributions(Part B) S -
184.28
Total for the reporting perlod (2) S
3.Conhibuttons Over$250.00_(From Part C and Part D) _
Contributions Received from Political Committees(Part C) 8
All Other Contributions(Part D) S
Total for the reporting period (3) S
4.Other Receipts-Refunds;'Interest Earned;Returned Checks,ETC.(From Part E)
Total for the reporting period (4) S
Total Monetary Contributions and Receipts during this reporting period (Add and S
enteramount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report
Cover Page,Item B) 184.28
PART 8
All Other Contributions
S 50.01 TOS 250
Use this Part to itemize all other contributions with an aggregate value from
S 50.01 TO S 250 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
2016 C 0572
Full Name of Contributor: I Date[MM/DD(YYYY)M'; i.
r '. `, y Travis Law Office 1/24/16 20.00
House 1, treeY�titin Date.[,„-._D,
3904 ,: Trindle Road
1 /29/16 20.00
City : State Zip Code Datei[MM/DD/YYY1;) .€!'
Camp Hill, PA 17011 2/12/16 4.00
Full Name ofContnbutor° Date'[MM%DDI .-_,] t
R,
Travis Law Office 2/14/16 5.29
HouseB
3904 Streedd.�ess
Trindle Road
2/15/16 100.99
City_ State Zip Code Date;[ /DDlYYYY] _;S�i
Camp Hill PA 17011
21616 900
Full Name"of Contribut- Date[MM/Dl)kY;y�YY.1
> x Travis Law Office 3/4/16 25,00
-House# Se`�edi
z _ 3904 Trindle Road
z
City: State Zip Code Date[,,,,,. `pp-
Camp Hill PA 17011
+House'fa St �e� ess �Date't[, ;°, D'y,• �
City State Zip Code
ism
iFoll'Na G-tri d- spate°[.
;HousSt'A8%Cddress
�C gState ZipCode:i. Data GA2 'DD`, S
a Det
SCHEDULE II
IN-KIND CONTRIBUTIONS AND VALUABLE THINGS RECIEVED
USE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS DURING THE REPORTING PERIOD
DETAILED SUMMARY PAGE
2016 C 0572
UNITEM[ZED -KIND CONTRIBUTIONS RECEIVED-VALUE OF85000ORLESS PER CONTRIBUTOR+'fr �. *'",'*
'
TOTAL for the reporting period (1) . ..E,:..--.
- _ ..2--;-,IN-KIN0.CON RIBUTIONS RECEIVED-VALUE OF S 50.01 TO 8 250.00(FROM PART F)
TOTAL for the reporting period (2) E
..3-. IN-KIND CONT IBUTION RECEIVED VALUE OVER:250.00(FROM PART G)
TOTAL for the reporting period (3) E
3,200.00
TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING E
PERIOD(Add and enter amount totals from boxes 1,2,and 3;also enter 3,200.00
on Page 1,Report Cover Page,Item F)
/
1 /
_ f { Travis Law office� Trindle Road
C • 11 11
°• P]rt1'7`tJYCI? ®. q,,?r�:Pi+?.4.1,'3'F 'rJ.'�l:`i �`"'_ •• -•
i®a
i®
r• Vtcandidate/principal same
z a
7
0. S r4l7fMUS45411
SO ' DTWO° yyy° d
:1,73 •
. 1 ILS ° I• 1°.� B. B B' ' �,
9
d e?S^i
• 5' — a ° ,
q 0• , 0B
ter�1• ?.IBX °1 °S ii ° 1 '�n' ��:
A 7"
n- WO
'p B
M µ r
° L Ce`L! _ • A
stl L
SCHEDULE III
Statement of Expenditures
• a�* .�=: 2016 C 0572
To Whom Paid` - Date[MM/DD/YYYY](ty st_i„[!
Department of State 1/24/16 a 20.00
House€; Street Address' Descnptmri'sofExpen [lure ' " T
C-1 ty State Zip
Harrisburg I PA Code voter list not cashed
To Whom Paid I i Date[MM/DD/YYYY);$ f
Department of State 1 /29/16 20.00
House g _ - Street Address[ 1 Description of ExpendituheW,;£g,V t. k M
v
City : State - Zip online voter list did not
Harrisburg PA Code arrive timel
ToWhom Paid Date[MM]DDY,YYYy] IESQ'
-- Harrisburg Parking Jojx2/12/ 2AYA 4.00
House€ 223 StreetAddress ' Descnptionpt,Expeuditu,
T-7alnut Streetj2A.ax
Cihy - - State Zip -
HoJ• .; PA Code parking -
To Whom Paid a:,. Date,[M_M/DD/YYYY]�11 "S5
Staples P 2/14/16 ' ' 5.29
House I Descnpti6rf'of„Expenditute a w
5850 ^[ :' Carlisle Pke ... . m. +
City 1';State Zip -
:
^3echanicsbur Code 17055 pens that would write in col
To Whom Paid Date`[FAMJ�DD/Y,M;,,)t
e Commonwealth of PP. 2/15/16 100.00
Houses 210 Streedress n1 office .Dannpt,fon�;o�,Expen
City; Hbg ,State .'I Zip. -
PA Cade 17120 filing fee nom pet
To Who I '" aDate�[IKiJIYDD, t..p;]" nb 5
S 2/15/16 99
.House,€4 S'ee ddes3Descn�p`titt"
'.R 105 N Sporting Hill Rd
�
.Ci.[y;,' :State: Zip
Me h Code 7055 mon order fee
yTeoWho '. 91 Date4[MM DD; ;X] S
Harrisburg Parking 2/16/16 9.00
c 'oYlsa` a "dress D9sd MON
" .. d u'
1201 7th Street I,
: sCi ,. . -, -� ate' :,LPs1a� ;; -
MAIM
Hai sbur PA ;Coded rkin
Harrisburg Parking 3/4/16 25.00
rHaj�ri
7th Street
o e
iDarkincr obi nom hearincF