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Home My WebLink AboutKricher, Alexis - 2016 2nd Friday Pre-Election Reset Form Print Form .. II il . Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Filer Identification Report Filed By Candidate X Committee —1 ( Lobbyist Number (Mark X) ( Nameof Filing Committee,Candidate or Lobbist -A V m5 •Kf, cMer Street Address . )14 a5 e d-FD M b I vt City 01 1 ' State. V n Zip Code Cl 'n I I Type of Report(Place x under repo type) /-j 'f V 1 1-6th Tuesday 2- 2nd Friday 3-30 Day Post 4 60 Tuesday S.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 o x Date Of Election@ Year 1 - Amendment Termination (MM/DD/YYYY) I(f 08 I)OI L' i 01 ta0 Report Report ' Summary of Receipts and From Date To Date For Office Use Only Expenditures • v/ INI)0 w1a /1b • A.Amount Brought Forward From Last Report $ t') D U B.Total Monetary Contributions and Receipts $ ' o+ (From Schedule I) 0 I C.Total Funds Available $ .. --.-4 (Sum of Lines A and B) . V D.Total Expenditures $ �� q� 1 .--4.--4(From Schedule 111) r. -CY _ E.Ending Cash Balance $ , (Subtract Line D from Line C) -- ( q L{ , q V�� e r7%). F.Value of In-Kind Contributions Received $ ,.c-- (From Schedule II) `�' CD • G.Unpaid Debts and Obligations $ (�I 1 (� (From Schedule IV) I"I i 1 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. Sworn to//��and subscribed before me this // ti e�/ a1SJ day of OCalae t' 2Q!V7 t 5 na .e o P rso ubmittin report fix% 5 Kr 1 Signature/ 8' �t 1/ rinted Name '7 �jy1 My Commission expires 0(f g i / ( -j T/ 1 v t ' '7 7 `-� v MO. DAY YR. Area Code Daytime Telephone Number 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(P.t.1333,NO.320)as amended. Sworn to and subscribed before me this day of 20 Signature of Candidate Signature Printed Name My Commission expires • MO. DAY YR. Area Code Daytime Telephone Number COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL September E.Harkins.Notary Public Silver Spring Top..Cumberland County iMy Commission Expires April 21.2018 MEMBER, ?ERNST-61NC. ASSOCIATION OF NOTARIES SCHEDULE I Contributions and Receipts Detailed Summary Page Filer Identification Number i 1.Unitemized Contributions and Receipts-$50.00 or Less per Contributor Total for the reporting period (1) $ 2.Contributions of$50.01 to $250.00(From Part A and Part B) Contributions Received from Political Committees(Part A) $ All Other Contributions(Part B) $ Total for the reporting period (2) $ 1 • j 3.Contributions Over$250.00(From Part C and Part D) 1/Contributions Received from Political Committees(Part C) $ All Other Contributions(Part D) $ Total for the reporting period (3) $ 1 J4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) Total for the reporting period (4) $ Total Monetary Contributions and Receipts during this reporting period(Add and $ tV enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report 1 Cover Page,Item B) • PART A Contributions Received From Political Committees $50.01 TO$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value from$50.01 TO$250.00 in the reporting period. Filer Identification Number Amount Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYYJ $ Full Name of Contributing Date[MM/DO/YYYY] $ Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date(MM/DD/YYYYJ $ City State Zip Code Date(MM/00/YYYY] $ Full Name of Contributing Date[MM/OD/YYYY] $ Committee House# Street Address Date(MM/DD/YYYYJ $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributing Date(MM/DD/YYYY] $ Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date(MM/DD/YYYY] $ Full Name of Contributing Date[MM/DD/YYYY] $ Committee House# Street Address Date(MM/DD/YYYYJ $ City State Zip Code Date[MM/DD/YYYY] $ PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) Filer Identification-Number. Full Name of Contributor Date[MM/DD/YYYY) $ a House# Street Address Date(MM/DD/YYYY) $ aty State Zip Code Date(MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date(MM/DD/YYYY) $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYYJ $ City State Zip Code Date(MM/DD/YYYY) $ Full Name of Contributor Date(MM/DD/YYYYJ $ House# Street Address Date(MM/DD/YYYY] $ City. a State ZipCode -. _Date(MM/DD/YYYYJ $_ Full Name of Contributor Date(MM/DD/YYYYJ $ House# Street Address Date(MM/DD/YYYY) $ City State Zip Code Date(MM/DD/YYYY)- $ Full Name of Contributor Date(MM/DD/YYYYJ $ House# Street Address Date(MM/DD/YYYY) $ City State Zip Code Date[MM/DD/YYYY] $ 1 PART C Contributions Received From Political Committees Over$250.00 Use this Part to itemize only contributions received from Political Committees with an aggregate value over$250.00 in the reporting period. Filer Identification Number: Full Name of Date[MM/DD/YYYY] '$ Contributing Committee O House# Street Address Date[MM/DD/YYYY] $ Cry_ State Zip Code Date[MM/DD/YYYY] $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Date[MM/OD/YYYY] $ Contributing Committee House# Street Address Date[MM/DD/YYYY) $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Full Name of Date[MM/DD/YYYY) $ Contributing Committee House# Street Address Date[MM/DD/YYYY] City State Zip Code Date[MM/DD/YYYY] $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee House# Street Address Date[MM/DO/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ PART D All Other Contributions Over$250.00 Use this Part to itemize all other contributions with an aggregate value over$250.00 in the reporting period. (Exclude contributions from political committees reported in Part C) Filer Identification Number: Full Name of Contributor Date(MM/DD/YYYYJ $ 0 House#' Street Address Date(MM/DD/YYYY) $ City State Zip Code , Date[MM/DD/YYYYJ $ Employer Name Occupation; Employer Mailing Address/ Principal Place of Business Full Name of Contributor. Date(MM/DD/YYYYJ .$• I House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date(MM/DD/YYYYJ • $ I • Employer Name , Occupation i Employer Mailing Address/ Principal Place of Business 'Full Name of Contributor-• ,Date[MM/DD/YYYY] . . -$- \ ' House# Street Address Date[MM/DD/YYYY] $ ,City State Zip Code Date[MM/DD/YYYYJ $ •Employer Name• - 4 -••• •- -Occupation Employer Mailing Address/ Principal Place of Business Full Name of Contributor Date[MM/DD/YYYY] 1 . i House# Street Address Date(MM/DD/YYYY] $ I City ' State Zip Code Date[MM/DD/YYYY] , .$ Employer Name• Occupation Employer Mailing Address/ Principal Place of Business - PARTE Other Receipts REFUNDS,INTREST INCOME,RETURNED CHECKS,ETC. Use this Part to report refunds received,interest earned,returned checks and prior expenditures that were returned to the filer. Filer Identification Number: Full Name House# Street Address j City State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name House it Street Address City State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address City State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address City State Zip Date[MM/DD/YYYY] $ Code Receipt Description Full Name House# Street Address City State Zip Date{MM/DD/YYYY] $ Code Receipt Description Full Name House it Street Address City 1 State Zip Date[MM/DD/YYYY] $ Code Receipt Description SCHEDULE 11 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 IFiler Identification Number: I I1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR TOTAL for the reporting period (1) $ I. 2. IN-KIND CONTRIBUTIONSRECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F) TOTAL for the reporting period (2) $ I 3. IN-KIND CONTRIBUTION RECEIVED-VALUE OVER$250.00(FROM PART G) . • TOTAL for the reporting period (3) $ TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING $ PERIOD(Add and enter amount totals from boxes 1,2,and 3;also enter on Page 1,Report Cover Page,Item F) �,'1?\ Vd\uW ( S y; U4 SCHEDULE lI PART F In-Kind Contributions Received ,V VALUE OF$50.01 TO$250 Filer Identification Number Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Description-of Contribution Full Name of Contributor Date[MM/DD/YYYYj $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MMIDD/YYYY] $ Description of Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date(MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Description of Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY) S City State Zip Code Date[MM/DD/YYYY] $ Description of Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Description of Contribution SCHEDULE II Part G In-Kind Contributions Received VALUE OVER$250 Filer Identification Number Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/OD/MY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description' Place of Business of Contribution Full Name of Contributor .Date[MM/DD/YYYY] $ House# Street Address Date[MM/OD/YYYY] $ City State Zip Code' Date[MM/DD/YYYY] $ Employer Name• Occupation Employer Mailing Address/Principal Description Place of Business of • -Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution Full Name of Contributor Date[MM/DD/YYYY] $ House# Street Address Date[MM/DD/MY] $ City State Zip Code Date[MM/DD/YYYY] $ Employer Name Occupation Employer Mailing Address/Principal Description Place of-Business • -• of Contribution SCHEDULE III Statement of Expenditures Filer Identification Number: • To Whom Paid Date[MM/DD/YYYY] $ 6-\- I io / Ib/Jol 6 N+ I ', qb House# 5(0 m �5-U r Street Address co"I\OR ?\/ p Description of Expenditure City K ,,aI1l;SbJY9 /State J 1)14. i Zip Code ' 11-0q p&( bVO pari To Whom PaidS r �S Date IMM/OD/YYYY] $ 31?, ��, �� aif1o/ ib/2oIb House# c ) O Street Address ^ a(1;c\e )'i\64, Description of Expenditure aty rnebl ari1LS�OUll State T1' 1 Code 1 f / pe.)(14e4 In14/ par To Whom Paid ' o Date[MM/DD/YYYY] $ / House# 14y) Street Address (� a,r d s4... Description of Expenditure J • • City Zip '----- C Am MI1 State APA C6di PIM I n y' ( cyan) • To Whom Paid [MM/DD/YYYY] $ St-Of low- -DH )03r9 House#. 1 ��0 Street Addr ss s a nd S Description o Expenditure City C 0Zip ^n Ih\1 .State f/n -Code 1 I 1 14, (n(Nagril) y e 1)0 iw) .To Whom-Paid .: r f', _Date[MM/DD/XY.YY]_ .$ House# Street Address Description of Expenditure City State Zip Code To Whom Paid , Date[MM/DD/YYYY] $ House# Street Address Description of Expenditure - City ,- State Zip Code To Whom Paid . Date[MM/DD/YYYY] S House# Street Address Description of Expenditure . City State Zip Code To Whom Paid Date IMM/DD/YYYY)• $ House# Street Address Description of.Expenditure City State Zip Code 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. Filer Identification Number. Name of Creditor Outstanding Balance of Debt -- � nuI Ca(1 � VCS .... - -.4 A,. .� House# +Street Address rr11 (� �` U it(.9)( 1 DATE DEBT INCURRED $ 4 C i01 / aolrp 1 ►'-l ` o city NO/JO o /J N State � Code Q I.) Description of Debt )14 V(5 J V DVal'Ii(k-I-cdt fCr DYc -Name of Creditor.-- .. 1Outstanding Balance of Debt House# Street Address (IUM expre,SS DATE DEBT INCURRED $ - y o box i 2'� . oMi /o] . 4 I V4, 90 t `317.4 city �t }/� ,/ State NI j up o�10k'' 4LW, 7 \��.'oU.(' s IV Code 1,,-0 Description of Debt 51/C(0/6S - Vi na-c>', ir1=r Pc xi �XQ y/ L Name of Creditor /� i r., , ,, ,p Cs Outstanding Balance of Debt House# Street Address L J 1�`�) DATE DEBT INCURRED $ �j u '6(X 1 4�1 V [MM/DD/YYYYJ 'L/3a,$ - "I 3 ., ' p 1� °1 ar f a a► City N'LW W ,L State N Zip o 101 ��l, 5 Code 1 1) Description of Debt— C yi 112 - ,n`- G ,.J„) e en! ' �P • . _ J�J IN 1L ( (/V i J � �( Name of Creditor Otlf&IViOutstanding Balance of Debt House# Street Address ' DATE DEBT INCURRED $ v o cf7 OX l a..-( V [MM/DD/YYYY] S/q 1.5-6 1,70 3< City • �{ pp /, `/ State wt Zip 0/1101- % '4 / /, 9 Ko \" V i,ki U`(-, o J Code )11-0 cam . Description Debt bt' -- _..-- - S.4-cy Lei - * h l- ( ne'm en-f'a, y e if o w) ex pori' Name of Creditor Outstanding Balance of Debt - House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYYJ City , , State Zip Code Description of Debt ' Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip 'Code _ Description of Debt