HomeMy WebLinkAboutSilcox, Nathan - 2016 2nd Friday Pre-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 IDENTIFICATIONREPORT FILED I 2.
NUMBER FILING COMMITTEE,
BEHALF OF Ow �[ COMMITTEE - LOBBYIST
NAME OF COMMITTEE,CANDIDATE OR LOBBYIST '
P-1-4-4.D . ")Lc
STREET ADDRESS
4,9 I A.)U i 'C.c. "IP23 U c.
CITY STATE /V CODE
i�r�FLt�4ti.71C� �� 1'
0-c?0
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) MO. DAY YEAR
6m TUESDAY � P Corn ry rSsr ca,-x-S? 1 t g .at
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY I YEAR
2ND FRIDAY 2' DATES OF
PRE-PRIMARY REPORTING TO
PERIOD c- t(O t D ZLI I(�
30 DAY 3'
POST-PRIMARY
CASH BALANCE AT END
6TH TUESDAY 4. OF REPORTING PERIOD: $ ® �•,�
PRE-ELECTION C.7
TOTAL AMOUNT OF FILER'S
2ND FRIDAY 5' OUTSTANDING DEBTS OR LIABILITIES 0 r L
PRE-ELECTION Z AT THE END OF REPORTING PERIOD: $
6. I•-•
30 DAY AMENDMENT
POST-ELECTION YES NO
REPORT?
7. ...
ANNUAL TERMINATION YES NO I ,
REPORT REPORT?
AFFIDAVIT SECTION
PART I-
If statement is filed on behalf of a Political Committee or Candidates'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(5250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF 7RUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS'
rO O
b DAY OF `f(.J03 r^ 20 gc, SIGNATURE OF PERSON SUBMITTING REPORT
. • , F-D�J-(&.0 S1t�c7r�C
PRINTED NAME
SIGNATU•E
tiDganpir4LTI OF YEN VANIA YR. -)
AREA CODE ZaFs
DAYTIME TELEPHONE NUMBER
Notarial Seal
Adam C. Wagner, Notary Public
PAR-IlClty of Harrisburg, Dauphin Co_n
If stat lerPlA aiti tldxir a eef ,uN •ate's Authorized Committee,Candidate must sign here.
MEM@ER.PENNSYLVANIA ASSOCIATION OF NOTARTE.
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
SIGNATURE OF CANDIDATE
DAY OF 2O
PRINTED NAME
SIGNATURE
MY COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR. •
Department of State • Bureau of Commissions,Elections and Legislation
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280
.