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Home My WebLink AboutFriends of Nate Silcox - 2016 2nd Friday Pre-Election 'loll ��Fieset Form Print Form' . Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be dear and legible.It should be typed) Filer Identification Report Filed By Candidate Committee Lobbyist l l Number i Mark X) Name of Filing Committee,Candidate or by Friends of Nate Silcox Lobist Street Address P.O.Box 882 City Camp Hill State PA Zip Code 17011 Type of Report(Place x under report type) 1-6th Tuesday 2- 2"°Friday 3-30 Day Post 4-6tTuesday 5-rd Friday 6-30 Day Post 7-Annual Special es Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre Election Post-Election Date Of Election Year Amendment Termination (MM/OD/YYYY) 11/08/16 2016 Report Report • Summary of Receipts and From Date To Date For Office Use Only Expenditures k 05/16/2016 10/24/2016 A.Amount Brought Forward From Last Report $ 11,266.27 B.Total Monetary Contributions and Receipts $ O�1 I L-��,`Q . 1,530.00(From Schedule I) C.Total Funds Available $ (Sum of Lines A and B) 12,796.27 D.Total Expenditures $ 1,831.14 (From Schedule Ill) E.Ending Cash Balance $ (Subtract Line D from Line C) 10,965.13 F.Value of In-Kind Contributions Received $ (From Schedule II) 578.98 G.Unpaid Debts and Obligations $ 0 (From Schedule IV) 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 be '. rily knowledge and belief true,correct and complete. Sworn to and subscribed before me this _A %A Lw iv C d•y of la-406c-c- 20 _ _� ....mum. I not re of Persoon/Subm n ^ „rwi� ra� r !e��ag Signature Printed Name My CQ MMf�l i -TWA PE 4YLVA�tI -- / i i - t 4 lo Notal Seal DAY YR. Area Code Daytime Telephone Number Adam C. Wagner, Notary Public Part I- VI $'q(;IillS}�-` ' •.i• ••., f4 r. •I•,,Committee,candidate shall sign here. I swe. • ••• •• • • T••- •— - ••• •• •---nd belief this political committee has not violated any provisions of the Act of June 3,1937(PA.1333,N0.320)as amenalSER.P NSTLVAN A A S• IATIO OF NOTA- ES etr Sworn to and subscribed before me this / T.P day of �G e e 20 Signature of Candidate 'Jeer-141a.J c S>ai_c Signature Printed c Printed Name My Commission expires 1pI ''1t'-7 10447 ZOcgr- COMMONWtOEQTH OP' 'ENNSYLVANIA Area Code Daytime Telephone Number Notarial Seal Adam C. Wagner, Notary Public • City of Harrisburg, Dauphin County My Commission Expires Dec. 2, 2017 .,'"1. MINIM.PENNSYLVANIA ASSOCIATION OF NOTARIES ' ' r t SCHEDULE I Contributions and Receipts Detailed Summary Page IFiler Identification Number I I LUnitemized Contributions and Receipts-$50.00 or less per Contributor I Total for the reporting period (1) $ 525.00 2.Contributions of$50.01 to$250.00(From Part A and Part B) Contributions Received from Political Committees(Part A) $ 00 Ail Other Contributions(Part B) $ 505.00 Total for the reporting period (2) $ 1,005.00 t 3.Contributions Over$250.00(From Part C and Part D) Contributions Received from Political Committees(Part C) $ 0 All Other Contributions(Part D) $ 0 Total for the reporting period (3) $ 0 I4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) Total for the reporting period (4) $ 0 Total Monetary Contributions and Receipts during this reporting period(Add and $ enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report Cover Page,Item B) 1,530.00 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/YYYYJ $ Committee Miilliron&Goodman PAC 250.00 05/25/2016 House# Street Address Date[MM/DD/YYYYJ $ 200 N.Third Street City State .Tip Code Date[MM/DD/YYYYJ $ Harrisburg PA 17101 Full Name of Contributing Date[MM/DD/YYYYJ $ Committee HRG PAC 05/25/2016 250.00 House# Street Address Date[MM/DD/YYYYJ $ 369 E.Park Drive City State Trp Code Date[MM/DD/YYYYJ $ Harrisburg PA 17111 Full Name of Contributing Date[MM/DD/YYYYJ $ Committee House# Street Address Date[MM/DD/YYYY] $ City State Zip Code Date[MM/DD/YYYYJ $ Full Name of Contributing Date[MMJDD/YYYYJ $ Committee House# 'Street Address Date[MM/DD/YYYYJ $ City ' State Tip Code Date[MM/DD/YYYYJ $ Full Name of Contributing Date[MM/DD/YYYYJ $ Committee House# Street Address Date[MM/DD/YYYYJ $ City State Zip Code Date[MM/DD/YYYYJ $ Full Name of Contributing Date[MM/DD/YYYYJ $ Committee House# Street Address Date[MM/DD/YYYYJ $ City State Zip Code Date[MM/DD/YYYYJ $ 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/YYYYi $ Keith Brenneman 05/24/2016 100.00 r House# Street Address Date(MM/DD/YYYYJ $ 5808 Stephens Crossing City State Zip Code Date[MM/DD/YYYY) $ Mechanicsburg PA 17050 Full Name of Contributor Date(MM/DD/YYYYJ $ Donald&Roberta McCallin 05/25/2016 75.00 House# Street Address Date(MM/DD/YYYYJ $ 501 Lamp Post Lane City State Zip Code Date(MM/DD/YYYY) $ Camp Hill PA 17011 Full Name of Contributor Date[MM/DD/YYYYJ $ Charley&Dottie Hall 05/25/2016 80.00 House# Street Address Date[MM/DD/YYYYJ $ 776 Lancaster Avenue City State Zip Code Date[MM/DD/YYYY] $ Enola PA 17025 Full Name of Contributor Date[MM/DD/YYYY) $ John Murphy 05/25/2016 250.00 House# `Street Address Date[MM/DD/YYYYJ $ 565 Brent water Road 4 City State Zip Code Date(MM/DD/YYYYJ $ Camp Hill PA 17011 Full Name of Contributor Date(MM/OD/YYYYJ $ , House# Street Address Date[MM/DD/YYYYJ $ City State Zip Code Date[MM/DD/YYYYJ $ Full Name of Contributor Date(MM/DD/MY] $ House it Street Address Date(MM/DD/YYYY) $ City State Zip Code Date[MM/DD/YYYY] $ 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. Flier Identification Number: Full Name of Date[MWDO/YYYYI $ Contributing Committee House# Street Address Date IMM/OD/M11 $ City State Zip Code Date[MM/DD/YYYYI $ Full Name of Date[MM/DD/MY] $ Contributing Committee • House if Street Address Date[MM/DD/YYYYJ $ City State Zip Code Date[MM/DD/YYYYJ $ Full Name of Date[MM/OD/YYYY] $ Contributing Committee House# Street Address Date[MM/DD/YYYY) $ City State Zip Code Date[MM/DD/YYYYJ $ Full Name of Date[MM/DD/YYYY] $ Contributing Committee House# Street Address Date[MM/OD/MY] $ City State Zip Code Date[MM/DD/YYYYJ $ Full Name of Date[MM/DD/YYYY) $ Contributing Committee House# Street Address Date[MM/DD/YYYYI $ 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) $ PART 0 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/DDIYYYYJ $ House* Street Address Date[MM/DD/YYYYJ $ 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 $ House it Street Address Date[MM/DD/YYYY1 $ City State Zip Code Date[MM/DD/YYYYI $ Employer Name Occupation Employer Mailing Address/ Principal Place of Business Full Name of Contributor Date[MM/DD/YYYYJ $ House# Street Address Date[MM/DD/YYYYJ $ 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 $ House# Street Address Date[MM/DD/YYYY] $ City State Tip Code Date[MM/DD/YYYYJ $ Employer Name Occupation Employer Mailing Address/ Principal Place of Business PART E 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# l'Street Address City State Zip Date[MM/DD/MIll $ Code Receipt Description Full Name House# Street Address City State Zip Date[MM/DD/YYYYJ $ Code Receipt Description Full Name House# Street Address City State Zip Date[MM/DD/YYYYJ $ Code Receipt Description Full Name House# Street Address City State Zip Date[MM/DD/YYYYJ $ Code Receipt Description Full Name House# Street Address City State Zip Date[MM/DD/YYYYJ $ Code Receipt Description Full Name House# Street Address, City I State Zip Date[MM/DO/YYYYJ $ Code Receipt Description 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 Filer Identification Number: 1. UNITEMMED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR I TOTAL for the reporting period (1) $ 54.98 2. IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F) TOTAL for the reporting period (2) $ 524.00 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) 578.98 SCHEDULE II PART F In-Kind Contributions Received VALUE OF$50.01 TO$250 Filer WenaYwstion timber: Full Name of Contributor Date[MM/DDJYYYYI $ Raymond Bramley 05/25/2016100.00 House ff Street Address Date[MM/DD/YYYYJ $ Houston Drive city State Tp Code Date[MM/DD/YYYYJ $ Mechanicsburg PA 17050 Description of Contribution Use of Facilty for Event Full Name of Contributor Date(MM/DD/YYYII'J $ Albert Kominski 05/25/2016 120.00 House# Street Address Date[MM/DD/YYYYJ $ 5008 Greenwood Orde City State Zip Code Date[MM/DD/YYYYJ $ Enda PA 17050 Description of ContributionFood for Event Full Name of Contributor Date[MM/DD/YYYY[ $ Nathan Larsen 05/25/2016 204.00 House# Street Address Date(MM/OD/YYYYJ $ 35 W Main Street City State rip Code Date[MM/DD/YYYYJ $ Mechanicsburg PA 17055 Description of Contribution Drinks for Event Full Name of Contributor Date[MM/DD/YYYYJ $ James Silcox 05/25/2016 100.00 House It Street Address Date IMM/DD/YYYYJ $ 915 Mateo 4305 City State Tip Code Date[MM/DD/YYYYJ $ Los Angeles CA 90021 Description of Contribution Musical Entertainment Full Name of Contributor Date[MM/DD/YYYYJ $ House# Street Address Date[MM/DD/YYYYJ $ City State Tap Code Date[MVI/OD/WTI $ Description of Contribution