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Commonwealth of Pennsylvania

PAGE 5 OF
CAMPAIGN FINANCE REPORT (COVER PAG&

(NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink,;

Filer Identification
Number:

6TH TUESDAY 2ND FRIDAY


TYPE OF
PRE-PRIMARY PRE-PHIMARY
REPORT
BTH TUESDAY 2ND FRIDAY 30 DAY
PRE-ELECTION PRE-ELECTION POST ELECTION
(place X to
the right of FILING METHOD
report type) IVI CHECK ONE
Name of Office Sought by Candidate

(SEE INSTRUCTIONS FOR CODES!


FOR OFFICE USE ONLY
Summary of Receipts
and Expenditures from:

A. Amount Brought Forward From Last Report

3- Total Monetary Contributions and Receipts (From Schedule I)

C. Total Funds Available (Sum of Lines A and B)

Total Expenditures (From Schedule III)

E Ending Cash Balance (Subtract Line D from Line C)

F. Value of In-Kind Contributions Received (From Schedule II)

G. Unpaid Debts and Obligations (From Schedule IV)

PART I - If this is a Committee report treasurer sign here. If this is l Candidate report fjndldM sisnn«rr
I awear {or affirm) that this report, including the attached schedule, on paper or compvt«r tfickme, are to «.« beat of my KMOWIMB* «m belief true,
correct and complete.

Daytime Teiep-hone r.ymbor

PART H - If this is a report of a Candidate's Aathonzad Committon, cy.did.rta sKatl sign hare.
I sweat (or affirm) that to the best erf my knowledge and belief this political committee ham not violated any previsions of tha Act of June 3, 1937
{P.L. 1333, No. 320) as amended.
Sworn to and tubseribed before m« thii

day of tfi
Signature of Candidet*

Printed Name
My commission axpjras
Daytime Telephone Number

Department of State • Bureau of Commissions, Elections and Legislation


303 North Office Building • Harrlsburg, PA 17120-0029 • (717) 787-5280
DSEB-592 (7-99I
PAGE "2- OF
SCHEDULE Hi

STATEMENT OF EXPENDITURES

Nwne of Filing Committee or Candidate Reporting Period

To Whom Paid / c \ t ^ /"X^ ' M O. DAY JEAR 1 Amount

Mailing Addr«=a
IA .S K?r (Jrrtce r 1.3
Description of Eypnn.rH*ufa
0<
? L? n^.'r^
City State Zip Coda (Plus 4)

To Whom Paid - ^ T~} [


ffi MOj DAY YEAR lAmoimt
/ryK6YAc^X) VvCMTVAta 1]^ iHtt-eA <S~ /5~ o? |f Ifti^^fp^
Mailing Address {7 1 Description of Expenditure
i /-, t
oC O 1
/? if L,.^ <ZL
/ / D Vy-yj G<,Vb\ 0 TO*J J2LJ
Stetc Zip Coda (Plus 4) c/
f}A
J^ d&vVA
MO. DAY YEAR lAmOUnt
"' /^ fi fl ^x
<T 19 ^|s loorOP
Mailing Addrsss

s
"""""'" °^27Jci ^/ ^./-y
Zip Cod* (Plus 4) / y
^ka4j
! MO. DAY Y E A R ! Amount
" ''"''''' ' ' <^~ A /
^S" 2 1- i?f If o^|^ . -i Y-
Mailing Addrass / /'O .

s
_^2) $C»~-~ ' jr&tr^^i Ct <^
Zip Cod* Plus 4

/£//0*kuri
T w m p id MO. DAY YEAR |Al«dunt
° " ' jp A\5 -5 y <? b^ 1 -S -^ o /
Muling Address .

4lfy
T5 \yv #"4,7^- /^A tfre^l £&Y* l^f £-^l

To Whom Paid
/4/y 7s /9-
Zip Cod* (Plus 4)

MO. DAY | YEAR |AfTlQum

Mailing Address Description of


1
Exparsditur*
|f

City

To Whom Paid MO. DAY Y E A H l '••'"•" f

Mailing Address Description of Expenditure


If
City State Zip Cod* (Pint 4)

To Whom Paid

Mailing Address
«0. DAY

Description of ExpenditlQ'*
YEAR

u
|AmOUnt


City State Zip Cod* (Pius 4}

I
PAGE TOTAL
5 S 2\(2~ f 1 8
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 IDENTIFICATION ^
CA»D».TE COMMITTEE 1\/ LOBBYIST
ON BEHALF OF ^| 1 A 1

fff r
NAME OF FILING COMMITTEE, CANDIDATE OR LOBBYIST

f\

STREET ADDRESS
( ^ C?^AA4 -U £/£C / T e h * S4W&.
<
? rl<? T^V-EI J-e-rtsvi \\e. j^naei
STATE ZIP

/) _
' \c *r m& "\ 04-tM)
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE T DISTRICT NO. PARTY
••BiESESi^^uESBHH
(CHECK ONE) MO. DAY YEAR

1.
6TH TUESDAY Ce£mAjcM £r Xr=r I! V£*) JT 1^ ^CXJ
PRE-PRIMARY / ^ FOR OFFICE USE ONLY

2. DATES OF
2ND FRIDAY
REPORTING .— TO
6 g 09
PRE-PRIMARY
PERIOD ^
JL c>°( ir. .
X
30 DAY r
POST-PRIMARY
CASH BALANCE VT END r 5pl s
OF REPORTING F ERIOD: $
GTH TUESDAY
PRE-ELECTION ^^
TOTAL AMOUNT OF FILER'S
2ND FRIDAY
5. OUTSTANDING D -:BTS OR LIABILITIES
lH,S"oD.e.o
:IH:: 5 g
PREELECTION
AT THE END OF REPORTING PERIOD: $
' —j ""• - U ' |
30 DAY
AMENDMENT
POST-ELECTION
REPORT?
YES NO
X -> r' '- "
ro ::.".
-;
—.
_j
ANNUAL TERMINATION
REPORT REPORT?
YES NO
x^
:
. 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 ASOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS ($250.00) AND THIS REPORT IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, CORRECT AND COMPLETE.

DAYTIME TELEPHONE NUMBER

PART II -
If statement is filed on behalf of a Candidate's Authorized 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 TO AND SUBSCRIBED BEFORE ME THIS


SIGNATURE OF CANDIDATE

PRINTED NAME

DAYTIME TELEPHONE NUMBER

Department of State • Bureau of Commissions, Elections and Legislation


303 North Office Building • Harrisburg, PA 17120-0029 • (717)787-5280
DSEB-503 (12-99)
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.
• Name of Filing Committee or Candidate Reporting Persoc

S .jL^l£££fcjbLl3lllCl!E— $—™A§..c Z™JS ?K*3 Sitf TT A

Niame of Cred'tor , p A Outstanding b5;ar;ce of DetJt

MsiNng Address ~ MO-- DAY - -YEAR

^5*.5~|. ^ JN v^iecJ^os \)i i [<? Kpoxi- INCURRED


City / n i l
\ C fi v^^rn &.V\A. \D TD v1 Sf \totrj-
cript
°" """'
NST-S o j Crec:tor
\p^ Outstanding Baiance of Debt
$
Meiling Address DATE WO, ' DAY YEAR
DSBT
INCURRED
City
-

Descriotion of Debt

Narns of Crecitor J-utstar-.ding Ba.ance or DeDt


$
Ma, ling Acdress WO- - DAY Y"EA?1 . -

INCURRED
-' 'Y S:ate Z,p Cede Pius 4:

Description of Debt

Name of editor
-j,..«..Bo ra«^ s ra
Msiling Aaoress P/IC. DAY YEAR
DS5T

C,,V i.a.e ^tp _ccs Vi^s 4!

Description of Debt

Name of Creditor Cj-.stanaing Balance of Eebt


S
DATE MO. DAY Y^AR -
" !"9 DEBT
INCJ^StD
i.i.e i,p ^ c o e
"V
""'*
Description of Debt

Name of Creditor Cutstanaing Balance of Debt


S
Mailing Address DATE WO- GAY YEAR
DEBT

City PL i ! 5 4:
_

f________^
PAGE TOTAL
Enter Grand Total of Unpaid Debts on Page 1, Report Cover Page, Item G,

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