Beruflich Dokumente
Kultur Dokumente
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:
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.
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
STATEMENT OF EXPENDITURES
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)
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)
City
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.
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.
PRINTED NAME
Descriotion of Debt
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
Description of Debt
City PL i ! 5 4:
_
f________^
PAGE TOTAL
Enter Grand Total of Unpaid Debts on Page 1, Report Cover Page, Item G,