Commonwealth of

Pennsylvania

PAGE

OF

CAMPAIGN FINANCE REPORT

NOTE:
Filer

Identification

This report must be clear and legible. It may be typed or printed in blue or black ink.)
Report

Name of Filing Committee, can"

LOBBYIST 3

COMMITTEE''

CANDIDATE

ate or Lobbyist:

Address:

c,5 .A.-Lt,

s21

Stat

City:

MECtIcL,%
ME

place

the

of

TUESDAY'

ELECTION

to
Of

right

type)

report

8TH

Office

1.

Sought

by

2.

2ND FRIDAY

4'

5.

30

PRE- ELECTION
YEAR

6.

TERMINATION

ELECTION

YES

REPDA77

FILING METHOD
I CHECK ONE

Candidate:

District

WSKETTE
Office

Party

County

Code

Code

Code

Number

CI

ti

c/

lM.

DAY

55;, 47 , c

J
I

NO

PAPER

r .

MO.

YES',

REPORT?

DAY

POST

AMENDMENT

POSTPRIMARY

2ND FRIDAY

7.

30' DAY

PRE- PRIMARY

ANNUAL
REPORT

..

3055

PREPRIMARY

PRE-

ode:
Zip Code-

b,!

STHTUESDAY

TYPE OF
REPORT

Name

It

Filed By:.

Number:

Street

COVER PAGE)

YEAR

ry

4- v{

1ir

SEE INSTRUCTIONS FOR

CODES)

FOR OFFICE USE ONLY

MO.

Receipts
Expenditures from: ,

Summary
and

A. Amount Brought Forward

Total

B.

DAYYEAR

Mo.

DAY

'

YEAR

of

d'

From Last

Monetary Contributions

C. Total Funds Available ( Sum

and

Zc71S

1I I zc)IS

To

Report

Receipts ( From Schedule

C-)

1) $

r._ a

of Lines A and B)
5

D.

Total Expenditures ( From Schedule IIO

E.

Ending Cash Balance ( Subtract Line D from Line C)

F.

Value of

G.

Unpaid Debts and Obligations ( From Schedule IV)

7
N

tut

InKind Contributions Received ( From Schedule IO $

AFFIDAVIT

PART i

If this is a Committee report. treasurer sign here.

If this is a Candidate report, candidatesign here.

I swear for affirml that this report, including the attached schedules, on paper or computer diskett
correct

and

r65o Jhe

Sworn to and

ltl

subscribed

day

before me

of \ (

II

20

C YJ

v-

s gralure of

Y+^
rn
Signature

OF

OMMOHWEALT

PART II
swear

W. L.

j
t

NRET

I;

DAY

L ARULO

47,
a

-,

1e(

6.

g Report
a

YR.

meq,
r
qI 7

Area Code

Daytime Telephone( Number

il Authorized Committee, oxididate shall sign here.

RE,

rson Submin

Printed

PENNSYLVANW

co

FIFTANY 5

my knowledge and belief true,

this

MY

at o

complete.

and belief this political committee has not violated any provisions of the Act of June 3, 1937

1333, No. 320) as amended.

Sworn to and subscribed before me this

day

20

of

Signature

Signature

of

Candidate

Printed Name

My commission expires
MO.

DAY

YR.

Area

Code

Daytime

Telephone

Number

Department

of

303 North Office

DSEB- 502 ( 7- 99)

State

Building

Bureau of Commissions, Elections and Legislation

Harrisburg,

PA

17120- 0029 (

717) 787- 5280

OF

PAGE

SCHEDULE III

STATEMENT OF EXPENDITURES
Name

of

Filing Committee
G

To

Whom

or

Candidate

tCk('

Paitl

Address

State

Zip Code ( Plus 4)

V,/}

I
ilbw

Paid

MO.

Mailing Address

State
v

P4 I

la

Paid

Description

City

State

Whom

Mailing

MOI

Address

State

Address

State

Mailing

Mailing

YEAR

mount

Expenditure

DAY

YEAR' S

mount

YEAR

Amount

c'r(DAY

YEAR

Amount

Zip Code ( Plus 4)

Paid

DAY:

MO.

Address

YEAR

Amount

Description of Expenditure

State

Zip Code ( Plus 4)

Paid

MO.

Address

<

Description

City

State

DAY.

YESR.

mount

of Expenditure

Zip Code ( Plus 4)

PAGE

Enter Grand Total

DSEB- 502 ( 7- 99)

77

Amount

Description of Expenditure

State

Whom

of

iDAY

MD.

City

To

YEAR

Nna' r/ in

Zip Code ( Plus 4)

Address

Whom

DAY

Description of Expenditure

City

To

a.

Zip Code ( Plus 4)

Whom Paid

Mailing

`:

Mo.

City

To

nL

Description of Expenditure

Whom Paid

Mailing

L/ 4

Zip Code ( Plus 4)

Paid

City

To

Expenditure

DAY

MO:.

of

Expenditures

on

Page 1,

<

Zip Code ( Plus 4)

Mailing Address

To

:'.

Description of Expenditure

City

Whom

CJ

mount

it1

To

of

YEAR

eldgwt/

City

Whom

To

DAY=

Description

EPe'

To

From

MO.

y
Mailing

Reporting Period

Report Cover Page, Item D.

TOTAL

1.