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. REPORT FILED NUMBER
^
CANDIDATE
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COMMITTEE
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LOEBVIST
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NAME OP FILING COMMrTTEi, gANDIDATE OR LOBBYIST
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STREET ADDRESS
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STATE
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"NAME OF OFFICE SOUGHT BY CANIIDATE
TYPE OF REPORT (CHECK ONE)
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P CODE
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PARTY
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6TH TUESPAY
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FOR OFFICE USE ONLY
PRE-PRIMARY
DATES OF REPORTING PERIOD
2
2ND FRIDAY
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PHE-PRIMARY
3
30 DAY
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TO
0^ 6% 0=1
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POST-PRIMARY
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4
6TH TUESDAY
CASH BALANCE AT END OF REPORTING PERIOD:
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PRE-ELECTION
TOTAL AMOUNT OF FILER'S OUTSTANDING DEBTS OR LIABILITIES AT THE END OF REPORTING PERIOD!
5. 2ND FRIDAY PRE-ELECTION
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53
30 DAY. YES
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YES
NO
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AMENDMENT POST-ELECTION
REPORT?
ANNUAL
TERMINATION
REPORT
REPORT?
11 = 3 ::^:-
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AFFIDAVIT SECTION PART 1 If statement is filed on behalf of a Political Committee or Candidates's Committee, the 7V easurer must sign here. If statement is fifed 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 RECE PTS OR DISBURSEMENTS OR LJABIIJTieS NCURR5D DUR N3 THE EXCEED TWO HUNDRED AND FIFTY DOLLARS (5250.00) AND THIS REPORT IS, T 0 THE B£ST OF MY KNOWLEDGE AND BEL EF,
RiPO,^TtI-
SWORN TO AND SUBSCRIBED BEFORE M£ THIS
i-.'T^t 1*1
1j DAY
OF
Vy-/ (-41
.\ $ J?
20 "
SIGNATURE OF PERSO
7
e PERIOD INDICATED ^BOTE DID NOT jXUc, CORRECT AND COMPLETE.
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* SUBMITTING REPORT
^C(,^^^^r\i»MriMii&fA^0=^^M^\fi\/\ R|R6S/'
MY COMMISSION E <
'™fe-.BlStSi
-Dn*i,b_ "-'--• DAY' - • - • ' WJ5"" CtyOfEsstor. •' . ;.-'/;:;•• ^OLi'^r)-1 My Gommission c.xovt;^ viar. 31 , 2
6 ta
AREA CODE
ttr/i^aJTr.
" DAYT ME TELEPHONE NUMBER
•'AKI II Member, Psrirjsvfvan a Assr>Qi?iion of t f statement is filed on benaif of a Candidate s Aut lonzed Comm ttee, Candidate must si ^n here, i SWEAR (OR AFFIRM) THAT TO THE BEST OF MY KNOWLEDGE AND BEL EFTHIS POUT CAL COMMITTEE HAS NOT VIOLATED ANY JUNES, 1937 (P.L, 1333, No. 320} AS AMENDED.
PROVISIONS OF THE ACT OF
SWORN TO AND SUBSCR BED BEFORE ME THIS DAY OF
20 PRINTED NAME SIGNATURE
MY COMMISS ON EX MO.
DSEB-503 (12-99)
DAY
YR.
Department of State * Bureau of Commissions, Elections and Legislation 210 North Office Building • Harrisburg, PA 17120-0029 • (717) 787-5280
Cornmonweslth of Pennsylvania
CAMPAIGN FINANCE REPORT Filer Identification ^, Number: P^
Report Filed By:
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CANDIDATE
3
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COMMITTEE
'^/ LOBBYIST
Name of Filing Committee, Candidate or Lobbyist:
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TYPE OF REPORT
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Zip Cede:
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-ML__ 2ND FSiDAY PRE-PRiMARY
6TH TUESDAY PRE-PB1MARY
2
-
V 6.
2ND PR I DAY
(place X to the right of report type)
£E-™SC™N
PRE-ELECTiDN
POST ELECTION
YEAR
7,
ANNUAL REPORT
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30 DAY
(«•
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PAPER Disuict
DA Y f
DISKETTE Office
'srty
County
(££E INSTRUCTIONS "OR COD=S!
FOR OFFICE USE ONLY
Summary of Receipts fc^,, and Expenditures from: 1
11
Q£ ?<m
A. Amount Brought Forward From Last Report B. Totsl Monetary Contributions snd Rec eipts From Schedule 1) C. Total Funds Av; liable (Sum cf Lines A and S) D. Total txpenditu es (From Schedule I! i
To $
t. Ending Cash Balance (Subtract Line D from Line C)
G. Unpaid Debts ar d Obligations (From Scheauie iV)
(Z
* - 7 . C'H(^ 5 ?' 5
F. Value of In-Kin d Contributions Rece ved (F 'on Schedule M)
$4' Lj
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AFFIDAVIT SECTION PABT i - if this is s Committee report, treasurer sign here, if this is 2 Candidate report candidate sign here.
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TERMINATION REPORT?
FILING METHOD fc. ( 1 CHECK OWE fr
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REPORT?
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Vuicano, Wa'3f' f tastSn
PART ti - if this is a report'of a Candidate's Authorized Committee, candidate snsli sign here.
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SCHEDULE I
CONTRIBUTIONS AND RECEIPTS Detailed Summary Page
1. UNITEMIZED CONTRIBUTIONS AND RECEIPTS - $50.00 OR LESS PER CONTRIBUTOR TOTAL for the Reporting Period
2.
(1)
S
H9G^
CONTRIBUTIONS $50.01 TO $250.00 (FROM PART A AND PART Bi
Contributions Received from Political Committees (Part A)
$ %)°^
$ 2,eo —
All Other Contributions (Part B! TOTAL for the Reporting Period
(2)
$ ££0^ 3.
CONTRIBUTIONS OVER $250.00
Contributions Received from Political Committees (Part C)
$ I ^QQ0'^
All Other Contributions (Part D)
£_
TOTAL for the Reporting Period
4.
(31
—D UL $ KsbO^
OTHER RECEIPTS - REFUNDS, INTEREST EARNED, RETURNED CHECKS, ETC. (FROM PART El TOTAL for the Reporting Period
TOTAL MONETARY CONTRIBUTIONS AND RECEIPTS DURING THIS REPORTING PERIOD (Add and enter amount totals from Boxes 1, 2, 3 and 3; also enter this amount on Page T, Report Cover Page. Item 3.)
(4)
S'Z^O.^
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PART A
7
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. Reporting Period
if Filing Committee or Candidate
i,Js A
R.li Ll
From 0 ^ - O C - C " 1
To
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YEAR
MO.
DAY
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YEAH
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DAY
YEAR
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DAY
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MO.
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MO.
DAY
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cf Contribuling Committee
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atete
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700^ YEAR
DAY
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ns of C3ntributing,Committg= 0,/~
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s $
? $ $ $
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T,e of Con.rihJting Comm.ttee Adcress
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DAY
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f/n
DAY
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DAY
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we.
DAY
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s $
$ $ s s $
$ $ PAGE TOTAL,
Grand Total of Part A on Schedule !, Detsiled Summary
Page, Sectic T
2.
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$ ">S<J -"
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PART B
Abt_.q_
ALL OTHER CONTRIBUTIONS S50.01 TO $250.00 Use this Part to itemize all other contributions with an aggregate value from $50.01 to $250.00 in the reporting period. (Exclude contributions from political committees reported in Part A.) R sporting "eriod
Nsme of F ling Committee or Candidate 1 s t c' v\c/ >
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AMOUNT
DATE
MO.
Full Name of Contributor
^kadis
-^ Mcti/iYA
Me.ling Address
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l ) e [ f t K / a ,/-e
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D*^T;-*tt P^ '
DAY
wo.
(j
YEAR
GAY
$
D>r: J $
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PAY
YEA3
fv'C.
DAY
YEAR
0V
?&3'°(
MO.
LI
DAY
YEAR
MO.
DAY
YEAR
Full Name of Contributor
MO.
DAY
YEAR
Mailing Address
MO.
DAY
YEAR
MO,
DAY
YEAR
Full Name o-f Contributor
MO
DAY
YEAR
Msilino A o d r e e s
MO.
DAY
YEAR
WO
DAV
YEAR
City
| State
a
£ "SLft£
flailing Address
I ) i. *\
City
Aa ./-, ,v
-L S 1 GI/W /!/'
Z > p Coce (Plus 4!
•£ '
• Fu-i Name ofdcontributor
£ ' r, ^ ^
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Ka M ^ 6 .
Ir^i v lV\
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i State
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f A
City
*rt
$
$ $
1 SOL, zr
Jstste
Z:p Code (Plus 4)
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$ $ S
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S
rul! Name of Contributor
[/£,
W a i t i n g Address
MO.
CAV
VSAR
r/o.
DAY
Y5Afi
Full Nsrne of Ccntribuicr
wo.
DAY
YEAR
r/.aihng Address
MO.
DAY
YEAR
MO.
DAY
Y=AR
DAY
YEAR
rv;o.
DAY
YEAR
Full Neme of Contributor
MO.
PA •
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Waning Address
MO.
DAY.
YEAR
f/0.
DAY
YEAR
$ S
City
State
Zip Coae iPius 4/
$ S
-
City
stE'.e j
Zip Code iPius 4;
$
1
S
$
Full Name of Contributor
S Msiiing A a d r e s s
E/0.
CITY
S.a.e
ilp
wO^S
Iri^a
i)
1
S
I
City
S
sisie
tip Coce !rl^^ 4;
1
$ S S
i
PAGE TOTAL
Enter Grand Tots! of Part B on Schedule f. Detailed Summarv
Pace- Seetinr
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PART C
CONTRIBUTIONS RECEIVED FROM POLITSCAL 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. Reporting Period
TO G-\l'Qc\
fi.-
fr*^ (n> t vrc. ^jfjTegft •
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Mailing Addre
CAY
«t Cc^
I
YEAR
ISrO^ SW^ryg^ilW Vt"
Full Nsme of Contibuling Committ >AY Zip Code (Plus 4)
MO.
.
DAY
...MO-
J
PAY
. YEAR
iSOHn
MO.
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DAY
|
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YEAFi
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Ststs
PAY j
DAY
i
V£AP
DAY
I
YEAR
'£
j.ip Ce
(PAGE TOTAL
Enter Grand Total of Part C on Schedule I, Detailed Summary Pase. Section 3.
SCHEDULE III
STATEMENT OF EXPENDITURES TO i,-i2-o° To Whom Paid
DAY, ]
YEAR
Amount
o*^4» ]5v y 'i(o/A*-y, To Whom Peld
WO.
DAY
fi-^ s
YEAH
Msiling A d d r e s s
™xai To Whom Paid
MO.
i
MO.
j
DAY
n JM
HI M.
Stcte
Zip Code (Plus 4)
PA To Whom P s i d
_.S^X-I-—-A^j ^moun1:
I IM
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DAY
j
YEAR
DAY
I VEAR
"WU.^r* "bv
Tc Whom P a i d
21 n
MO.
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Amoun1
va
To Whom Paid
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Evntsr Grsnd Tots! of Expenditures on Paga 1, Report Cover Pags, Item D.