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.
AFFIDAVIT SECTION t PART I If statement is filed on beho'f of 3 PoH'ica! Comn-iiliee orCand'dates's Committse, the Treasurer must sign here. If statemen: ; s filed on behalf of a Candidate, the Candidate must sign here. If statement is filed on bens f of a Contributing Lobbyist, the Lobbyist must sign here.
PART I! if statement i.= !i!9d on behe of a Candidate's A-.tinr,.-ori Cnmrnittee. Candidate must sign here. JUNE; SWORN
DAYriP,-!- TEL^PHONff NUWBER
;epanmsni of State » Bureau of Commissions, Elections and Legislation K'orih Office Building » Hgrnsburg, PA 17120-0029 « (717S 787-5280
uommonweaitn o' Pannsytvania
'j~'
CAMPAIGN FINANCE REPORT
(COVER PAGE)
AFFIDAVIT SECTION PART ! - If this is 2 Committee report, treasure*" sign here f th s is a Candidate report, candidate &'an here. dge and belief true,
COMMONWEALTH OF PENNSV1VANI r-tolaral Seal Mary E. Baftet, NolsyPublic Lo\w Nazareth Twp., Northampton c. My Comml5StovE)lti)feftSept-29,2011_
Bra,;r;
PART IJ - If this is a report of a Candidate's Authorized Committee, candidate shall sign here.-
'Xsoartnent of Slate @ Bureau of Commissions, Elections and Legislation l C ^ o r t h O f f i c e Building ffi Harrisburg, PA 17120-0023 • (717) 787-5230 DSEB-5C2 (7-99)
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SCHEDULE i
PAGE 2 OF
CONTRIBUTIONS AND RECEIPTS Detailed Summary Page Reporting Period
Name of Filing Committee or Candidate
From
.1. UNITEMIZED CONTRIBUTIONS AND RECEIPTS - $50.00 OR LESS PER CONTRIBUTOR TOTAL for the Reporting Period
2,
(1)
CONTRIBUTIONS $50.01 TO- $250.00 (FROM PAHT A AND PART B)
* /00.0&
'•
Contributions Received from Political Committees (Part A)
* /60. *0
All Other Contributions (Part B)
$
TOTAL for the Reporting Period
3.
(2)
CONTRIBUTIONS OVER S250.00 {FROM PART C AND PART D)
•"
SAS&O, °°
Contributions Received from Political Committees (Part C) All Other Contributions (Part D!
? TOTAL for the Reporting Period
4.
ScAo.*^
$
(31
,-Cb
$
OTHER RECEIPTS - REFUNDS, INTEREST EARNED, RETURNED CHECKS, ETC. (FROM PART E) TOTAL for ths Reporting Per od
TOTAL MONETARY CONTRIBUTIONS AND RECEIPTS DURING THIS REPORTING PERIOD (Add and enter amount totals from Boxes f , 2. 3 and &.\ a] so enter this amount on Page 1 , Report Cover Page, Item B.)
DSEB-502 (7-99)
(4)
£
-^
.-
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 reportins period. Name of Fifing Committee or Candidate
DAY
MO.
<"
M l^^^f^s^i^^^^I
YEAR
l£l -0^09
S
DAY
YEAR
•
DAY
• YEAR
*
DAY
-YEAR -
MO.
DAY
YEAH
full Name of Contributing Commiu..
MO-
DAY
YEAR
Mailing Address
MO-
DAY
YEAR
MO.
DAY
- YEAR
DAY
YEftfl
$
DAY
YEAR
$
7or'u3«akVc.-ws^ -
i-Ss-fon" '"" """' °' t="""'ib"'i"» "-™1"" 9i
r , ii /*•%,
MO.
S
isoittiL
ing
MO.
•MO-
$
/ o o . °^
$ $ S
P LDd. ,,.
City
Full Name of Contributing commit!.*
!Y!O.
Mailing Address
MO.
•
$
$ $
MC-.
$ Full Nome of Contributing Commillee
' 'MO-'
Mailing Address
-
City
Fun Nome of Contributing Commiuee
$
MO.
DAY
YEAP
MO-
DAY
YEAR
MO-
DAY
VEAS "
$ S S
Full Name of Cnntribut.ng Committee
CTty
r«M
Nor™
of
C^M.FUulu.y
Cy
-
DAY
YEAP
MO.
DAY
YEAR
MO.
DAY
YEAR
$
MO.
DAY
YEAR
$
MO,
DAY
YEAR
MO.
" "^
TPfiR
Mite
Mailing Address
MO,
-
DAY
YEAR-
$ $
$
S $
YEAR
$ PAGE TOTAL
Enter Grand Total of Part A on Schedule 1, Detailed Summary Page, Section 2. DSE3-50I (7-9S'
f&o ,
ALL OTHER CONTRIBUTIONS $50.01 TO $250.00 Use this Part to itemize a!j 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.) Name of Filing Committee or Candidate
Reporting Period
w
[?0b^-
Ja^
j S. City
A/q za^g j-{^_ • _ M 9 ; - -•( "• BAY
S
75-go
Full Name of Contributor Contrib
off
B.
/^ f f ]A
\?{0^--
M°.
PAGE TOTAL
Enter Grand Total of Part B on Schedule I, Detailed Summary Page, Section 2. D5EB-502 17-99)
$ 5~3 o
PAGE
O
OF
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. Name of Filing Committee or Candidate
(2 r£~ /ires E MO.
*#TFj^«etoT£/0£>
P/\r
Mailing Address
•
DAY
YEAR .
•5"
/ t~f~
'MO, '
DAY
'YEA'S
MO
DAY
YEAR -
c?DO ^f
S
$
yo.rrcs Coo \r
PA
^1PU"'4'
S
^^"OO,
" • DAY
MO.
~ N.m. 0, C m ,ri B u,in a t^m,,,«
r
~~~~
YEAH
$ ,llmg Add!.!
DAY
MO.
YEAR
$
$ Full Nome of Contribute, C o m m i t t e e
MO.
DAV
VCiB'
MO.
DAY
YEAR.
Ma,
DAY
Y£AH
DAY
YEAH •
MO.
DAY
YEAR
MO
DAY
YEAH
MO,
DAV
VEAR:
$
MO.
DAY
YEAR
MQ.
DAY
...YEAR
$ s
MO.
DAY
YEAR
MO.
DAY
YEAR
MO.
DAY
YEAR
"MO.
DAY
yEAB"
MO,
DAY
YEAR
MO
DAY
YcAR
s
MO.
DAY
rSAR . .
$
MO.
DAY
YEAR
s
$
$ Cily
-
$ MO.
Full N.me of Contriving CommiUte
•
$
$
-
FuM N am =
Mailing
Of
Confuting Comminee
Address
Full Nstte of Contnbutmg Committee
" "^
Ci1y
Full Name o* Con.nbutmg Committee
Z i p Lads (Plus 4(
.
S
$ s $
s $
$ PAGE TOTAL
Enter Grand Total of Part C on Schedule i, Detailed Summary Page, Section 3. 3SEB-502 (7-991
0O
PAGE
/„
OF
SCHEDULE III
STATEMENT OF EXPENDITURES Name of Fi!;rg Co-nr-
DAY | YEAR -^Amount
L4
•Ms 5~\3t \3acff: pl:on of Expenditure^
.-*T
I
-hsLw^
Mailing Addre
MO.
DAY
To Whom Pei
City
Sieto
To Whom Peid
YEAR
1 Amount
YEAR
Amount
—
ZIB Cod. l"lu, 4)
MO
T
DAY
{ "t^R
1
j Amount
Is
Mailing Address City
Si BIB
PAGE TOTAL
Enter Grand Totaf of Expenditures on Ps je 1, Report Cover P sge. Item D.
$^?-a
Ocs '
SCHEDULE IV
STATEMENT OF UNPAID DEBTS Use this Section to itemize a!l unpaid debts and obligations which are outstanding at the end of the reporting period. Reporting Period To
Grand Totai of Unpaid Debts on Page 1, Report Cover Page, Itam G.