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Commonwealth of Pennsylvania - Campaign Finance Repor t(Note: This report must be clear and legible . It should be typed )

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_'C.1'Mi.l: 4 _Type of Report (Place x under report type )~,. 6th TuesdayPre-Primary

2- 2nd FridayPre-Primary

3- 30 Day post 4- 6th Tuesday 5- el FridayPre- Election

6- 30 Day PostElection

7- Annual Special 2"d FridayPre-Election

Special 30 Da yPost Electio nPrimary Pre- Election

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,1F . value of In-Kind Contributions Receive d

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'G . Unpaid Debts and Obligations(From Schedule IV)

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Affidavit SectionPart 1- tf this is a Committee report, treasurer sign here. if this is a Candidate report, candidate sign here.I swear (or affirm) that this report, including the attached schedules on paper, is to the best of my

owl r ge and belief true, correct and complete .Sworn to and subscribed before me this

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,R of- 13SCHEDULE I

Contn utions and Receipts1'

Detailed Summary Page

Filer Identification Number

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';: 1 .Unitemized Contributions and Receipts-$50 .00 or Less per Contributor

2 . Contri utao50.01 tO 25100 FrOMPart A and Part B)

Total for the reporting period

(1). 66

Contributions Received from Political Committees (Part A )

All Other Contributions (Part B)

Total for the reporting period 2

(600,0~~aao,00

4 . Other Receipts-Refunds, interest Earned, ReWrned Checks, ETC_ (From Part E ),

Total for the reporting perio d

Total Monetary Contributions and Receipts during this reporting period (Add andenter amount totals from Boxes 1, 2, 3 and 4 ; also enter this amount on Page 1, ReportCover Page, item B)

(4) fl$

3oF ( 3

PART AContributions Received From Political Committee s

$50 .01 TO $250.00Use this Part to itemize only contributions received from Political Committee s

with an aggregate value from $50 .01 TO $250.00 in the reporting period .

Filer Identification Number

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.w.apmalwolmnamllAmountFull Name of Contributing

.Committee

Date [MM/DD/YYYYI $

Noise # Street Address Date (MM/DD/YYYY] $

City State Zip Code . Date [MM/DD/YYYY] $

Full Name of ContributingCommittee

Date [MM/DD/YYYY] $

House It Street Address Date [MM/DD/YYYY] $

City State Zip Code Date [MM/DD/YYYY] $

Full Name of ContributingCommittee

Date [MM/DD/YYYY]. $

House # Street Address Date [MM/DD/YYYY] $

City State Zip Code Date [MM/DD/YYYY] $

. Full. Name Of ContributingCommittee

Date [MM/DD/YYYY] $

House # Street Address Date [MM/DD/YYYY] $

City State Zip Code Date [MM/DD/YYYY] $

. Full Name of Contributing

•Committee

Date [MM/DD/YYYY] $

House # Street Address Date [MM/DD/YYYY] $

City State Zip Code Date [MM/DD/YYYY] $

Full Nameof ContributingCommittee

Date [MM/DD/YYYY] $

House # Street Address Date [MM/DD/YYYY] $

City State Zip Code Date [MM/DD/YYYY] $

L/ OF i3PART B

All Other Contribution s$50.01 TO $25 0

Use this Part to itemize all other contributions with an aggregate value from$50.01 TO $250 in the reporting period.

(Exclude contributions from political committees reported in Part A. )

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PART C

ContribuUons Received From Political Committee sOver $250 .0 0

Use this Part to itemize only contributions received from Political Committee swith an aggregate value over $250.00 in the reporting period .

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PART D

All Other Contributions

Over $250.00

Use this Part to itemize all other contributions with an aggregate value over $250 .00 in the reporting period .

(Exclude contributions from political committees reported in Part C)

full Name of Contnbutor Date Mll

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All Other Contributions

Over $250.44

Use this Part to itemize all other contributions with an aggregate value over $250.00 in the reporting period.

(Exclude contributions from political committees reported in Part C)

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PART EOther Receipts

REFUNDS, INTREST INCOME, RETURNED CHECKS, ETC .Use this Part to report refunds received, interest earned, returned checks and prior expenditures that were returned to the filer .

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~~oF 13SCHEDULE II

IN4(IMD CONTRIBUTiONS AND VALUABLE THINGS RELIEVE DUSE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS DURING THE REPORTING PERIO D

DETAILED SUMMARY PAG E

TOTAL for the reporting period (2 )

TOTAL for the reporting period

(3 )

TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTIN GPERIOD (Add and enter amount totals from boxes 1, 2, and 3; also ente ron Page 1, Report Cover Page, Item F)

/Oof 13SCHEDULE I I

PART FIn-Kind Contributions Received

VALUE OF $50 .01 TO $250

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SCHEDULE I IPart G

!n(ind Contributions ReceivedVALUE OVER $250

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SCHEDULE II I

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:State .

/ 3 ~Fi3SCHEDULE I V

Statement of Unpaid DebtsUse this Section to itemize all unpaid debts and obligations which are outstanding at the end of the reporting period .

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