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
Bra,;r;Mary E. Baftet, NolsyPublic
Lo\w Nazareth Twp., Northampton c.
My Comml5StovE)lti)feftSept-29,2011_ p

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)
 SCHEDULE i PAGE 2 OF

CONTRIBUTIONS AND RECEIPTS

Detailed Summary Page

Name of Filing Committee or Candidate Reporting Period

From

.1. UNITEMIZED CONTRIBUTIONS AND RECEIPTS - $50.00 OR LESS PER CONTRIBUTOR

TOTAL for the Reporting Period (1)

* /00.0&

2, CONTRIBUTIONS $50.01 TO- $250.00 (FROM PAHT A AND PART B) '•

Contributions Received from Political Committees (Part A)

* /60. *0
All Other Contributions (Part B) $
ScAo.*^
TOTAL for the Reporting Period (2) $

3. CONTRIBUTIONS OVER S250.00 {FROM PART C AND PART D) •"

Contributions Received from Political Committees (Part C) SAS&O, °°
All Other Contributions (Part D! ? ,-Cb

TOTAL for the Reporting Period (31 $

4. OTHER RECEIPTS - REFUNDS, INTEREST EARNED, RETURNED CHECKS, ETC. (FROM PART E)
TOTAL for ths Reporting Per od (4) £ -^ .-

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)
 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

MO. DAY YEAR

<" l£l -0^09
S

M
l^^^f^s^i^^^^I YEAR

7or'u3«akVc.-ws^ -
MO. DAY
S

• DAY • YEAR

isoittiL
MO.

i-Ss-fon- " r
ii ,
/*•%, $ / o o . °^
'"" """' °' t="""'ib"'i"» "-™1"" •MO- * DAY -YEAR -
$
9i ing MO. DAY YEAH
$
S
full Name of Contributing Commiu.. MO- DAY YEAR
$
Mailing Address MO- DAY YEAR
$
City P LDd. ,,. MO. DAY - YEAR

$
Full Name of Contributing commit!.* !Y!O. • DAY YEftfl
$
Mailing Address MO. DAY YEAR
$
MC-.

$
Full Nome of Contributing Commillee ' 'MO-'
$
Mailing Address MO. DAY YEAP
$
City

Fun Nome of Contributing Commiuee

- MO- DAY

DAY
YEAR
S
MO- VEAS "
S
MO. - DAY YEAP
" "^
$
MO. DAY YEAR
$
Full Name of Cnntribut.ng Committee MO. DAY YEAR
$
MO. DAY YEAR
$
CTty MO, DAY YEAR

$
r«M Nor™ of C^M.FUulu.y Cy Mite TPfiR
S
Mailing Address MO, DAY YEAR-
$
- YEAR

$
PAGE TOTAL
Enter Grand Total of Part A on Schedule 1, Detailed Summary Page, Section 2.
f&o ,
DSE3-50I (7-9S'
 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^-

j Ja^
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. $ 5~3 o
D5EB-502 17-99)
 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. • DAY YEAR .

*#TFj^«etoT£/0£>
S
P/\r •5" / t~f~ c?DO ^f
Mailing Address 'MO, ' DAY 'YEA'S
$

^1PU"'4'
MO DAY YEAR -

yo.rrcs Coo \r<v' PA S

^^"OO, r
~~~~

~ N.m. 0, C m ,ri B u,in a t^m,,,« MO. " • DAY YEAH

$

,llmg Add!.! MO. DAY YEAR

$

Full Nome of Contribute, C o m m i t t e e MO. DAV VCiB'

$

MO. DAY YEAR.

$

Cily Ma, DAY Y£AH

- $

Full N.me of Contriving CommiUte MO. • DAY YEAH •

$

MO. DAY YEAR

$

MO DAY YEAH
- S
MO, DAV VEAR:
$
MO. DAY YEAR
$
MQ. DAY ...YEAR
s
FuM N am = Of Confuting Comminee MO. DAY YEAR
$
Mailing Address MO. DAY YEAR
s
MO. DAY YEAR
- $
Full Nstte of Contnbutmg Committee "MO. DAY yEAB"
s
MO, DAY YEAR
" "^
$
Ci1y Z i p Lads (Plus 4( MO DAY YcAR
s
Full Name o* Con.nbutmg Committee MO. DAY . rSAR . .
$
MO. DAY YEAR
s
$
PAGE TOTAL
0O
Enter Grand Total of Part C on Schedule i, Detailed Summary Page, Section 3.
3SEB-502 (7-991
 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 YEAR 1 Amount

To Whom Pei YEAR Amount

City Sieto ZIB Cod. l"lu, 4) —

To Whom Peid MO T DAY { "t^R j Amount

1 Is
Mailing Address

City Si BIB

PAGE TOTAL

Enter Grand Totaf of Expenditures on Ps je 1, Report Cover P sge. Item D. $^?-a<O 7 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.