PAGE 1 Commonwealth of Pennsylvania Campaign Finance Report (NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.) Filer Identification Number : 20120063 Report Filed By : CANDI COMMITTEE LOBBYIST Name of Filing Committee, Candidate or Lobbyist: Street Address: 174 NORTH LINDEN STREET : MANHEIM State: PA Zip Code: 17545 TYPE OF REPORT 6TH TUES PRE-PRIMARY 1. 2ND FRI PRE-PRIMARY 2. 30 POST-PRIMARY 3. AMENDMENT REPORT? Yes No (place X to the right of report type) 6TH TUES PRE-ELECTION 4. 2ND FRI PRE-ELECTION 5.X 30 POST-ELECTION ANNUAL REPORT 7. Year 2014 FILING METHOD ( ) CHECK ONE 6. TERMINATION REPORT? PAPER Yes No DISKETTE Name of Office Sought by Candidate: OF ELECTION District Number Office Code Party Code County Code REP 11 4 2014 (SEE INSTRUCTIONS FOR CODES) Summary of Receipts and Expenditures from: 9 16 2014 TO 10 20 2014 FOR OFFICE USE ONLY A. Amount Brought Forward From Last Report B. Total Monetary Contributions And Receipts (From Schedule I) C. Total Funds Available (Sum Of Lines A and B) D. Total Expenditures (From Schedule III) E. Ending Cash Balance (Subtract Line D From Line C) F. Value Of In-Kind Contributions Received (From Schedule II) G. Unpaid Debts And Obligations (From Schedule IV) 17,580.96 4,925.00 22,505.96 2,184.58 20,321.38 3,428.45 5,625.00 AFFIDAVIT SECTION PART I - If 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 filed on paper or by electronic medium, are to the best of my knowledge and belief, true correct and complete. Sworn to and subscribed before me this day of 20 Signature of Person Submitting Report My Commission Expires Signature Printed Name Email YR Area Code Daytime Telephone Number Part II- If this is a report of a candidate's authorized Committee, Candidate shall sign here. I swear (or affirm) that to the best of my knowledge and belief this political committee has not violated any provisions of the act of June 3,1937 (P.L. 1333, No 320) as amended. Sworn to and subscribed before me this day of 20 Signature of Candidate Printed Name My Commission Expires Signature Email YR Area Code Daytime Telephone Number
PAGE 2 SCHEDULE I CONTRIBUTIONS AND RECEIPTS Detailed Summary Page 1. Unitemized Contributions Received - 50.00 or Less Per Contributor TOTAL for the (1) 0.00 2. Contributions Received - 50.01 To 250.00 (From Part A and Part B) Contributions Received From Political Committees (Part A) 250.00 All Other Contributions (Part B) 250.00 TOTAL for the (2) 500.00 3. Contributions Received Over 250.00 (From Part C and Part D) Contributions Received From Political Committees (Part C) All Other Contributions (Part D) 1,200.00 3,225.00 TOTAL for the (3) 4,425.00 4. Other Receipts, Refunds, Interest Earned, Returned Checks, Etc. (From Part E) TOTAL for the (4) 0.00 Total Monetary Contributions and Receipts During this (Add and enter amount totals from Boxes 1,2,3 and 4; also enter this amount on Page1, Report Cover Page, Item B.) 4,925.00
PAGE 3 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 reporting period. Full Name of Contributing Committee LANCASTER GENERAL HEALTH PAC 50 PROVIDENCE ROAD 250.00 MEDIA State Zip Code (Plus 4) PA 19063 9 29 2014 Enter Grand Total of Part A on Schedule I, Detailed Summary Page, Section 2. 250.00
PAGE 4 PART B ALL OTHER CONTRIBUTIONS 50.01 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) Full Name of Contributor KENNETH & LEE KAUFFMAN 5920 MAIN STREET 250.00 EAST PETERSBURG State Zip Code (Plus 4) PA 17520 8 9 2014 Enter Grand Total of Part A on Schedule I, Detailed Summary Page, Section 2. 250.00
PAGE 5 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 from Over 250.00 in the reporting period. Full Name of Contributing Committee NRA - PAC 11250 WAPLES MILL ROAD 600.00 FAIRFAX State Zip Code (Plus 4) VA 22030 6 19 2014 Full Name of Contributing Committee FRIENDS OF JOSH PARSONS 830 MILLERS RUN LANE 600.00 LANCASTER State Zip Code (Plus 4) PA 17601 9 8 2014 Enter Grand Total of Part C on Schedule I, Detailed Summary Page, Section 3. 1,200.00
PAGE 6 PART D ALL OTHER CONTRIBUTIONS OVER 250.00 Use this Part to itemize all other contributions with an aggregate value of over 250.00 in the reporting period. (Exclude contributions from political committees reported in Part C.) Full Name of Contributor JOHN & FRANCES KRECEK Mailing Address 618 RANDOLPH DRIVE 2,225.00 State Zip Code (Plus 4) LITITZ PA 17543 6 19 2014 Employer Name FENNER DRIVES Occupation PRESIDENT Employer /Principal Place of Business State Zip Code (Plus 4) 311 W STIEGEL ST MANHEIM PA 17545 Full Name of Contributor BERNARD & NORMA RRISSEY Mailing Address 254 CHURCH STREET 500.00 State Zip Code (Plus 4) STEVENS PA 17578 9 8 2014 Employer Name RRISSEY INSURANCE Occupation OWNER / RETIRED Employer /Principal Place of Business State Zip Code (Plus 4) 890 N. READING RD. EPHRATA PA 17522 Full Name of Contributor DAVID & DEBORAH HOLLINGER Mailing Address 755 WHITE OAK ROAD 500.00 State Zip Code (Plus 4) DENVER PA 17517 9 8 2014 Employer Name FOUR SEASONS PRODUCE Occupation CEO Employer /Principal Place of Business State Zip Code (Plus 4) 400 WABASH RD EPHRATA PA 17522
Enter Grand Total of Part C on Schedule I, Detailed Summary Page, Section 3. PAGE 7 3,225.00
PAGE 8 PART E OTHER RECEIPTS REFUNDS, INTEREST INCOME, RETURNED CHECKS, ETC. Use this Part to report refunds received, interest earned, returned checks and prior expenditures that were returned to the filer. To: Full Name 0.00 State Zip Code (Plus 4) Receipt Description Enter Grand Total of Part E on Schedule I, Detailed Summary Page, Section 4. 0.00
PAGE 9 SCHEDULE II IN-KIND CONTRIBUTIONS AND VALUABLE THINGS RECEIVED USE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS DURING THE REPORTING PERIOD. Detailed Summary Page 1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED - VALUE OF 50.00 OR LESS PER CONTRIBUTOR TOTAL for the (1) 0.00 2. IN-KIND CONTRIBUTIONS RECEIVED - VALUE OF 50.01 TO 250.00 (FROM PART F) TOTAL for the (2) 161.64 3. IN-KIND CONTRIBUTION RECIEVED - VALUE OVER 250.00 (FROM PART G) TOTAL for the (3) 3,266.81 TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING PERIOD (Add and enter amount totals from Boxes 1,2, and 3; also enter on Page 1, Reports Cover Page, Item F.) 3,428.45
PAGE 10 SCHEDULE II PART F IN-KIND CONTRIBUTIONS RECEIVED VALUE OF 50.01 TO 250.00 Full Name of Contributor CLEMENS FOOD GROUP 2700 CLEMENS ROAD 6 20 2014 161.64 State Zip Code (Plus 4) HATFIELD PA 19440 Description of Contribution: GRILLED MEAT FOR CLAY SHOOT FUND RAISER Enter Grand Total of Part F on Schedule II, In-Kind Contributions Detailed Summary Page, Section 2. 161.64
PAGE 11 SCHEDULE II PART G IN-KIND CONTRIBUTIONS RECEIVED VALUE OVER 250.00 9/16/2014 To: 10/20/2014 Full Name of Contributor DAVID DUNN 910 N. HANOVER ST 3,266.81 ELIZABETHTOWN State Zip Code(Plus 4) PA 17022 6 23 2014 Employer of Contributor TROP GUN SHOP Occupation CEO Employer /Principal Place of Business 910 N. HANOVER ST State Zip Code(Plus 4) ELIZABETHTOW N PA 17022 Enter Grand Total of Part G on Schedule II, In-Kind Contributions Detailed Summary Page, Section 3. Description of Contribution MERCHANDISE & SERVICES / CLAY SHOOT 3,266.81
PAGE 12 SCHEDULE III STATEMENT OF EXPENDITURES From To Whom Paid CABELA'S 100 CABELA DRIVE 6 20 2014 184.87 State Zip Code (Plus 4) HAMBURG PA 19526 Description of Expenditure CLAY SHOOT SUPPLIES To Whom Paid EPHRATA AREA REPUBLICAN COMM. 800 DURLACH ROAD 8 9 2014 45.00 State Zip Code (Plus 4) STEVENS PA 17578 Description of Expenditure EDUCATIONAL SCHOLARSHIP AUCTION To Whom Paid THE TROPHY HOUSE 237 NORTH PRINCE ST. 8 21 2014 374.71 State Zip Code (Plus 4) LANCASTER PA 17603 Description of Expenditure CLAY SHOOT TROPHY To Whom Paid ACTION OF PA - LANCASTER CHAPTER 5845 CLARKSON DRIVE 9 25 2014 250.00 State Zip Code (Plus 4) EAST PETERSBURG PA 17520 Description of Expenditure BREAKFAST TABLE - TOM CORBETT To Whom Paid SUPPORTERS OF DAVE ZIMMERMAN P.O. BOX 232 9 25 2014 300.00 State Zip Code (Plus 4) EAST EARL PA 17519 Description of Expenditure DONATION
PAGE 13 To Whom Paid MILLER VICTORY COMMITTEE 959 WOOLRIDGE BLVD. 10 6 2014 500.00 State Zip Code (Plus 4) LANCASTER PA 17601 Description of Expenditure To Whom Paid SIGN ME UP 142 S. PITT ST. 10 6 2014 530.00 State Zip Code (Plus 4) MANHEIM PA 17545 Description of Expenditure Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D. 2,184.58
SCHEDULE IV STATEMENT OF UNPAID DEBTS Use this Section to itemize all unpaid debts and obligations which are outstanding at the end of the reporting period Outstanding Balance of Debt Name of Creditor MELINDA S. FEE 174 N. LINDEN ST. 2 2 2012 1,125.00 State Zip Code (Plus 4) MANHEIM PA 17545 Description of Debt CAMPAIGN EXPENSES Outstanding Balance of Debt Name of Creditor MELINDA S. FEE 174 N. LINDEN ST. 4 30 2012 4,500.00 State Zip Code (Plus 4) MANHEIM PA 17545 Description of Debt CAMPAIGN EXPENSES Enter Grand Total of Unpaid Debts on Page 1, Report Cover Page, Item G. 5,625.00