REPORT OF RECEIPTS AND DISBURSEMENTS
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1 Image# /19/ : 43 1 / FEC FORM 3 REPORT RECEIPTS AND DISBURSEMENTS For An Authorized Committee Office Use Only 1. NAME COMMITTEE (in full) TYPE OR PRINT Example: If typing, type over the lines. 12FE4M5 P.O. Box 280 ADDRESS (number and street) Check if different than previously reported. (ACC) Brookville PA FEC IDENTIFICATION NUMBER C C CITY STATE ZIP CODE STATE DISTRICT 3. IS THIS NEW AMENDED REPORT (N) OR (A) PA TYPE REPORT (Choose One) (a) Quarterly Reports: April 15 Quarterly Report (Q1) July 15 Quarterly Report (Q2) October 15 Quarterly Report (Q3) (b) 12-Day PRE-Election Report for the: (12P) (12G) Runoff (12R) Convention (12C) Special (12S) Election on in the State of January 31 Year-End Report (YE) (c) 30-Day POST-Election Report for the: (30G) Runoff (30R) Special (30S) Termination Report (TER) Election on in the State of 5. Covering Period 01 through I certify that I have examined this Report and to the best of my knowledge and belief it is true, correct and complete. or Print Name of Treasurer Matt Ryan Signature of Treasurer Matt Ryan [Electronically Filed] Date NOTE: Submission of false, erroneous, or incomplete information may subject the person signing this Report to the penalties of 2 U.S. 437g. Office Use Only FEC FORM 3 (Revised 02/2003)
2 Image# FEC Form 3 (Revised 02/2003) Page 2 2 / Write or Committee Name SUMMARY of Receipts and Disbursements Report Covering the Period: From: 01 To: Net Contributions (other than loans) COLUMN A This Period COLUMN B (a) Total Contributions (other than loans) (from Line 11(e)) (b) Total Contribution Refunds (from Line 20(d))... (c) Net Contributions (other than loans) (subtract Line 6(b) from Line 6(a)) Net Operating Expenditures (a) Total Operating Expenditures (from Line 17)... (b) Total Offsets to Operating Expenditures (from Line 14)... (c) Net Operating Expenditures (subtract Line 7(b) from Line 7(a)) Cash on Hand at Close of Reporting Period (from Line 27) Debts and Obligations Owed TO the Committee (Itemize all on Schedule C and/or Schedule D).... Debts and Obligations Owed BY the Committee (Itemize all on Schedule C and/or Schedule D) For further information contact: Federal Election Commission 999 E Street, NW Washington, DC Toll Free Local
3 Image# DETAILED SUMMARY of Receipts FEC Form 3 (Revised 12/2003) Page 3 3 / Write or Committee Name Report Covering the Period: From: 01 To: I. RECEIPTS COLUMN A Total This Period COLUMN B 11. CONTRIBUTIONS (other than loans) FROM: (a) Individuals/Persons Other Than Political Committees (i) Itemized (use Schedule A)... (ii) Unitemized... (iii) TOTAL of contributions from individuals... (b) Political Party Committees... (c) Other Political Committees (such as PACs)... (d) The Candidate... (e) TOTAL CONTRIBUTIONS (other than loans) (add Lines 11(a)(iii), (b), (c), and (d)) TRANSFERS FROM OTHER AUTHORIZED COMMITTEES LOANS: (a) Made or Guaranteed by the Candidate... (b) All Other Loans... (c) TOTAL LOANS (add Lines 13(a) and (b)) FSETS TO OPERATING EXPENDITURES (Refunds, Rebates, etc.) OTHER RECEIPTS (Dividends, Interest, etc.) TOTAL RECEIPTS (add Lines 11(e), 12, 13(c), 14, and 15) (Carry Total to Line 24, page 4)
4 Image# DETAILED SUMMARY of Disbursements FEC Form 3 (Revised 02/2003) Page 4 4 / II. DISBURSEMENTS COLUMN A Total This Period COLUMN B 17. OPERATING EXPENDITURES TRANSFERS TO OTHER AUTHORIZED COMMITTEES LOAN REPAYMENTS: (a) Of Loans Made or Guaranteed by the Candidate... (b) Of All Other Loans... (c) TOTAL LOAN REPAYMENTS (add Lines 19(a) and (b)) REFUNDS CONTRIBUTIONS TO: (a) Individuals/Persons Other Than Political Committees... (b) Political Party Committees... (c) Other Political Committees (such as PACs)... (d) TOTAL CONTRIBUTION REFUNDS (add Lines 20(a), (b), and (c)) OTHER DISBURSEMENTS TOTAL DISBURSEMENTS (add Lines 17, 18, 19(c), 20(d), and 21) III. CASH SUMMARY 23. CASH ON HAND AT BEGINNING REPORTING PERIOD TOTAL RECEIPTS THIS PERIOD (from Line 16, page 3) SUBTOTAL (add Line 23 and Line 24).... TOTAL DISBURSEMENTS THIS PERIOD (from Line 22) CASH ON HAND AT CLOSE REPORTING PERIOD (subtract Line from Line 25)
5 Image# SCHEDULE A (FEC Form 3) ITEMIZED RECEIPTS 11a 11b 11c 11d 12 13a 13b Carole Briggs Stonehenge Cir. Brookville PA Date of Receipt 07 Transaction ID : SA11AI.6764 FEC ID number of contributing federal political committee. None Receipt For: 2016 C Retired 520 Amount of Each Receipt this Period 250 Carole Briggs Stonehenge Cir. Brookville PA Date of Receipt 07 Transaction ID : SA11AI.6780 FEC ID number of contributing federal political committee. None Receipt For: 2016 C Retired 530 Amount of Each Receipt this Period James Clair 622 Melvins Rd. Telford PA Date of Receipt Transaction ID : SA11AI.6789 FEC ID number of contributing federal political committee. Retired Receipt For: 2016 C Retired 30 Amount of Each Receipt this Period SUBTOTAL of Receipts This Page (optional) ,,. FEC Schedule A (Form 3) (Revised 02/2009)
6 Image# SCHEDULE A (FEC Form 3) ITEMIZED RECEIPTS 11a 11b 11c 11d 12 13a 13b Hopkins Heltzel LLC 0 Meadow Ln Suite 5 Du Bois PA Date of Receipt 23 Transaction ID : SA11AI.6765 FEC ID number of contributing federal political committee. C Amount of Each Receipt this Period 0 Receipt For: Peter Morris 1820 Bayfield Ct. State College PA Date of Receipt 27 Transaction ID : SA11AI.6787 FEC ID number of contributing federal political committee. Retired Receipt For: 2016 C Retired 30 Amount of Each Receipt this Period Shari Jill Odenheimer 408 Washington Rd Wayne PA Date of Receipt 13 Transaction ID : SA11AI.6768 FEC ID number of contributing federal political committee. Chamberlain Hrdlicka Receipt For: 2016 C Attorney 50 Amount of Each Receipt this Period 50 SUBTOTAL of Receipts This Page (optional) ,,. FEC Schedule A (Form 3) (Revised 02/2009)
7 Image# SCHEDULE A (FEC Form 3) ITEMIZED RECEIPTS 11a 11b 11c 11d 12 13a 13b Janice Perison 778 Beaver Branch Rd. Pennsylvania Furnace PA Date of Receipt 23 Transaction ID : SA11AI.6770 FEC ID number of contributing federal political committee. None Receipt For: 2016 C Unemployed 40 Amount of Each Receipt this Period 40 Janice Perison 778 Beaver Branch Rd. Pennsylvania Furnace PA Date of Receipt Transaction ID : SA11AI.6769 FEC ID number of contributing federal political committee. None Receipt For: 2016 C Unemployed 90 Amount of Each Receipt this Period 50 Timothy Roschke 1129A S. Main St. Dubois PA Date of Receipt 05 Transaction ID : SA11AI.68 FEC ID number of contributing federal political committee. Retired Receipt For: 2016 C Retired Amount of Each Receipt this Period SUBTOTAL of Receipts This Page (optional) ,,. FEC Schedule A (Form 3) (Revised 02/2009)
8 Image# SCHEDULE A (FEC Form 3) ITEMIZED RECEIPTS 11a 11b 11c 11d 12 13a 13b Querino Torretti 215 N. 4th St. Reynoldsville PA Date of Receipt 23 Transaction ID : SA11AI.6767 FEC ID number of contributing federal political committee. Self-Employed Receipt For: 2016 C Attorney 0 Amount of Each Receipt this Period 0 Daniel Trevino 121 Blueberry Hill Ln. Port Matilda PA Date of Receipt Transaction ID : SA11AI.6788 FEC ID number of contributing federal political committee. Retired Receipt For: 2016 C Retired 50 Amount of Each Receipt this Period Date of Receipt FEC ID number of contributing federal political committee. C Amount of Each Receipt this Period,,. Receipt For:,,. SUBTOTAL of Receipts This Page (optional) FEC Schedule A (Form 3) (Revised 02/2009)
9 Image# NY 11793,, Travel expenses - gas Transaction ID : SB Payroll Transaction ID : SB Meal expense - interns Transaction ID : SB ,,.
10 Image# NY 11793,, Meal expense - interns Transaction ID : SB Meal expense - interns Transaction ID : SB Travel expenses - gas Transaction ID : SB ,,.
11 Image# NY 11793,, Travel expenses - gas Transaction ID : SB Meal expense Transaction ID : SB Payroll Transaction ID : SB ,,.
12 Image# NY 11793,, Travel expenses - gas Transaction ID : SB Meal expense Transaction ID : SB Meal expense - interns Transaction ID : SB ,,.
13 Image# NY 11793,, Travel expenses - gas Transaction ID : SB Travel expenses - gas Transaction ID : SB Travel expenses - gas Transaction ID : SB ,,.
14 Image# NY 11793,, Meal expense Transaction ID : SB Travel expenses - gas Transaction ID : SB Payroll Transaction ID : SB ,,.
15 Image# NY 11793,, Payroll Transaction ID : SB Meal expense - interns Transaction ID : SB Travel expenses - gas Transaction ID : SB ,,.
16 Image# NY 11793,, Travel expenses - gas Transaction ID : SB Travel Expenses - gas Transaction ID : SB Travel expenses - gas Transaction ID : SB ,,.
17 Image# NY 11793,, Meal expense Transaction ID : SB Meal expense Transaction ID : SB Payroll Transaction ID : SB ,,.
18 Image# NY 11793,, Travel expenses - gas Transaction ID : SB Meal expense - Clinton County Dems Transaction ID : SB Meal expense - interns Transaction ID : SB ,,.
19 Image# NY 11793,, Travel expenses - gas Transaction ID : SB Payroll BizBuzzDesign Transaction ID : SB N/A 23 Boynton Beach FL Consulting services - marketing/website Transaction ID : SB ,,.
20 Image# BizBuzzDesign N/A Boynton Beach FL 33424,, Consulting services - marketing/web Transaction ID : SB BizBuzzDesign N/A Boynton Beach FL Consulting services - marketing/web Centre County Democratic Committee Transaction ID : SB S. Allen St. Suite 116 State College PA Marketing - advertisement Transaction ID : SB ,,.
21 Image# David Diano 236 Cornerstone Dr Newtown Square PA 19073,, Voterweb services (Nov15) 003 Transaction ID : SB David Diano 236 Cornerstone Dr Newtown Square PA Voterweb services David Diano 003 Transaction ID : SB Cornerstone Dr Newtown Square PA Voterweb services 003 Transaction ID : SB ,,.
22 Image# Foxdale Village 500 E. Marylyn Ave State College PA 16801,, Breakfast Reception - services 007 Transaction ID : SB Emmett Hare 50 Lincoln Rd. Apt. 5L Brooklyn Payroll - campaign help Office Sought: Indigo Strategies House th St. NW NY Disbursement For: Transaction ID : SB Washington DC 20 Consulting services - marketing Transaction ID : SB ,,.
23 Image# Indigo Strategies th St. NW Washington DC 20,, Consulting services - marketing (expenses) Transaction ID : SB Indigo Strategies th St. NW Washington DC 20 Consulting - marketing Indigo Strategies Transaction ID : SB th St. NW Washington DC 20 Consulting services - marketing Transaction ID : SB ,,.
24 Image# Unigraphics Communications 703 A West Simpson St Mechanicsburg PA 17055,, Consulting - marketing 004 Transaction ID : SB USPS White St Brookville PA Postage Transaction ID : SB ,,. Office Sought: House Disbursement For:
25 Image# SCHEDULE C (FEC Form 3) LOANS LOAN SOURCE Kerith Strano Taylor 340 Main Street Transaction ID : SC/.5256 Election: 25 13a 13b City State ZIP Code Brookville PA Original Amount of Loan Cumulative Payment To Date Balance Outstanding at Close of This Period List All Endorsers or Guarantors (if any) to Loan Source 1. TERMS Date Incurred Date Due Interest Rate Secured: On demand % (apr) Yes No City State ZIP Code 2. Amount Guaranteed Outstanding:,,. City State ZIP Code 3. Amount Guaranteed Outstanding:,,. City State ZIP Code 4. Amount Guaranteed Outstanding:,,. City State ZIP Code Amount Guaranteed Outstanding:,,. SUBTOTALS This Period This Page (optional)... TOTALS This Period (last page in this line only) Carry outstanding balance only to LINE 3, Schedule D, for this line. If no Schedule D, carry forward to appropriate line of Summary. FEC Schedule C (Form 3) (Revised 02/2003)
26 Image# SCHEDULE D (FEC Form 3) DEBTS AND OBLIGATIONS Excluding Loans of Debtor or Creditor Michael Moser (Use separate schedule(s) for each numbered line) Nature of Debt (Purpose): Salary (4/4) Carlton Dr. Lebanon PA Outstanding Balance Beginning This Period Amount Incurred This Period Payment This Period of Debtor or Creditor Michael Moser -50 Transaction ID : SD.4815 Outstanding Balance at Close of This Period Nature of Debt (Purpose): Salary (4/18) Carlton Dr. Lebanon PA Outstanding Balance Beginning This Period -0 Amount Incurred This Period Payment This Period Transaction ID : SD.4816 Outstanding Balance at Close of This Period -0 of Debtor or Creditor Michael Moser Nature of Debt (Purpose): Salary (5/30) 2006 Carlton Dr. Lebanon PA Outstanding Balance Beginning This Period 150 Amount Incurred This Period Payment This Period 1) SUBTOTALS This Period This Page (optional)... 2) TOTALS This Period (last page this line number only)... 3) TOTAL OUTSTANDING LOANS from Schedule C (last page only)... 4) ADD 2) and 3) and carry forward to appropriate line of Summary Page (last page only) Transaction ID : SD.4819 Outstanding Balance at Close of This Period 150,,.,,. FEC Schedule D (Form 3) (Revised 02/2003)
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