HomeMy WebLinkAboutRothman, Greg - 2016 Annual Report 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.
FILER IDENTIFICATIONREPORT FILED CANDIDATE I 2 3.
NUMBER 10, ON BEHALF OF lo, �i COMMITTEE LOBBYIST
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST //
STREET ADDRESS G/' 7
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CITY STATE ZIP CODE
../01.e..-44.0,--ni.06t.iJq ,.q /7050 -
TYPE OF REPORT NAME OF OFFICE SOUGHT//'- BY CANDIDATE J DISTRICT NO. PARTY DATE OF ELECTION
(CHECK ONE) . rn.s- .LJY. ?.'-.` i �L.- 7'.4 t O./✓
/� P j n vb(' MO. DAY YEAR
6TH TUESDAY 1 6--...7/...,,.../
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iG
PRE-PRIMARY FOR OFFICE USE ONLY
MO. I DAY YEAR MO. I DAY I YEAR
2ND FRIDAY 2' DATES OF
PRE-PRIMARY REPORTING TO C') CN=)
PERIOD f/ .? yo/. /y 31 2.o/G —
30 DAY 3. ~ '
fii C_
POST-PRIMARY rri .,
CASH BALANCE AT END
6TH TUESDAY 4. OF REPORTING PERIOD: $ r- c....,
PRE-ELECTION C)
TOTAL AMOUNT OF FILER'S CJ
2ND FRIDAY 5. OUTSTANDING DEBTS OR LIABILITIES C7
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ C� __
8
30 oar „G-
POST-ELECTION REPORT?NT YES NO I
7.
ANNUAL TERMINATION
REPORT REPORT? YES NO X
AFFIDAVIT SECTION
PARTI -
If statement is filed on behalf of a Political Committee or Candidates's Committee,the Treasurer must sign here.
If statement is filed on behalf of a Candidate,the Candidate must sign here.
If statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE_ PORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY N• E'- o ANn IE:,JRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS ,`ir.
Oiligiak
2 2 DAY OF 3C.�n..J.rir j 20/7 'Q �� QJ.i-NA'UR c PERSON SUBMITTING REPORT
SOF s •fit.•o°��'�°' \
SIGNATURE &��0°'p5' 0\n Cl6� PRINTED NAME
MY COMMISSION EXPIRES, 'e oG z;:,Y•NIA OP\G�Pe,- ,-�,��e
MO. DAY GO' �S a,vss''p�.Q\t8 •REA CODE DAYTIME TELEPHONE NUMBER
PART II- 00Gta�c\,cs•S
If statement is filed on behalf of a Candidate •,•' • ed Committee, Candidate must 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
SIGNATURE OF CANDIDATE
DAY OF 20_
PRINTED NAME
SIGNATURE
MY COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR.
Department of State • Bureau of Commissions,Elections and Legislation
DSPI3.501(I2_99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280