HomeMy WebLinkAboutFriends of Greg Rothman - 2016 Annual Report Commonwealth of Pennsylvania Page 1 of
• CAMPAIGN FINANCE REPORT (COVER PAGE
(NOTE: This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification likk, Report • 2• 3.
Number: 20150209 Filed By: ` CANDIDATE COMMITTEE .s X ,LOBBYIST
Name of Filing Committee,Candidate or Lobbyist:Friends of Greg Rothman
Street Address:
P.O. Box 1471
City: Camp Hill State: PA 1,Zip Code: 17001-
TYPE OF 6TH TUESDAY , - 1. ` 2ND FRIDAY 2. 30 DAY 3. AMENDMENT -
REPORT PRE-PRIMARY PRE-PRIMARY POST PRIMARY REPORT? YES NO x
6TH TUESDAY 4. 2ND FRIDAY 5. 30 DAY 6. TERMINATION
(place X to •PRE-ELECTION. PRE-ELECTION POST ELECTION REPORT? . YES NO' x
the right of • - • •
report type) ' ANNUAL 7. lkihn YEARFILING METHOD k
REPORT` XPPP- 2016 Whi4 ( y/ Rr•r
)CHECK.ONE ; PAPER X DISKETTE
Name of Office Sought by Candidate: DATE OF ELECTION District Office Party County
MO. DAY YEAR Number Code Code Code
Representative in the General Assembly STH REP 21
11 08 2016 87
(SEE INSTRUCTIONS FOR CODES)
MO. DAY YEAR MO. DAY YEAR
• FOR OFFICE USE ONLY •
Summary of Receipts 11 29 2016 12 31 2016
and Expenditures from: To
A. Amount Brought Forward From Last Report $ 24,650.73C'
- 4
B. Total Monetary Contributions and Receipts(From Schedule I) $ 0.00C,
n-i ?,.•
C. Total Funds Available(Sum of Lines A and B) $ 24,650.73
D. Total Expenditures(From Schedule III) $ 2,548.63 C7
E. Ending Cash Balance(Subtract Line D from Line C) $ 22,102.10 Cs) xi.
F. Value of In-Kind Contributions Received(From Schedule II) $ 0.00 r)
---
c
G. Unpaid Debts and Obligations(From Schedule IV) $ 0.00
- � x-
AFFIDAVIT SECTION
PART I,'-If this is a Committee-:report;treasurer"sign fiere.•If this is a. Candidate. report,candidate sign here. ,. y
I swear(or affirm)that this report,including the attached schedules,on paper or computer diskette,are to the best of my knowledge and belief true,correct and complete.
/
Sworn to and subscribed before me this 0r mi, } 1
/ f day of S....,,,,o, r/ 20 /7 • - ure o'--rso Submitting Report
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Signature Pte( �4.! otaH • 9 Printed(Naammee , ��
My commission expires 0� U� .,0. �o'CP44gly up`n5 o' `LOQ 1li _t"(�`C-350V
MO. DAYGO" YI.•(P5\1tg,\ P�9\1Area Code Daytime Telephone Number
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,PART,II,"-If this�is a report of a' Candida •' •`'- .d Committee, candidate shall sign here. , • : .P. ,_.-
•
I swear(or affirm)that to the best of my knowledge a•- •elief this political committee has not violated any provisions of the Act of June 3,1937(P.L.1333,No.320)as
amended.
SwornN5 to and subscribed before me this �\,`1? 41 16...__111_
2. 3 day of 3•.- 11 vµ �y 20 .,�''- " Q\0 -ign:ture of Candidate
/ -- /�Wit. Q-(Pp' pP.IX 0,1, 00,2
Signature . e51*• -'0g. es Pig Printed Name
My commission expires •••28 • _ , O . •0
MO. DAY - otn Area Code Daytime Telephone Number
01
3
05E8-502(7-99) Department of State • Bureau of Commissions,Elections and Legislation
210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280
SCHEDULE 1 Page 2 of
•
CONTRIBUTIONS AND RECEIPTS
Detailed Summary Page
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/29/2016 To 12/31/2016
1. UNITEMIZED CONTRIBUTIONS AND RECEIPTS—$50.00 OR LESS PER CONTRIBUTOR
TOTAL for the Reporting Period 11110., (1) $ 0.00
2. CONTRIBUTIONS.$50.01 TO$250.00(FROM PART A AND PART B)
Contributions Received from Political Committees (Part A) $ 0.00
All Other Contributions (Part B) $ 0.00
TOTAL for the Reporting Period 110• (2) $ 0.00
3. CONTRIBUTIONS OVER$250.00(FROM PART C AND PART D)
Contributions Received from Political Committees (Part C) $ 0.00
All Other Contributions (Part D) $ 0.00
TOTAL for the Reporting Period plow (3) $ 0.00
4. OTHER RECEIPTS-REFUNDS, INTEREST EARNED, RETURNED CHECKS, ETC;(FROM PART E)
TOTAL for the Reporting Period 100. (4) $ 0.00
TOTAL MONETARY CONTRIBUTIONS AND RECEIPTS DURING
THIS REPORTING PERIOD (Add and enter amount totals from Boxes $ 0.00
1, 2, 3 and 4;also enter this amount on Page 1, Report Cover Page, Item B.)
DSEB-502(7-99)
PART A Page of
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.
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/29/2016 To 12/31/2016
DATE AMOUNT
PAGE TOTAL
Enter Grand Total of Part A on Schedule I, Detailed Summary Page, Section 2. $ 0.00
DSEB•502(7-99)
PART B Page of
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.)
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/29/2016 To 12/31/2016
DATE AMOUNT
PAGE TOTAL
Enter Grand Total of Part B on Schedule I, Detailed Summary Page, Section 2. $ 0.00
DSEB-502(7-99)
PART C Page of
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 Reporting Period
Friends of Greg Rothman
From 11/29/2016 To 12/31/2016
DATE AMOUNT
PAGE TOTAL
Enter Grand Total of Part C on Schedule I, Detailed Summary Page, Section 3. $ 0.00
DSEB-502(7-99)
PART D Page of
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.)
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/29/2016 To 12/31/2016
DATE AMOUNT
•
PAGE TOTAL
Enter Grand Total of Part D on Schedule I, Detailed Summary Page, Section 3. $ 0.00
DSEB-502(7-99)
PARTE Page of
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.
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/29/2016 To 12/31/2016
PAGE TOTAL
Enter Grand Total of Part E on Schedule I, Detailed Summary Page, Section 4. 0.00
DSEB-502(7-99)
SCHEDULE II Page of
• 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
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/29/2016 To 12/31/2016
1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR
TOTAL for the Reporting Period Op (1) $ 0.00
2. IN-KIND CONTRIBUTIONS RECEIVED—VALUE OF$50.01 TO$250.00(FROM PART F)
TOTAL for the Reporting Period p► (2) $ 0.00
3. IN-KIND CONTRIBUTIONS RECEIVED--VALUE OVER$250.00 (FROM PART G)
TOTAL for the Reporting Period 11110. (3) $ 0.00
TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS
REPORTING PERIOD (Add and enter amount totals from Boxes 1, 2, $ 0.00
and 3;also enter on Page 1, Report Cover Page, Item F.)
DSEB-502(7-99)
• SCHEDULE H Page of
PART F
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OF$50.01 TO $250.00
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/29/2016 To 12/31/2016
DATE AMOUNT
Enter Grand Total of Part F on Schedule II, In-Kind Contributions Detailed PAGE TOTAL
Summary Page, Section 2. $ 0.00
DSEB-502(7-99)
SCHEDULE II Page of
•
PART G
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OVER$250.00
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/29/2016 To 12/31/2016
DATE AMOUNT
Enter Grand Total of Part G on Schedule II, In-Kind Contributions Detailed PAGE TOTAL
Summary Page, Section 3. $ 0.00
DSEB-502(7-99)
SCHEDULE III Page of —
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/29/2016 To 12/31/2016
To Whom Paid MO. DAY YEAR Amount
DTR consulting 12 01 2016 500. 00
Mailing Address Description of Expenditure
210 Kelker St _ Professional Services
_
City State – Zip Code(Plus 4)
Harrisburg PA 17102- ‘
To Whom Paid MO. DAY YEARI Amount
Hampden Youth Baseball Association 12 06 2016 IS 200.00
Mailing Address Description of Expenditure
c/o Jay Wiederhold 827 Mandy Ln Billboard
City State Zip Code(Plus 4) .
Camp Hill PA 17011-
To Whom Paid MO.• DAY YEAR Amount
Keystone Report, LLC12 14 2016 750.00
_
Mailing Address Description of Expenditure
1739 Creek Vista DrAds
. ,.._
City State Zip Code(Plus 4)
New Cumberland PA 17070-
To Whom Paid , MO. DAY YEAR Amount
Maverick Finance 12 19 2016 $ 975.30
Mailing Address Description of Expenditure
403 N Second St, 2FL , Commission
City State Zip Code(Plus 4)
Harrisburg PA 17101-
To Whom Paid 'MO. rDAY YEAR Amount
Pealer' s Flower Shop 12 t22 2016 123.33
Mailing Address Description of Expenditure
3720 Trinclie Rd Constituent gifts
City State Zip Code(Plus 4)
Camp Hill PA 17011-
-
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D. PAGE TOTAL
$
*REFER TO INSTRUCTIONS FOR EXPENDITURE CODE NUMBERS. 2,548.63
DSEB-502(7-99)
SCHEDULE IV Page of
STATEMENT OF UNPAID DEBTS
Use this Section to itemize all unpaid debts and obligations
which are outstanding at the end of the reporting period.
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/29/2016 To 12/31/2016
PAGE TOTAL
Enter Grand Total of Unpaid Debts on Page 1, Report Cover Page, Item G. 0.00
•
DSEB-502(7-99)