HomeMy WebLinkAboutBienstock, Albert - 2019 2nd Friday Pre-Primary 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 I. Z 3
NUMBER
10, ON BEHALF OF , CANDIDATE �✓ COMMITTEE LOBBYIST
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
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STREET ADDRESS - --
iJ Dib Ao J./4f',2 Az
CITY STATE ZIP CODE
C/9,1/ gL z 19/9 i 70// —a as'O
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION
. (CHECK ONE) / 'J C.�+ .fs MO. DAY YEAR
C/;,
6TH TUESDAY 1- 77,Ai //0 zw,-,/ /o/le,/� /'Q FP a..5 a?l oaly/ 9
PRE-PRIMARY - FOR OFFICE-USE ONLY -
MO. I DAY YEAR MO. DAY YEAR
PRE-PRIMARY2ND FRIDAY
2
.✓
REPORTING
ERORD NG TO
03 /l ad” 'f pec 10/y
30 DAY 3. M 2>II•
POST-PRIMARY- X, "<
CASH BALANCE AT END r„ 1
STH TUESDAY 4• OF REPORTING PERIOD: $ O
PRE-ELECTION - ! Q "12TOTAL AMOUNT OF FILERS C")
S' OUTSTANDING DEBTS OR LIABILITIES r)
2ND FRIDAY AT THE END OF REPORTING PERIOD: $ C
PRE-ELECTION'
C,
6. -
30 DAY -- -_
AMENDMENT /
POST-ELECTION REPORT? YES NO ✓ .
7.
ANNUAL TERMINATION
REPORT REPORT?
YES ' NO
AFFIDAVIT SECTION
PART I-
Q--fFstafi hent is filed on behalf of a Political Committee or Candidates's Committee,the Treasurer must sign here.
z df�,(gt silent is filed on behalf of a Candidate,the Candidate must sign here.
J Af� t t nent is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
›-
TZ0) SY,'E kRR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID N9.17
1
J 11E4 TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AND OMPLETE
r
D -a a ORN TO AND SUBSCRIBED BEFORE ME THIS / //Cie/l•
/./e)
^
0 < n< q DAY OF /V► 1/ 2016 SIGNATURE OF PERSbN SUBMITTING REISQ(2T
_ U x yF J. -s—I /
W PRINTED NAME
Z• y ti, SIGNATURE
ZO 'n E f COMMISSION P ES J J ) 2� 717
2 E o w MO. DAY YR. AREA ODE DAYTIME TELEPHONE NUMBER
o Y1�
U PAR '4e-
If statement is filed on behalf of a Candidate's Authorized 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
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280