HomeMy WebLinkAboutRothman, Greg - 2021 2nd Friday Pre-Primary CAMPAIGN FINANCE STATEMENT
File this in lieu of a full report only if aggregate receipts, expenditures, or
liabilities incurred each did not exceed $250.00 during the reporting period.
FILER IDENTIFICATION ® REPORT OLEO10, CANDIDATE I.`. COMMITTEE Z LOBBYIST A
emu NUMBER ON B OF '1S0
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
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STREET ADDRESS
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CITY STATE..--$ ZIP CODE
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TYPE OF REPORT NAME OF OFFICE sourrf Y CANDIDATE rr DISTRICT NO. PARTY DATE OF.'ELECTION.,i:. =•'_
(CHECK ONE) Z.E,p,,.,�..$w e--1,Y� t.—A.1. -f k4' r�-/L i l✓r1 • . MO. DAY� YEAR •,
SI
6TH'TU ESDAY I. / ef��is+P sl,-1 _ f S.4'tt// / c,s" /1 Z07.I
PRE-PRIMARY /f FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAY YEAR
2ND FRIDAY. 2. DATES OF
PRE-PRIMARY
X REPORTING TO
PERIOD 0} Q 1 zest (/,j '3 Z.ALt C2 s-�
4' t .'>
30 DAY 3. `—
POST-PRIMARY. I
' CASH BALANCE AT END `E
4. OF REPORTING PERIOD: $ Oi 'r'
6TH'TUESDAY T,-• "
PRE-ELECTION ?
TOTAL AMOUNT OF FILER'S � _
S. OUTSTANDING DEBTS OR UABIUTIES -•`�
'2ND FRIDAY (-) .- -
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ C'"7 •-
. t.a
S. C...]
30 DAY AMENDMENT .....3
POST-ELECTION REPORT?
Z YES NO -.<
, X
ANNUAL TERMINATION
REPORT REPORT? YES NO
AFFIDAVIT SECTION
PART I-
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 UABIUTIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS(S250.00)AND THIS REPORT IS,TO THE BEST OF MY KN WLED c AND ELIEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
ra
DAY OF y - 20.E/ V SIGNATUR OF PERSON SUBMITTING REPORT
/ f rr ,:X thotn
.— . >tY I b PRINTED NAME
SIGNATU•. • �1�T,R1C1ca h•
MY COMMISSION EXPIRES el �f4 011L1i 402E
MO. DAY joY� 92
tevites Au90at 4s7 AREAICODE DAYTIME TELEPHONE NUMBER
omit— t=v 1
PART II- Gomm BP+' - .
If statement is filed on behalf of a andidate's Authorized Committee, Candidate must sign here.
I SWEAR(OR AFFIRM)THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS POLITICAL COMMITME 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
DSS13-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280
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