HomeMy WebLinkAboutRothman, Greg - 2021 30-Day Post-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 IDENTIFICATION REPORT FILED CANDIDATE I COMMITTEE A LOBBYIST 7.
NUMBER ` ON BEHALF OF ® e /\_ ,
NAME OF RUNG COMMITTEE,CANDIDATE OR LOBBYIST
6-ref Arfll.M."
STREET ADDRESS
/ GI'ofok1c/,ar RI
CITY STATE ZIP COOS
`/
TYPE OF REPORT NAME OP OFFICE SCHIGtfeDY CANDIDATE ) DISTRICT NO. PARTY i.,;_;fi;>?DATE'OP E ::4 LECTION ,4 e
(CHECK ONE) o '.y 4 L'6'✓•s- I.-) 704 t. A.O. OAY YEAR'
1. �,wa/ ovv--0 �/. I 7 Tt�p��Nr -. 05' i 9. zoo./
Bra TUESDAY S -
PRE-PRIMARY / FOR OFFICE USE ONLY
No. DAY YEAR MO. DAY i YEAR
2ND FRIDAY 2. DATES OF -
REPOR
PRE-PRIMARY PERIOD
7.. i TO L
O v J D7 Z�2) r M..
30 DAY 3 $f 0 t...,.' .
POST-PRIMARY
CASH BALANCE AT END e ` C '
STH1rvESDAY 4. OF REPORTING PERIOD: $ .e-.
PRE-ELECTION ...,—
TOTAL AMOUNT OF FILER'S c:ci
5. OUTSTANDING DEBTS OR LIABILITIES t.:_
PRE-ELECTION AT THE END OF REPORTING PERIOD: $$
6. - tINI)
POST-ELECTION REPORT?AMENDMENT YES NO X ,"y
7•
ANNUAL TERMINATION
REPORT REPORT? YES NO
...•._ — - - - ::bi:t° :ri.r.: • , - -^1 r „.„:„.. _-.•Cr,,,,._=�:v�hn1T'- .,..
tea'; .I_C'`�::�:�:_ r-=i:��
r._ c: - �.3" 't; /AFFtDi4Vl SECT ON. .- _ --='�,+
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 SEST OF HY KNO 'LEDG D BELIEF,TRUE.CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
G DAY OF .T�y..e, 21_— ,01a�sea% SIGNATURE PE ON SUBMITTING REPORT
_, 411,of penngylva�Willa
pubiic
/' �sIGNAT6u-' �Ou la5��nl�cpcds4 ntY 3 PRINTED NAME
MY COMMISSION EXPIRES Cr v G 4 ` /�n mossQB,2a2
MO. MY �i�C n n fimber 12924 - ODE DAYTIME TELEPHONE NUMBER
PART 11-
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 POUTICAL COMMITTEE HAS NOT VIOLAT'EO 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 e Bureau of Commissions,Elections and Legislation
DSEB-503(12-95) 210 North Office Building o Harrisburg,PA 17120-0029 a (717)787-5280