HomeMy WebLinkAboutBeinstock, Albert - 2015 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 IDENTIFICATION ' REPORT FILED , CANDIDATE I COMMITTEE LOBBYIST 3
NUMBER ON BEHALF OF
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST
0
STREET ADDRESS
-
CITY STATE ZIP CODE
A 70l! oSo
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY
(CHECK ONE) To AJA161f/P Co.tiM/ssl'o n��,e MO.• pAY YEAR
6TH TUESDAY T. Al Y RS -;-SRetz P
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. WY YEAR
2ND FRIDAY Z' / DATES OF
PRE-PRIMARY ✓ REPORTING TO p /(
PERIOD IO DO 0/O
30 DAY S'
POST-PRIMARY
CASH BALANCE AT END
STH TUESDAY 4' OF REPORTING PERIOD: $
PRE-ELECTION
TOTAL AMOUNT OF FILER'S
5. OUTSTANDING DEBTS OR LIABIUTIES
2H0 FRIDAY
PRE-ELECTION AT THE END OF REPORTING PERIOD: $
8.
30 DAY AMENDMENT
POST-ELECTION AMENDMENT
TES NO
7.
ANNUAL TERMINATION
REPORT REPORT? YES NO y/
AFFIDAVITe
S If Std 9 ant is filed on behalf of a Political Committee or Candidates's Committee, the Treasurer must sign here.
I trtent is filed on behalf of a Candidate,the Candidate must sign here.
E IRS dent is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here. $,g0
Z (OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
W 2� O HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE PEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORRECT AN •M
g E n RN TO AND SUBSCRIBED BEFORE ME THIS
F, N 2 c Z DAV F 20 SIGNATURE OF PSRS SUBMITTING REPORT
Ei
44e,,4!7 A, B/G�nlS70C�
Z -+ nPRINTED NAME
E O d SIG ATURE
E $s V OMMISSION EXPIRE . . 3C11
/
OU £ MO. DAY YR AREA ODE 76 DAYTIME TELEPHONE NUMBER
PARTII -
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 COMAffTTEE 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 MO. DAV YR. AREA CODE DAYTIME TELEPHONE NUMBER
t�
Department of State • Bureau of Commissions,Elections and Legislation \�
DSER-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280