HomeMy WebLinkAboutRothman, Greg - 2015 2nd Friday Special COMMONWEALTH.OF PENNSYLVANIA
CAMPAIGN FINANCE STATEMENT �R 1
File this in lieu of a full report only if aggregate receipts, expenditures, or
liabilities incurred each did not exceed $250.00 during the reporting period.
FILER IDFNSIf1GTRIN REPORT FILED 1 � 1.
NUMBDi ON BEHALF OF
CANDIOATB X _COMMATEE LtlHBYIST
NAMEOF FILINq GCMMr U.GANCOATE OR LOBLBYIST
GY"GC CFI �H1c4//
STREETMBREES / R01
CITY STATE y/ ZIP CDOE
1?re • .ry:GS6Ut � 7'5 /
TYPE OF REPORT NAME OF OFFICE SOUGHT'BY CANDIDATE DISTRICT NO. PARTY a F
(CHECK ONG) `�� /,�� (�.y;VZ ♦'JL -A' A10. DAY YEAR
STH TUESDAY 1' Caa��l ssti�ET� i7 zar
PRE-PRIMARY FOR OFFICE USE ONLY
M0. DAY YEAR NO- DAY YEAR
2N0 FRIDAY 2' DATE$ IN �.G _
PRE-PRIMARY REPORG
PERIODn CC "' +-('/� TO 07 IZ•L'
30 DAY
POST-PRIMARY .v
CASH BALANCE AT END �
67H TOESDAY 4. OF REPORTING PERIOD: $
PRE-ELEGMON
TOTAL AMOUNT OF FILER'& 7D
2ND FRIDAY OUTSTANDING DEBTS OR LIABILITIES
PRE-ELECTION X AT THE END OF REPORTING PERIOD!
�V
30:DAY
POBTrELECTWN AMENDMENT
REPORT? YES NO
7,
ANNUAL TERMINATION
REPORT REPORT'? YES NO X
AFFIDAVIT
PART I-
If statement Is filed on behalf of a Political Committee or2rididates's Committee,the Treasurer must sign here,
If statement is filed on behalf of a Candi a e,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 LIASILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY CXO A T AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
�L•'OAY OF TIA c 20L SIGNATURE OF P S N SUBMITTING REPORT
163LtttL24 W. Gr.e6 R KMAN
PRINTED NAME
SSW"NATURE
MY COMMISSION EXPIRES LYi l tt�, i/I .✓CI l 6 �� 5-71-53"15
YR. AREA CODE OAYnME TELEPHONE NUMBER
PART 11- CQMMONWEALTH OF PENNSYLVANIA
If Sta s Authorized Committee, Candidate must sign here.
I SWEAR(OR AFFIFflliljty++PLOIIYIIE I EST OF MY 1 EDGE ANO RELIEF THIS POLITICAL COMMITTEE HAS NOT VIOLATED ANY PROVISIONS OF THE ACT OF
JUrtrEfAD 7(SI O,t�fFkl'Bth1:AtJ19MM04DE .
Wrnmisss'on,Expires Jun 4,2018
SWORAND
SIGNATURE OF CANDIDATE
DAY OF 20
PRINTED NAME
SIGNATURE
MY COMMISSION EXPIRES MO. DAY VR. AREA CODE DAYTIME TELEPHONE NUMBER
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DSBB-303(1?-99) 210 Ndrth Office Building • Harrisburg,PA 17120.0029 a (717)787.6280
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