HomeMy WebLinkAboutRothman, Greg - 2015 30-Day Special 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 IOENTFlCATION REPORT nLFD CANDIDATE 1. BpMMIR¢ LOBBVA4Y
NUMBER y ON BEHALF OF
NAME OF PUNS GOMMLTTFE,CMJOIDATE OR LOBBYIST
STREETADDRESS
CITY Hyl ( STATE �J ZIP CODE
TYPE OF REPORT NAME OF OFFICE SCISO/NT CANDIDATE DISTRICT NO. PARTY • > <
(CHECK ONE) � i`sS�hYt f'✓'"� �� . „ ' DAY YEAR. ...
STH iOEsDAY 1. 7 �f.a6/i ca" O t4MOIo
mE-PRIMARY FOR OFFICE USE ONLY
MO, MY YEM MD. DAY I YEAR
2N9 FRIDAY REPORTING
DATES OF
300APRE-PB�RY PERIOD
NG CJ7 ZI 'ICES TO (JE7 I`j Z�TIS
Y 3. �O
POSTPRIMARY Q 0
CASH BALANCE AT END
5THTUEsDAY 4. OF REPORTING PERIOD: $
PRE-ELECTION
TOTAL AMOUNT OF FILERS
5- OUTSTANDING DEBTS OR LIABILITIES "� ��
2ND FRIDAY AT THE END OF REPORTING PERIOD: $ Z
PRE-ELECTION � �` ��
$0 DAY
B: V
PQST�, LECTK/N Ilk-
REPORT?REPOR 7M YES NO I/ ` `O
ANNUALTERMINATION
REPORT REPO YES NO
REDB
PART 1-
If statement Is filed on behalf of a Political Committee orCandidates's Committee, the Treasurer must sign here.
If statement is filed on behalf of a Candidate.the Candidate must sign here.
If statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
1 SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISEURSMA S OR LIABILITIES.INCURRED DURING THE R QRTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLAR$(MO.00)AND THIS REPORT IS,TO THE BEST OF W KNoiIQ.E AHD IEF,TRUE,CORRECT AND COMPLETE.
SWORN TO ASIS IStjJ(�y$vjt"Fi9FP tjI� VAN1A ' tW,
D OF � IV V'1' f.�Y I. 2D/�� SIGNATUR F S N 5 EMITTING REPORT
.(PSS. (r.. .+ 011.0 Wu, ♦�-_
City of H _ ?l: 01 Du A "NTED N
y coffEXPIRES
MY COMMISSION EXPIRES
MD. DAY YR. I AREA CODE DAYTIME TELEPHONE NUMBER
PART II-
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 SEUEF THIS FOUTICAL COMMITTEE HAS NOT VIOIATSD ANY PROVISIONS OF THE ACT OF
JUNE 3,1937(P,L 1333,NO.320)AS AMENDED.
SWORN TO AND SUBSCRMED BEFORE ME THIS
SIGNATURE OF CANDIDATE
DAY OF 20
PRINTED NAME
3TGNATHRE
MY COMMISSION EXPIRES MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
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