HomeMy WebLinkAboutRothman, Greg - 2015 Annual Report 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 FAEO I A T
NUMBER ONOEHALPOI OµpOATE COMMTREe .LOEBYLST .
NAME OF FILING COMMITTEE,CANDIDATE OR LOBBYIST IJ
STREET ADORESS
CRY STATE ZIP CODE
TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY
(CHECK ONE) %Z of/L S..A+t�a.�•1/v • " r* /).' ,MO.,• DAY YEAR
6TH TUESDAYt 1 t E^or./ ! 4M•/y/ L7 '�1-= yt�: // p3
PRE:PRIMARY FOR OFFICE USE ONLY
'2ND FRIDAY ' Z' DATES OF
REPORTIPREPRIMARY' PERIOD
NP' f I Z� �-0�� TO
CT
•30 DAY S'
POST ARIMARY M i
:.-. CASH BALANCE END
'<. OF REPORTING PEE x
6TH TUESDAY; PERIOD: $ t— fV
_ D O
PRE•ELECTION�.�, .Z
TOTAL AMOUNT OF'FILER'S O
- -'''s•
2N1FRIDAY.' OUTSTANDING DEBTS OR LIABILITIES ="
:• � S
ReE•ELEcnoN-: AT THE END OF REPORTING PERIOD: $ O
C --
30 DAY -.-� N
AMENDMENT
POST-ELECTION YES ND
REPORT?
T
7.
.ANNUAL TERMINATION
.REPORT• " - ,; f/ REPORT? YES NO X
YAFFIDAVIT
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 S'NFAR(OR AF NT
,THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR UASIUTIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
E%GEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEO AND a IEF,TRUE,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS �y1/�_/I
,��DAY OF J T'-^'�A-� 12for PENNSYMNIA SIGNATUR OF P.RSON SUBM G REPORT
�- NOTARIALSS N LaN OTJ
SIGNATU = PRINTED NAME Al
OO- f HartiSbu DaUPhin County
MY COMMISSION EXPIRES Or/ mFPjires August 06,20 S-]J
MO. AREA CODE DAYTIME TELEPHONE NUMBER
PARTII-
If statement is riled on behalf of a Candidate's Authorized Committee,Candidate must sign here.
I SWEAR(OR AFFIRM)THAT TO THE BEST OF MY 104OWLEDGE AND BELIEF THIS POLITICAL COMMITTEE HAS NOT VIOLATED ANY PROVISIONS OF THE ACT OF
JUNE 3,1937(P.L. 1333,No.320)As AM=_NoEo.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
SIGNATURE OF CANDIDATE
DAY OF 20
PRINTED NAME
SIGNATURE
MY COMMISSION EXPIRES MO. DAY YR. AREA CODE DAYTDAE TELEPHONE NUMBER
Department of State • Bureau of Commissions,Elections and Legislation
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787.5280
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