HomeMy WebLinkAboutFriends of Greg Rothman - 2015 Annual Report Commonwealth of Pennsylvania Page 1 of /Z^
CAMPAIGN FINANCE REPORT (COVER PAGE)
(NOTE: This report must be clear and legible.It may be typed or printed in blue or black ink.)
Filer Identification Report � ,ar'^w>��-'^--•�� 1. ,� 2. - 3.
Number: Y 20150209 Filede : CANDIDATE;; jCOMMITTEE:: LOBBYIST h.,:z„_:ti_.,-s.r.F::•� ::s._+,:.•.,.i.acuir.e-( X
Name of Filing Committee,Candidate or Lobbyist:Friends of Greg Rothman
Street Address: P.O. Box 1471 t
City. Camp Hill State: PA Zip Code: 17001-
TYPE OF 6T}1 TUESDAY? 1. ^2ND FRIDAY, a 2, E30 DAY;„o!�r 3. AMENDMENT,+- '? ++�
REPORT ;PRE-PRIMARYi 1 ;,PRE-PRIMARYi POST PRIMARY
�REPORT7r YES 7NO; X
r6TH.TUESDAY ? 4. =2ND FRIDAY eo-$j 5. 30DAY+-:arm -• ;.
r (place x to "fWRE-ElECT10Nf� ;PRE-EL_EC710N-, >: .t^` B. rTERMINATION r4 +-.-� X
the right of - _ ON FPOST ELECTION y' 4REPORT?.' �' , _IYEs YNO;
report type) ANN UALx•� 7. YEAR FILING METHOD Y r -+�--
�REPORTA,-(,:rhh X ► 2015 ;(_'�/-)CHECK ONEI' ^ P�APEk X DISKETTE
Name of Office Sought by Candidate: r • • District r OfficeForty Y A County
Representative In the Genera(Assembly .MO, DAY. a-.YEAR c Number Codeode Code
11 03 2015 87STHLP 21
(SEE INSTRUCTIONS FOR CODES)
MO.,,j DAY. 'ae'YEARt! M_O I`677n.YEAR d,1 ”msµ-''rO FOR OFFICE'USE 0NLY.*c�m:tr
Summary of Receipts 111111110. 1 l 24 2015 12 31 2015 c o
and Expenditures from: To
fP! }s
A. Amount Brought Forward From Last Report S 59,639.00 a
B, Total Monetary Contributions and Receipts(From Schedule 1) $ 1,150.00 '' W
C. Total Funds Available(Sum of Lines A and B) S 60 889.00 -p
D. Total Expenditures(From Schedule III) $ 260.00 O
E. Ending Cash Balance(Subtract Line D from Line C) S 60,629.00 7
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F. Value of In-Kind Contributions Received(From Schedule II) S 0.00 co
G. Unpaid Debts and Obligations(From Schedule IV) S 0.00
PART I Y=If this Is a"Committee;report,,treasurer slgn here.:If this is a ijCandidate j.report„candidate sign
I swear(or affirm)that this report,including the attached schedules,on paper or computer diskette.are to the Nestor my knowledge and belief true,coned and complete.
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Sworn to and subscnli efore me this
/1-1) tlay of 204_ ignature of Person Submitting Report
ov COI ONH.NNSYLVANIA
Han sbu FLICK Notaryloublic ' Printed Name
My commission expires r9 City'Dauph Cgount �/ y 7� Z �-
M "��'.2019 Area Code Daytime Telephone Number
PART.iir'Ifthis'isa report of a.Caridldote's Authorized Committee,!candidate.shall sl9n,here.iy;::*,;32!S
`; Y;,�s},Y4 'r�a +'C�«•.
I swear(or affirm)Thal to the best of my knowledge and belief this political committee has not violated any provisions of the ActA of June 3,1937(P.L.1333,No.320)as
amended.
Sworn to dna BUDScdDeO� me this
day of 20 /(0 1
// Signature of Candidate
M EALT NSY ANIA 1Nt��f4gn ( �,,,
ignature NOT IALSEAL Printed me
SHEILA REED FLICKINGER,N to Public
My commission expires rHS�g 1 Alli -71-7 _76S-12-)Z
D'My Com iKifS§o E pr(WMay 31,Z019 Area Code Daytime Telephone Number I !1
( DSEB-502(7.99) Department of State • Bureau of Commissions,Elections and Legislation vnT7
210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280 \FJ��
SCHEDULEI Page 2 of 17� _
CONTRIBUTIONS AND RECEIPTS
Detailed Summary Page
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/24/2015 To 12/31/2015
1rtUNI7EMIZED;C''ONTRI0UTIONS AND�RECEIPTS;_ $50 4OL0R;LESF;f5R CONTRIBUTOR
TOTAL for the Reporting Period , (1) 0.00
2' CONTRIBUTIOTJS$'50`09`i 6;$250 00:(FF20NI PA}27 A AND'PART
Contributions Received from Political Committees(Part A) $ 250.00
All Other Contributions (Part B) S 0.00
TOTAL for the Reporting Period `. (2) S 250.00
�3:,CONTRIBUTIONSMOHER,.$250.OA`(FRO.M PART'C'AND:P_ART,Da
Contributions Received from Political Committees(Part C) S 0.00
All Other Contributions(Part D) S 1,000.00
( TOTAL for the Reporting Period , (3) S 1,000.00
4:;OTHER;RECEIPTSREFUNbS,1NTERESTiEARyED;RETURNED CHEOKS;ETC;
TOTAL for the Reporting Period ` (4) S 0.00
TOTAL MONETARY CONTRIBUTIONS AND RECEIPTS DURING , S 1,250.00
THIS REPORTING PERIOD (Addend enter amount totals from Boxes
1, 2, 3 and 4;also enter this amount on Page 1, Report Cover Page, Item B.)
SEB-502(799)
PART A Page 3 of J"y
CONTRIBUTIONS RECEIVED FROM POLITICAL COMMITTEES
$50.01 TO$250.00
Use this Part to itemize only contributions received from political committees
with an aggregate value from$50.01 to$250.00 in the reporting period.
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11124/2015 To 12/31/2075
DATE AMOUNT
Full Name of Contributing Committee '* O. ' '�; HAZ. $ 250.00
School Bus PAC 12 04 2015
Mailing Address ;aM
355 N 21st St #200 $
City State Zip Code(Plus 4)
Camp Hill PA 17011-
PAGE TOTAL
Enter Grand Total of Part A on Schedule I, Detailed Summary Page, Section 2. $ 250.00
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PART B Page of
ALL OTHER CONTRIBUTIONS
$50.01 TO $250.00
Use this Part to itemize all other contributions with an aggregate value from
$50.01 to $250.00 in the reporting period.
(Exclude contributions from political committees reported in Part A.)
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11%24/2015 To 12/31/2015
DATE AMOUNT
PAGETOTAL
Enter Grand Total of Part B on Schedule I, Detailed Summary Page, Section 2. S 0.00
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t SEB-502(7.99)
PART C Page _ of
CONTRIBUTIONS RECEIVED FROM POLITICAL COMMITTEES
OVER $250.00
Use this Part to itemize only contributions received from political committees
with an aggregate value over$250.00 In the reporting period.
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/24/2015 To 12/31/2015
DATE AMOUNT
PAGE TOTAL
Enter Grand Total of Part C on Schedule I, Detailed Summary Page, Section 3. $ 0.00
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DSEB-602(740)
PART D Page 4 of 17-
ALL OTHER CONTRIBUTIONS
OVER$250.00
Use this Part to itemize all other contributions with an aggregate value of
over$250.00 in the reporting period.
(Exclude contributions from political committees reported in Part C.)
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/24/2015 To 12/3 1/2015
DATE AMOUNT
Full Name of Contributor WARNIftEA1941
Terry L Harris 12 21 2015 11000.00
Mailing Address 21t
2214 Eaglesmoor Ln
City State Zlp Code(Plus 4)
Enola PA 17025-
Employer Name Occupation
McKonly & Asbury CPA
Employer Mailing Address/Principal Place of Business
415 "Fallowfield Rd, Camp Hill, PA 17011
PAGE TOTAL
Enter Grand Total of Part D on Schedule I, Detailed Summary Page, Section 3. $ 1,000.00
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DSEe-502(799)
PART E Page 7 of
OTHER RECEIPTS
REFUNDS, INTEREST INCOME, RETURNED CHECKS, ETC.
Use this Part to report refunds received, interest earned, returned checks and
prior expenditures that were returned to the filer.
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/24/2015 To 12/31/2015
PAGE TOTAL
Enter Grand Total of Part E on Schedule I, Detailed Summary Page, Section 4. 0.00
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BSEB58219-98)
SCHEDULEII Page 8 of
IN-KIND CONTRIBUTIONS AND VALUABLE THINGS RECEIVED
USE THIS SCHEDULE TO REPORT ALL IN-KIND CONTRIBUTIONS OF VALUABLE THINGS
DURING THE REPORTING PERIOD.
Detailed Summary Page
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/24/2015 To 12/31/2015
f.: ll'NITEMIZED IN=KIND CONTRIBU TtUI1S REG IUED=VA}GlE i�F' 59':90'DR 4ESS",PEl2 CCINTRIB.UT;1�R aa,�.
TOTAL for the Reporting Period D. (1) $ 0.00
2.,I14 KIWDCtJNTi21BU (OtE3 R OE11FEb, UALi1ZOF;S5.041;:TO.$25D.00=(FR<)TVI!P.AIt] �17Ee_7� «�i1"¢�°�,, 7 > -
TOTAL for the Reporting Period (2) $ OM
3:,;IN�KINDZONTRJ UTIC3N3 R CE)1FE[3 ;1tA4U�Q f R$x$0:00'(f'ROIVI^PRRT G} i f. .* ,- a „�»; .": ,
TOTAL for the Reporting Period (3) $ 0.00
TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS
REPORTING PERIOD (Add and enter amount totals from Boxes 1, 2, $ 0,00
and 3:also enter on Page 1, Report Cover Page, Item F.)
OSED-502(7-99)
SCHEDULEII Page (_ of i2
PART F
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OF$50.01 TO$250.00
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/24/2015 To 12/31/2015
DATE AMOUNT
Enter Grand Total of Part F on Schedule II, In-Kind Contributions Detailed PAGE TOTAL
Summary Page, Section 2. $ 0.00
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DSEB-502(7-99)
SCHEDULEII Page iO of 12r
PART G
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OVER$250.00
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/24/2015 To 12/31/2015
DATE AMOUNT
Enter Grand Total of Part G on Schedule II, In-Kind Contributions Detailed PAGE TOTAL
Summary Page, Section 3. $ 0.00
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J DSEB-502(7-99)
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SCHEDULE III Page of /-z-
STATEMENT
zSTATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/24/2015 To 12/31/2015
To Whom Paid `.MODA' ` '� "i Amount
Centric Bank 11 1 30 12, 15 , 5. 00
Mailing Address Description of Expenditure
1625 Market St Service Fee
City State Zip Code(Plus 4)
Camp Hill PA 1 17011-
To Whom Paid MO,�« 'd3.A '±iYDWAmount
DTR Consulting 12 1 01 12015 IS 250.00
Mailing Address Description of Expenditure
210 Kelker St Professional Services
City State Zip Code(Plus 4)
Harrisburg PA 17102-
To Whom Paid i7901R",'D"A.Y15..1YVAR"+ Amount
Centric Bank 12 131 12015 S 5.00
Mailing Address Description of Expenditure
I 1625 Market St Service Fee
` City State Zip Code(Plus 4)
Camp Hill PA 17011-
Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D. PAGE TOTAL
"REFER TO INSTRUCTIONS FOR EXPENDITURE CODE NUMBERS. $ 260.00
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DSEB-502(7-99)
SCHEDULE IV Page T' of I v
STATEMENT OF UNPAID DEBTS
Use this Section to itemize all unpaid debts and obligations
which are outstanding at the end of the reporting period.
Name of Filing Committee or Candidate Reporting Period
Friends of Greg Rothman
From 11/24/2015 To 12/31/2015
PAGE TOTAL
Enter Grand Total of Unpaid Debts on Page 1, Report Cover Page, Item G. g 0.00
n5BB592('l99)