HomeMy WebLinkAboutCharles, Bob - 2016 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 $250.00 during the reporting period.
FILER IDENDFlCADON ' REPORT FILED I, / i. J.
NUMBE0. ONBEHALFOF CANDIDATE I/ COMMITTEE LOBBYIST
NAME pi fiLlkG LOME,CANDIDATE
l OR LOeDY5i
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STREET ADDRE
115 Wlt��ie IG! ✓'
CITY STATE ZIP G
rn p fh�i lN^A 10-7011 —
TYPERT R µE OF
OFFICE$,p,UG @lDj, DISTRICT NO, PARTY
(HEECK ONE) � IVI ' 'MIO. DAY YEAR,
6TH TUESDAY 1. (ble� 5
-7 D 1w)(0
PRE-PRIMARY FOR OFFICE USE ONLY
MO. DAY YEAR MO. DAV YFA0.
2ND FRIDAY 2. DATES OF
PRE-PRIMARY v REROD
C= CZD
30 DAY 3. V l/T-I'TING 0110 I O� X`/_ TO n6 I I IJ
K�
POST-PRIMARY- O3 3�
CASH BALANCE AT END _ 53 CCi M —0
k1NDTH TUESDAY a. OF REPORTING PERIOD: $ te70
RE-ELECTIONTOTAL AMOUNT OF FILER'S
FRIDAv 6' OUTSTANDING DEBTS OR LIABILITIES t-y
PRE-ELECTION AT THE END OF REPORTING PERIOD: $ _
30 DAY
POST-ELECTION' 'AMENDMENT REPORT? YES NO -C N
7.
ANNUAL TERMINATION
REPORT REPORT? YES NO
AFFIDAVIT SECTION
PARTI -
If statement is filed on behalf of a Political Committee or Candidates's Committee,the Treasurer must sign here. a y
If statement is filed on behalf of a Candidate,the Candidate must sign here. m s
If statement is filed on behalf of a Contributing Lobbyist, the Lobbyist must sign here. oH K
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1 SWEAR(OR AFFIRM.)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING TWPERIIOCD/pD IINNiDIICCATEED�ABOVE DID NOT B �� {gyp Z
EXCEED O HUNDRED AND FIFTY DOLLARS(S2SO.00)AND THIS REPORT IS,TO THE BEST OF MY XNO� BE� C�TRUE,%v✓�ECT� COMPLETE. ,Mu 0 Z
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SWORN TO AND SUBSCRIBED BEFORE ME THIS '04 > _m
th � =
DAY OF_ /"1 2O 51 ATURE OF PERSON SUBMITTING REPORT n z D O
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SIGNATURE PRINTED NAME0 MO
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MY COMMISSION EXPIRES lc��D��
ELL
MO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER N n <
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PART 11 - n
If statement is filed on behalf of a Candidate's Authorized Committee, Candidate must sign here.
1 SWEAR(OR AFFIRM)THAT TO THE BEST OF MY KNOFVLEDG-°AND BEUEF THIS POLITICAL COMMITTEE 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
PRINTEDNAME
SIGNATURE
MY COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR.
Department of State • Bureau of Commissions,Elections and Legislation
DSEB-503(12-99) 210 North Office Building • Harrisburg,PA 17120-0029 • (717)787-5280