HomeMy WebLinkAboutRothman, Greg - 2016 30-Day Post-Primary iCOMMONWEALTH OF PENNSYLVANIA
CAMPAIGN FINANCE $TATE (ENT
File this in lieu of a full report only if aggregate relceipts, expenditures, or
liabilities incurred each did not exceed $250.00 dulling the reporting period.
FKER wUmlK:ATWH REPORT n4ED
MINDER �,��y OH DERM/'N {:/JIpIDA'16 1,( CON,ErtIlEv -LOLBriSF
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TYPE OF REPORT HOME Of OFFICE SOUGHT BYJ DMATE DISTRICT no. PARTY ! E
(CHECK ONE) f''+j.,,Gnt�✓Z !1/t � .,` le7
ay MO., OAY -YEAR
6TH lUESOAY ..
PREPttUMART I FOFLOFFICE UaE'7SVLY_
MO. OAY YEAR NO. DAY YEAR
2N0 FRIDAY 2. DATES OF
PAC-PALMARY Pmoa
TNG To Y Y
ETaoay !z 20/4 1 03 14 awl rn
30 oar s' I rte— c_«D
POST-PRWARY l/ - w
I^ II GASH BALANCE AT END
STN TUESDAY .. N' OF REPORTING PERIOD: $� C'3 3r
PaELrrnorN C'1 r-
TOTAL AMOUNT OF FILER'S
s. OUTSTANDING DEBTS OR LIABILITIES
2ND;FWAY.
PRE-ELEcnoN AT THE END OF REPORTING PERIOD: $
30 BAY: AMENDMENT
POSTECECROH REPORTT' YES ND
7
ANNUAL TERMINATION
REPORT
REPORT?
- Yt:S Ne
AFFIDAVIT SECTION
PART I-
If statement is flied on bhalf of a Politics[Co mittee or Candidates's Com itt e,the Treasurer must sign here.
If statement is filed on b6half of a Candidate,the Candidate must sign here.
If statement is filed on behalf of a Contr briny LQbbvist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THEIAGGREGATE RECEIPTS OR DISBURSEMENTS OR UABIA.ITIES DNCURRED DURING REPORTING PERIOD INDICATED ABOVE DID NOT
EY.CEEO TWO HUNDRED AND FIT DOLLARS(5250.00)AND THIS REPORT IS,TO THE BEST OF MYE _ANp UEF,TRU°,CORRECT AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS
, e_DAY OF y 2012 SIGNATURE F ERSON SUBMITTING REPORT
IAWU
I LVANIA PRINTE}DD NAME
G t+iWEALTH
MY coM '3310,ExalREsf -74-3.t`T tZt2.
alp LAST MCKAR C�Public
TITY
PART 11- MY Can
AREA CODE DAYTIME TELEPHONE NUMBER
I mission EXplres Augur I
If statement is filed on be an I t ' uth rized Committee,Candidate must sign here.
I SWEAR(OR AFFIRM)THATITO THE BEST OF MY W40VAEOGE AND EEUEF THIS POLnK1.t COAO.ETTEE HAS!(OT VIOLATED ANY PROVISIONS Or THE ACT of
JUNE 3,1937(P.L. 1333 No.320)As AMENDED.
SWORN TO AND SUBSCREIED BEFORE ME THIS
SK, ATURE OF CANDIDATE
DAY OF 20L_
PRINTED NAME
SIGNATURE
MY COMMISSION EXPIRESMO. DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER
I
Department of State • Bureau of Commissions,Electio s and Legislation
DSED•50){13-99) 210 North Office Building 0 Harrisburn.PA 1TtOOJ+n^n