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Home My WebLink AboutBloom for the 199th - 2016 30-Day Post-Primary PAGE 1 Commonwealth of Pennsylvania 11111111111■111111111 Campaign Finance Report 225137 (NOTE:This report must be clear and legible. It may be typed or printed in blue or black Ink.) Filer Identification 2010108 Report CANDIDATE I COMMITTEE LOBBYIST Number: I Filed By Name of Filing Committee,Candidate or Lobbyist: BLOOM, STEPHEN FOR THE 199TH COM Street Address: 2100 LONG GAP ROAD City: CARLISLE State: PA Zip Code: 17013-8651 TYPE OF 6TH TUESDAY 1. 2ND FRIDAY PRE- 2. 30 DA44;W AMENDMENT Yes No REPORT PRE-PRIMARY PRIMARY PRIMREPORT? 6TH TUESDAY 4. 2ND FRIDAY PRE- 5. 30 DATERMINATION Yes No (placex to PRE-ELECTION ELECTION ELECREPORT? the right of report type) ANNUAL REPORT 7, Year 2016 FILINPAPER DISKETTE ( ) Name of Office Sought by Candidate: a Number Code Party Coda CounCounty YEAR 199 Ent REP 21REPRESENTATIVE IN THE GENERAL ASSEMBLY 2016 (SEE INSTRUCRONS FOR CODES) Summary of Receipts and MO DAY YEARMO DAY YEAR FOR OFFICE USE ONLY Expenditures from: 4 12 2016 TO 1 5 16 2016 o rn A.Amount Brought Forward From Last Report $ 25,200.24 fTl ri B.Total Monetary Contributions And Receipts(From Schedule I) 1,650.00 T C.Total Funds Available(Sum Of Lines A and B) $ 26,850.24 CD D.Total Expenditures(From Schedule III) 1,000.000 O E.Ending Cash Balance(Subtract Line D From Line C) 1 25,850.24 1 F.Value Of In-Kind Contributions Received (From Schedule II) 84,78 W G.Unpaid Debts And Obligations(From Schedule IV) $ 0.00 AFFIDAVIT PART I-If this Is a Committee report,treasurer sign hero If this is a Candidate report,candidaaatt{)e sign here. I swear(or affirm)that this report,Including the attadhed schedules filed on paper or by de.troni�, V to of my Imowledge and belief,true correct and complete. Swom to and subscribed before me this Silna of Person Submitting Report --h day of 20 4-0 J. ?.yKfic)1D Printed Name Signattue CO Q7.AMtBU'%& Ce"C4 gT. 001E My Commission Expires TML Email -li-� S4n,- -)aS-3 MO DAY Rotary PYNICYR Area Code Daytime Telephone Number Part II-If this is a reportof a nd-- (W et>WrE10MA1t , nd ate shall_sign here. I swear(or affirm)that to the best of my knowledge and belief this polidcol committee has not violated e p on ot`tf a Te 3,1037(P.L.1333, No 320)as amended. Shorn to and subscribed before me this .Irlt�t Signature of i to �day of 20 v� dry r t ' � I p Printed Name 11 g. re sem. L�� —l-c-L'N_G1Mai l- M My commission Expires C_D A WNEALi)1 PENNSYLVANIA Email NOTARIAL SEAL —71 -7— —7o1 - N-349 0I6 Area Code Daytime Telephone DINICUAryPublic YR yt phone Numbcr CARLIS Laaaaommllrilrlfl Expires Jxn Iq,2p(g 5/19/2016 6:00:15 AM PAGE 2 SCHEDULEI CONTRIBUTIONS AND RECEIPTS Detailed Summary Page Name of Filing Committee or Candidate Reporting Period BLOOM, STEPHEN FOR THE 199TH COM From: 4/12/2016 To: 5/16/2016 1.Unitemized Contributions Received-$50.00 or Less Par Contributor TOTAL for the Reporting Period (1) ; 0.00 2.Contributions Received- $50.01 To;250.00(From Part A and Part 0) Contributions Received From Political Committees(Part A) # 150.00 All Other Contributions (Part B) $ 0.00 TOTAL for the Reporting Period (2) $ 150.00 3.Contributions Received Over$250.00(From Part C and Part D) Contributions Received From Political Committees(Part C) $ 1,500.00 All Other Contributions (Part D) $ 0.00 TOTAL for the Reporting Period (3) $ 1,500.00 4.Other Receipts,Refunds,Interest Earned,Returned Checks, Etc.(From Part E) TOTAL for the Reporting Period (4) S 0.00 Total Monetary Contributions and Receipts During this Reporting Period(Add and enter amount 1,650.00 totals from Boxes 1,2,3 and 4;also enter this amount on Pagel,Report Cover Page,Item B.) 5/19/2016 6:00:15 AM PAGE 3 PART A 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 BLOOM, STEPHEN FOR THE 199TH COM From: 4/12/2016 To: 5/16/2016 DATE AMOUNT Full Name of Contributing Committee NO DAY w--fYEAR BRADLEY A. MENTZER Melling Address 2 BRADI DRIVE $ 150.00 City CARLISLE State Zip Code(Plus 4) 5 4 2016 PA 17015 PAGE TOTAL Enter Grand Total of Part A on Schedule I, Detailed Summary Page,Section 2. $ 150.00 5/19/2016 6:00:15 AM PAGE 4 PART B 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 From: To: DATE AMOUNT Full Name of Contributor MO DAY YEAR Mailing Address $ 0.00 City State 21p Code(Plus 4) PAGETOTAL Enter Grand Total of Part A on Schedule I, Detailed Summary Page,Section 2. $ 0.00 5/19/2016 6:00:15 AM PAGE 5 PART C Contributions Received From Political Committees OVER $250.00 Use this Part to itemize only contributions received from Political committees with an aggregate value from Over $250.00 in the reporting period. Name of Filing Committee or Candidate Reporting Period BLOOM, STEPHEN FOR THE 199TH COM From: 4/12/2016 To: 5/16/2016 DATE AMOUNT Full Name of Contributing Committee FRIENDS OF JOHN McGINNIS MO DAY YEAR Mailing Address 1505 SAINT FRANCIS LANE # 1,500.00 CityALTOONA TStat; 21p Code(Plus 4) 5 2 2016 16602 PAGE TOTAL Enter Grand Total of Part C on Schedule I, Detailed Summary Page,Section 3. 1,500.00 5/19/2016 6:00:15 AM PAGE 6 PART D ALL OTHER CONTRIBUTIONS OVER $250.00 Use this Part to Itemize all other contributions with an aggregate value of 1. over $250.00 In the reporting period: "C (Eliciude contributions from political committees reported In Part-Q)L Name of Filing Committeeor Candidate,.,,- _.,,, � ,,, ..,,,� „ _-Reporting Period-. From: To: - 4.. •.... . - ,- -.-a..F- -.►a. ..-i -::...... ..,..�...+i..r. .--DATE,.. .... +...,ww..rrAMOUNT .. Full Name of,Contributor, _ ..... .. .. . - a MO DAY YEAR Mailing, .. _�. _ _ .. Address r - - �` _ rt.` �.' $ 0.00 city __ _ _ _ _ - State ..... Zip Code(Plus 4) I 1 Employer NameccuPN_on . . Employer . . . Mailing Address/Principal Place of _City p Co , - State Zip (Plus 4) Business _ �.. - - Enter Grand Total of Part C on Schedule I,Detailed Summary Page„Section 3. PAGE TOTAL S 0.00 5/19/2016 6:00:15 AM • - .- '--- - /19]ZD136[DOT15"AM ' TAA4 .^J'�.� ,I.):J3,'�:) 03Y1.ni1T9A '�"".1,1;1f!I TZ3i'9TF1' ,k'CrIRU'➢3A vr.a zY-IjH7 bnmufti ,Game- Pm-i�)lni tTCy - r 0, hrq C,,It t- -ofn crit a9 it muLiY »,)v In, •_.ufiGntq•.s Yoliq CnC.I fa sn'I r , T •mm ' j TG.JCMA Lml_!i.ai r ,4.,"m JAT::T:�M1 r•�•f�ro.. ,:CsS rftmrnaB p-arrsarr I nfu6eR---_ ruo 9 iir'.9 to Ia1crT arra;' r, tn! C'.. . I PAGE g SCHEDULE II 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 BLOOM, STEPHEN FOR THE 199TH COM From: 4/12/2016 To: 5/16/2016 1.UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR TOTAL for the Reporting Period (1) $ 0.00 2.IN-KIND.CONTRIBUTIONS RECEIVED-VALUE OF 350 01 T0,5250:00(FROM PART F),, u` - TOTAL for the Reporting Period (2) $ 84.78 3.IN-KINDICONTRIBUTION RECIEVED,?,VALUE OVER$250.00(FROM TOTAL for the Reporting Period (3) $ 0.00 TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING PERIOD(Add and enter 7g amount totals from Boxes 1,2,and 3;also enter on Page 1,Reports Cover Page,Item F.) 5/19/2016 6:00:15 AM PAGE 9 SCHEDULE II PART F IN-KIND CONTRIBUTIONS RECEIVED VALUE OF $50.01 TO $250.00 Name of Filing Committee or Candidate Reporting Period BLOOM, STEPHEN FOR THE 199TH COM From: 4/12/2016 To: 5/16/2016 DATE AMOUNT Full Name of Contributor GREG ROTHMAN MO DAY YEAR Mailing Address 1 GUNPOWDER ROAD $ 84.78 5 5 2016 City MECHANICSBURG State Zip Code(Plus 4) PA 17050 Description of Contribution: DIGILAND 7 TABLETS Enter Grand Total of Part F on Schedule II,In-Kind Contributions Detailed Summary Page, PAGE TOTAL Section 2. $ 84.78 5/19/2016 6:00:15 AM PAGE 10 SCHEDULE II PART 6 IN-KIND CONTRIBUTIONS RECEIVED VALUE OVER $250.00 Name of Filing Committee or Candidate Reporting Period From: To: DATE AMOUNT Full Name of Contributor MO DAY YEAR Mailing Address $ 0.00 City State Zip Code(Plus 4) Employer of Contributor Occupation Employer Mailing Address/Principal Place of City State Zip Code(Plus Description of Contribution Business 4) Enter Grand Total of Part G on Schedule II,In-Kind Contributions Detailed PAGE TOTAL Summary Page,Section 3, 0.00 5/19/2016 6:00:15 AM PAGE 11 SCHEDULE III STATEMENT OF EXPENDITURES Name of Filing Committee or Candidate Reporting Period BLOOM, STEPHEN FOR THE 199TH COM From 4/12/2016 To: 5/16/2016 DATE AMOUNT To Whom Paid HOUSE REPUBLICAN CAMPAIGN COMMITTEE MO DAY YEAR Mailing Address 500 N. 3RD ST, 4TH FLOOR 5 8 2016 s 1,000.00 City HARRISBURG State 21p Code(Plus 4) Description of Expenditure PA 17108 REPUBLICAN ROUNDUP SPONSORSHIP PAGETOTAL Enter Grand Total of Expenditures on Page 1, Report Cover Page,Item D. $ 1,000.00 5/19/2016 6:00:15 AM