Loading...
HomeMy WebLinkAboutBloom, Stephen - 2016 2nd Friday Pre-Election 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. FLLER R)E mFICATION REPORT FILED , CANDIDATE: L+ NUMBER ON BEHALF OF 7( .CONNRTEELOBBYIST; NAME OF FCIUNG COMMITTEE,CANDIDATE OR LOBBYIST [ O O M STREET ADDRESS at 00 Lo,jc (2 1 CITY • STATE ZIP CODE TYPE OF REPORT NAME OF OFFICE SOUGHT BY CANDIDATE DISTRICT NO. PARTY DATE OF ELECTION (CHECK ONE) c -tc�✓ �Jl'E'(�-C.V c2 L- MD DAY .: YEAR 6TH TUESDAY 1. /� 1 t a 6 PRE-PRIMARY FOR OFFICE USE ONLY .. ..'.MO.":: .DAYS .. .. . .. .. .. YEAR 2ND FRIDAY 2. DATES OF ^ ?RE-PRIMARY PERIOD RTING S 1 , t 6 TO to e�Lt- t 6 30 DAY 3. ` POST-PR1MARY CASH BALANCE AT END 4OF REPORTING PERIOD: 0.00 - sTH.TUESDAY •:::<»:: $ PRE-ELECTION TOTAL AMOUNT OF FILER'S s. OUTSTANDING DEBTS ORLIABILITIES 2NDsFRNAY ©�C)° -°7 PREELECTION; X AT THE END OF REPORTING PERIOD: $ S. £,..,! 30 DAY POST-ELECTION AMENDMENT REPORT? Y NO y G 1 ANNUAL TERMINATION REPORT REPORT? YES NO AFFIDAVIT SECTION 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 SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND B F TRU RECT AND COMPLETE. S ORN TO AND SUBSCRIBED BEFORE ME THIS P DAY OF alt At ter►_ 20)4-0 TURE F PERSON SUBMITTING REPORT -t- P �lo or-, •..;"f!0If,.,_, ^ �.. L tL✓ r` PRINTED NAME coMMLsslo NOTARIA/EAL I`7 --7Q I - 1 LE 3 sl> IR4esiu,rmul e Notary•Publiel°' DAY YR. AREA CODE DAYTIME TELEPHONE NUMBER PART I - My Commission Expires Oc17.2017 If statement is filed on behalt of a uanalaai-'s Authorized Committee,Candidate must sign here. I SWEAR(OR AFFIRM)THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF 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 PRINTED NAME SIGNATURE MY COMMISSION EXPIRES AREA CODE DAYTIME TELEPHONE NUMBER MO. DAY YR. DSEB-503(12-99)