HomeMy WebLinkAboutBloom for the 199th - 2016 30-Day Post Election PAGE 1
Commonwealth of Pennsylvania 111111111®®1®,®II'll111
Campaign Finance Report 253932
(NOTE:This report must be clear and legible. It may be typed or printed in blue or black ink.)
Filer Identification 2010108 Report CANDIDATE COMMITTEE If LOBBYIST
Number: 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 DAY POST- 3. AMENDMENT Yes No
REPORT PRE-PRIMARY PRIMARY PRIMARY REPORT?
6TH TUESDAY 4. 2ND FRIDAY PRE- 5. 30 DAY POST- 6.X TERMINATION Yes No
(place X to PRE-ELECTION ELECTION ELECTION REPORT?
the right of
report type) ANNUAL REPORT 7. Year 2016 FILING METHOD PAPER DISKETTE
( )CHECK ONEiiso/
DATE OF ELECTION District Office Party Code County
Name of Office Sought by Candidate: Number Code Code
MO DAY YEAR 199 STM REP 21
REPRESENTATIVE IN THE GENERAL ASSEMBLY
11 8 2016 (SEE INSTRUCTIONS FOR CODES)
Summary of Receipts and MO DAY YEAR MO DAY YEAR FOR OFFICE USE ONLY
Expenditures from: 10 25 2016 TO 11 28 2016
A.Amount Brought Forward From Last Report $ 18,395.68 . --
B.Total Monetary Contributions And Receipts(From Schedule I) $ 5,270.00 rti)
17
C.Total Funds Available(Sum Of Lines A and B) 23,665.68 "`
O.Total Expenditures(From Schedule III) $ 0.004 tr1
E.Ending Cash Balance(Subtract Line D From Line C) $ 23,665.68 -1 Z.-
F.Value Of In-Kind Contributions Received(From Schedule II) $ 1,000.97
G.Unpaid Debts And Obligations(From Schedule IV) $ 0.00
AFFIDAVIT SECTION
PART I-If this is a Committee report,treasurer sign here.If this is a Candidate report,candidate sign here.
I swear(or affirm)that this report,including the attached schedules filed on paper or by electronic medium,are to the best of my knowledge and belief,true
correct and complete. rti /9
Sworn to aril subscribed bef e e this 11 �Signatur of Person Submitting Report
I-�Vj , day of 20 Itc? l4BiZT S- Zlhietrb
�' ` Printed Name
i i : '). 'a' (; J QZA'-(P b (( GOrt .4 .1)G!
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My •'•mmission ExpirNOTA•IAL S AL ill Email slo—70.3
.BETHANY SALWARU1O Telephone Number
Notary" dblic > DAY YR Area Code Daytime
OARLIKE UORO„CUMBER,r d tray
Part I-If aut •rized Committee,Candidate shall sign here.
�� 1531t�E>�fr�s�1. ,.�16f1�
I swear(or affirm)that to the •est of my knowledge and belief this political committee has not violated any pro isio he a une 3,1937(P.L.1333,
No 320)as amended.
sworn t��6eg ed before me this
T' 3Signar� Ca� 'd t;e
day of4ALAgric
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� Printed Name M
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My Commte4OMll ONWEALTH OF PENNSYLVANIA Ern
NOTARIAL.SFa1L 111 —701-04 36.
BETHANY SALZAINfLO DAY YR Area Code Daytime Telephone Number
Notary Public
..uunt HUM My Commission Expires Oct 7,2017Y
11/29/2016 6:59:32 AM
PAGE 2
SCHEDULE I
CONTRIBUTIONS AND RECEIPTS
Detailed Summary Page
Name of Filing Committee or Candidate Reporting Period
BLOOM, STEPHEN FOR THE 199TH COM From: 10/25/2016 To: 11/28/2016
1.Unitemized Contributions Received-$50.00 or Less Per Contributor
TOTAL for the Reporting Period (1) $ 120.00
2.Contributions Received- $50.01 To$250.00(From Part A and Part B)
Contributions Received From Political Committees(Part A) $ 1,500.00
All Other Contributions (Part B) $ 350.00
TOTAL for the Reporting Period (2) $ 1,850.00
3.Contributions Received Over$250.00(From Part C and Part D)
Contributions Received From Political Committees(Part C) $ 3,000.00
000.00
All Other Contributions (Part D) $ 300.00
TOTAL for the Reporting Period (3) $ 3,300.00
4.Other Receipts,Refunds,Interest Earned,Returned Checks, Etc.(From Part 5)
TOTAL for the Reporting Period (4) $ 0.00
Total Monetary Contributions and Receipts During this Reporting Period(Add and enter amount 5,270.00
totals from Boxes 1,2,3 and 4;also enter this amount on Pagel,Report Cover Page,Item B.)
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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: 10/25/2016 To: 11/28/2016
DATE AMOUNT
Full Name of Contributing Committee
DOMINION PAC MO DAY YEAR
Mailing Address ONE JAMES PLZ PO BOX 26666
# 250.00
CRY Zip Code(Plus 4) 11 5 2016
tY RICHMOND
VA 232610000
Full Name of Contributing Committee
CREDIT UNION POL COM (CUPAC) MO DAY YEAR
Mailing Address 4309 N FRONT ST
# 250.00
Ci State Zip Code(Plus 4) 10 27 2016
tY HARRISBURG
PA 171060000
Full Name of Contributing Committee
EXELON CORP PAC MO DAY YEAR
Mailing Address 101 CONSTITUTION AVE, NW, STE 400 EAST
# 250.00
CityState Zip Code(Plus 4) 10 25 2016
WASHINGTON
DC 20001
Full Name of Contributing Committee
HIGHMARK PAC OF HIGHMARK INC MO DAY YEAR
Mailing Address 1800 CENTER ST
# 250.00
Cit State Zip Code(Plus 4) 10 26 2016
Y CAMP HILL
PA 17089-0000
Full Name of Contributing Committee
MO DAY YEAR
BUCHANAN INGERSOLL&ROONEY COM EFF STATE GVT
Mailing Address ONE OXFD CTR 301 GRANT ST 20 FL 250.00
CI State Zip Code(Plus 4) 10 27 2016
tY PITTSBURGH
PA 15219-1410
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PAGE 4
Full Name of Contributing Committee
THE HARTFORD FINANCIAL SERVICES GROUP,INC PAC MO DAY YEAR
Mailing Address ONE HARTFORD PLAZA, HO-1-11
250.00
Cit State Zip Code(Plus 4) 11 6 2016
y HARTFORD
CT 06155
PAGE TOTAL
Enter Grand Total of Part A on Schedule I, Detailed Summary Page,Section 2. $ 1,500.00
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PAGE 5
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
BLOOM, STEPHEN FOR THE 199TH COM From: 10/25/2016 To: 11/28/2016
DATE AMOUNT
Full Name of Contributor
MODAY YEAR
3. MICHAEL ALDER
Mailing Address 2915 ENOLA ROAD
250.00
City CARLISLE State Zip Code(Plus 4) 10 26 2016
PA 17015
Full Name of Contributor fna
SHIRLEY F. CHAMBERLAIN MO DAY YEAR
Mailing Address 56 MCALLISTER CHURCH RD
S 100.00
City CARLISLE
State Zip Code(Plus 4) 10 28 2016
PA 17015
PAGE TOTAL
Enter Grand Total of Part A on Schedule I,Detailed Summary Page,Section 2. $ 350.00
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PAGE 6
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: 10/25/2016 To: 11/28/2016
DATE AMOUNT
Full Name of Contributing Committee
MO DAY YEAR
MARATHON PETROLEUM CORPORATION EMPLOYEES PAC (MPAC)
Mailing Address 539 S MAIN ST
# 500.00
City State Zip Code(Plus 4) 10 26 2016
FINDLAY
OH 45840-
Full Name of Contributing Committee
MO DAY YEAR
CABOT OIL&GAS PAC
Mailing Address p0 BOX 4544
# 500.00
State Zip Code(Plus 4)
City HOUSTON 10 31 2016
TX 77210-4544
Full Name of Contributing Committee
PA ABC PAC (PA ASSOC. BLDRS&CONTRACTORS) MO DAY YEAR
Mailing Address 135 SHELLYLAND ROAD
# 500.00
Cit State Zip Code(Plus 4) 10 25 2016
y MANHEIM
PA 17545
Full Name of Contributing Committee
FIRSTENERGY PAC MO DAY YEAR
Mailing Address 76 S MAIN ST
# 500.00
Cit State Zip Code(Plus 4) 11 7 2016
y AKRON
OH 443080000
Full Name of Contributing Committee
MO DAY YEAR
FIRST PAC (PA ASSN COMMUNITY BANKERS)
Mailing Address p0 BOX 5319
# 500.00
Cit State Zip Code(Plus 4) 11 12 2016
y HARRISBURG
PA 17110-5319
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•
PAGE 7
Full Name of Contributing Committee
EQT CORP STATE PAC
Mailing Address EQT PLZ,625 LIBERTY AVE,#1700
$ 500.00
CityPITTSBURGHState Zip Code(Plus 4) 11 10 2016
PA 152223111
PAGE TOTAL
Enter Grand Total of Part C on Schedule I, Detailed Summary Page,Section 3.
# 3,000.00
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PAGE 8
PART D
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
BLOOM, STEPHEN FOR THE 199TH COM From: 10/25/2016 To: 11/28/2016
DATE AMOUNT
Full Name of Contributor
ROBERT). MUSSER MO DAY YEAR
Mailing 8 CREEKVIEW DR
Address ; 300.00
Cit State Zip Code(Plus 4) 11 2 2016
y CARLISLE
PA 17015
Employer NameOccupation
RETIRED RETIRED
Employer Mailing Address/Principal Place of City State Zip Code(Plus 4)
Business
8 CREEKVIEW DR CARLISLE PA 17015
PAGE TOTAL
Enter Grand Total of Part C on Schedule I,Detailed Summary Page,Section 3.
300.00
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PAGE 9
PART E
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
From: To:
DATE AMOUNT
Full Name -- —.a 1
MO DAY YEAR
Mailing Address $ 0.00
City State Zip Code(Plus 4)
Receipt Description
PAGE TOTAL
Enter Grand Total of Part E on Schedule I, Detailed Summary Page,Section 4.
0.00
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PAGE 10
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: 10/25/2016 To: 11/28/2016
1.UNITEMIZED.IN KIND C9NTRIBUTI131N8 RECEIVED VALUE OF$SO 00 OR LES$PER CONTRIBUTOR
TOTAL for the Reporting Period (1) $ 0.00
2.IN-KIND CONTRIBUTIONS RECEIVED: VALUE OF$5001-1•0 S250.00'(FROM PART F)
TOTAL for the Reporting Period (2) $ 0.00
3.IN-KINDCONTRIBUTION RECIEVED ;VALUE OVER 25q.00(FROM PART,G)
$
TOTAL for the Reporting Period (3) $ 1,000.97
TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING PERIOD(Add and enter $ 1,000.97
amount totals from Boxes 1,2,and 3;also enter on Page 1,Reports Cover Page,Item F.)
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PAGE 11
SCHEDULE II
PART F
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OF $50.01 TO $250.00
Name of Filing Committee or Candidate Reporting Period
From: To:
DATE AMOUNT
Full Name of Contributor
MD UP N.T.VID
Mailing Address $ 0.00
City State Zip Code(Plus 4)
Description of Contribution:
Enter Grand Total of Part F on Schedule II,In-Kind Contributions Detailed Summary Page, PAGE TOTAL
Section 2.
$ 0.00
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PAGE 12
SCHEDULE II
PART G
IN-KIND CONTRIBUTIONS RECEIVED
VALUE OVER $250.00
Name of Filing Committee or Candidate Reporting Period
BLOOM, STEPHEN FOR THE 199TH COM From: 10/25/2016 To: 11/28/2016
DATE AMOUNT
Full Name of Contributor
HRCC MO DAY YEAR
C
Mailing Address P 0 BOX 11787
$ 426.47
Cit State Zip Code(Plus 4) 11 10 2016
y HARRISBURG
PA 171080000
Employer of Contributor HRCC Occupation
HRCC
Employer Mailing Address/Principal Place of City State Zip Code(Plus Description of Contribution
Business 4)
PO BOX 11787 HARRISBURG PA 17108 data, lists&postcards
r—
Full Name of Contributor j
ACRE(ACTION COM RURAL ELECTRIFICATION) MO DAY YEAR
Mailing Address 212 LOCUST ST
$ 574.50
City State Zip Code(Plus 4) 11 14 2016
HARRISBURG
PA 17101-0000
Employer of Contributor ACRE Occupation
ACRE
Employer Mailing Address/Principal Place of City State Zip Code(Plus Description of Contribution
Business 4)
212 LOCUST ST HARRISBURG PA 17101 FUNDRAISER FOOD& DRINK
Enter Grand Total of Part G on Schedule II,In-Kind Contributions Detailed PAGE TOTAL
Summary Page,Section 3. 1,000.97
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PAGE 13
SCHEDULE III
STATEMENT OF EXPENDITURES
Name of Filing Committee or Candidate Reporting Period
From To:
DATE AMOUNT
To Whom Paid
MO DAY YEAR
Mailing Address
# 0.00
City State Zip Code(Plus 4) Description of Expenditure
PAGE TOTAL
Enter Grand Total of Expenditures on Page 1, Report Cover Page,Item D.
0.00
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