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Home My WebLink AboutFriends of Dr. Ryan Argot - 2021 2nd Friday Pre-Primary \7, Pennsylvania Department of State Bureau of Campaign Finance&Civic Engagement 210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4) -." ' www.dos.pa.pov/campaignfinance • ra-stcampaignfinance@pa.gov, Unsworn Statement in Lieu of Sworn Statement for Campaign Finance Reports Note: Per Act 2020-15, which was signed into law on April 20, 2020 and allows for unsworn declarations, Campaign Finance Reports (form DSEB-502), Campaign Finance Statements In lieu of full reports(form DSEB-503), and Independent Expenditure Reports(form DSEB-505)need not be notarized. Instead, the filer may file with each report or statement the corresponding version of this form signed by the required individual(s). This particular form is to be used only for Campaign Finance Reports. This form must be signed by hand where a signature is required. ZfIRG CU Ala Co it ee, •andida er,.ai o/bbyis • - •o tr43@jgb Nam- ❑ Cycle 1 jCycle 2 ❑ Cycle 3 0 Cycle 4 0 Cycle 5 6th Tuesday 2nd Friday 30 Day 6th Tuesday 2nd Friday Pre-Primary Pre-Primary Post Primary Pre-Election Pre Election ❑ Cycle 6 ❑ Cycle 7 0 Cycle 8 0 Cycle 9 30 Day Post-Election Annual Report 2"d Friday Pre-Special Election 30 Day Post-Special Election Part I- If this form is submitted with a Committee report, the treasurer must sign here. If this form is submitted with a Candidate report, the candidate must sign here. If this report is submitted with a report by a contributing lobbyist, the lobbyist must sign here. I declare under penalty of perjury under the law of the Commonwealth of Pennsylvania that the f egoing is true and correct. �-- 050v/ o Signature of Treasurer, Candidate, or Lobbyist Date (DM/YY 1 I• eL Aii�,,,kr Pi/ bk Printed Name Location (City/State/Country) DSEB-502R Updated 6/24/2020 IriPennsylvania Department of State Bureau of Campaign Finance&Civic Engagement 210 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 4) www.dos.pa.gov/campaignfinance • ra-stcampaignfinancePpa.gov Part 11-If this form is submitted with a report by a Candidate's Authorized Committee, the candidate must sign here. I declare under penalty of perjury under the law of the Commonwealth of Pennsylvania that the foregoing is true and correct. . ...---___,-- ,....-7 , Signature of Treasurer, idate, or Lobbyist Date (DD/MM/YYYY) P7Of i'N A 1 C j-- ././11 er4:"•C 1 if " P (A "( Printed Name Location (City/State/Country) DSEB-502R Updated 6/24/2020 Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Filer Identification Report Filed By Candidate Committee Lobbyist Number 834101537 (Mark X) • Name of Filing Committee,Candidate or Lobbyist Friends of Dr.Ryan Argot Street Address 1034 Chelmsford Drive City Mechanicsburg State PA Zip Code 17059 Type of Report(Place x under report type) 1-6th Tuesday 2- 2nd Friday 3-30 Day Post 4-6thTuesday 5-el Friday 6-30 Day Post 7-Annual Special 2na Friday Special 30 Day Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election X Date Of Election Year Amendment Termination (MM/DD/YYYY) 5/18/2021 2021 Report Report Summary of Receipts and From Date To Date For Office Use Only Expenditures 1/1/21 5/3/2021 A.Amount Brought Forward From Last Report $ 56.49 -- B.Total Monetary Contributions and Receipts $ r.; y (From Schedule I) 98.23 ~.r r— f C.Total Funds Available $ (Sum of Lines A and B) 154.72 c n CJ D.Total Expenditures $ (From Schedule III) 0 E.Ending Cash Balance $ r- (Subtract Line D from Line C) 154'72 F.Value of In-Kind Contributions Received $ (From Schedule II) 25 G.Unpaid Debts and Obligations $ (From Schedule IV) 988.8 Affidavit Section Part 1-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 on paper,is to the best of my knowledge and belief true,correct and complete. Sworn to and subscribed before me this day of 20 ! - of Person Si5brnitting r rt t ( t Signature vd Printed Name My Commission expires MO. DAY YR. Area Code Daytime Telephone Number Part II-If this is a report of a Candidate's Authorized Committee,candidate shall 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 day of 20 Signature o idate Signature Printed Name My Commission expires 7 1 7 6/2 0 7S 2 MO. DAY YR. Area Code Daytime Telephone Number f -- SCHEDULE I Contributions and Receipts Detailed Summary Page Fifer Identification Number I '834101537 1.Unitemized Contributions and Receipts-$50.00 or Less per Contributor I Total for the reporting period (1) $ 98.23 2.Contributions of$50.01 to $250.00(From Part A and Part B) Contributions Received from Political Committees(Part A) $ NA All Other Contributions(Part 8) $ NA Total for the reporting period (2) $ NA 3.Contributions Over$250.00(From Part C and Part D) Contributions Received from Political Committees(Part C) $ NA All Other Contributions(Part D) $ NA Total for the reporting period (3) $ NA I4.Other Receipts-Refunds,Interest Earned,Returned Checks,ETC.(From Part E) Total for the reporting period (4) $ NA Total Monetary Contributions and Receipts during this reporting period(Add and $ enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Report 98.23 Cover Page,Item B) • 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 Filer Identification Number: 834101537 • I1. UNITEMIZED IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.00 OR LESS PER CONTRIBUTOR TOTAL for the reporting period (1) $ estimated$25 for votebuilder 2. IN-KIND CONTRIBUTIONS RECEIVED-VALUE OF$50.01 TO$250.00(FROM PART F) TOTAL for the reporting period (2) $ NA 3. IN-KIND CONTRIBUTION RECEIVED-VALUE OVER$250.00(FROM PART G) TOTAL for the reporting period (3) $ NA TOTAL VALUE OF IN-KIND CONTRIBUTIONS DURING THIS REPORTING $ PERIOD(Add and enter amount totals from boxes 1,2,and 3;also enter on Page 1,Report Cover Page,Item F) 25 SCHEDULE IV Statement of Unpaid Debts Use this Section to itemize all unpaid debts and obligations which are outstanding at the end of the reporting period. Filer Identification Number: 834101537 Name of Creditor Ryan Argot Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ Chelmsford Drive [MM/DD/YYYY] various City Zip Mechanicsburg State PA Code 17050 479.80 Description of Debt residual debt from 2020 Name of Creditor Ryan Argot Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ 1034 Chelmsford Drive [MM/DD/YYYY] 3/19/2021 City Zip Mechanicsburg State PA Code 17050 440 Description of Debt Signs and stands Name of Creditor Ryan Argot Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] 1034 Chelmsford Drive 3/26/2021 City Zip Mechanicsburg State PA Code 17050 69 Description of Debt stands Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip Code Description of Debt Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip Code Description of Debt Name of Creditor Outstanding Balance of Debt House# Street Address DATE DEBT INCURRED $ [MM/DD/YYYY] City State Zip Code Description of Debt