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HomeMy WebLinkAboutCommittee to Elect Safronia Perry - 2021 2nd Friday Pre-Primary Pennsylvania Department of State Bureau of Campaign Finance&Civic Engagement 210 North Office Building,Harrisburg,PA 17120 • 717.787.52E0(Option 4) vd5'f1y�r 2„•icarr ocnitn,..1ce • ra stcampaiKtIftwvw•,ypa coy 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 DSE8-502), 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. Nagle of Filing Committee, Candidate, or Lobbyist -_ - i44-1ttCt ; Reporting Cycle Name ❑ Cycle 1 ArCycle 2 0 Cycle 3 0 Cycle 4 0 Cycle 5 6th Tuesday 2nd Friday 30 Day 6th Tuesday 2"d Friday Pre-Primary Pre-Primary Post Primary Pre-Election Pre Election ❑ Cycle 6 0 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. 1 declare under penalty of perjury under the law of the Commonwealth of Pennsylvania that the foregoing is true and correct. 1447 Signature of Treasurer, Candidate, or Lobbyist Date (DDM/YYYY) 7 L A( LC.L.1 ,1,, USA Printed Name Location (City/State/Country) DSEB-502R Updated 6/24/2020 Vag Pennsylvania Department of State ' Bureau of Campaign Finance&Civic Engagement 210 North Office Building,Harrisburg.PA 1.7120 6 71.7.787.5280(Option 4) wvtvw.dos_pa.gov/camoalenfinance ra-stcampaigniinancerB pa.gov Part ii - If this is submitted with a statement in lieu of full report by a Candidate's Authorized Committee, candidate sign here. 1 declare under penalty of perjury under the law of the Commonwealth of Pennsylvania that the foregoing is true and correct. r Signature of Candidate Date(DD/PVMPVVYYYY) ct-Plbri u"-a\ Cad i' ler:?ifi RSA Printed Name Location (City/State/Country) DSEB-503S Updated 6/24/2020 Commonwealth of F'tnns ivania-(mpaign Aflame F aort (Note:This report must be dear and legible.It should be typed) Filer identification Report RiedSi Cletdidete Committee Lobbyist - Number (Men*X) Name o �F�IirtgCbtrurtlttee;Candidate or L CPIIA4I4CC k E/,,'L - (S1a')if�� Ralf greet Address to 602C IDw' -Po— lity eA,,,et b c) Sate 4 Zip ! `0 J 3 { Type of Resort(Race x under report type) 1-6th Terry 2- 2nd Friday'3-30 Day Prot 4 6thT y 5-2rd Friday 6-30 Day Post 7-Annual *edal 2"°Friday 30 Day Rre•Prirrary Re-Primary Primary Pre-Bedion Re Bedion Section Re6edion Post-Bedion Date Bedion Year Atrmud Trlextt. Termination (M M/DD/YYYY) Report Report SLmmary of Reoetptsand From Date To Date For Office Use Only Bcpencitures r c , 2c ti A 31 i A Amount t3�x41 Forward Fr Latit Report $ r. a Total Monetary(kxttributionsand Receipts $ I Q2�� _ (From Sliedute I) Z C Total FindsAvailable $ m '- (gin of LinesA and (/ -< Zc D.Total Stpenditures $ o (From&tedu le III) ` 5-1. 7 3 __ E EncfingOish Balance $ c-) _,.: (Subtract line Dfrom Line q 17-) Li 27 F.Value of In-Wnd CbntributionsRsoeived $ 2'7 '/ (From Schedule II) a.1. 4`6 -< G Unpaid Debtsand Obligations $ ` (From Szhedule IV) 4) _ Affidavit 9adion Part 1-If this isaCommittee report,treasurer sign here.If this isaCandidate report,candidate sign here. I swear(or affirm)that this report,induding the attached schedules on paper,isto the best y knowledge and belief true,correct and complete. Sworn to and subscribed before me this '� � I/� f /IlJ`day of 20 v �Cam/ gnature of F2r'sAnAn SLbmitling report 9gnature Rinted Name �7 My Commission expires lQ 7/ t /!a2 MO. DAY YR Area Code Daytime Telephone Number 'Will-If this is a report of a Qndidate'sAuthorfaed 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 Ad of dine 3,1937(P.L 1333,N0.320)as amended. Sworn to and subscribed before me this • day of 20 9gnatureof Candidate 9gnature Rinted Name • My Commission expires MO. DAY WI Area Code Daytime Telephone Number ULEI Contributions and Fioeipts Detailed Summary Page IAIffldTI (al�. (24c . 6 ��.t7 I `/_ cgr I +n� �-2 ei77- 1 1.Unitemiaed Oantributionsand Aeaeipts$50.00 or tamper Oantributor Total for the reporting period (1) $ 2.Cbrttributionsof$50.01 to $250.00(From Part Aand Part lit . Contributions Raeived from Fblitical Committees(Part A) $ • All Other Cbntribut ions(Part B) $ _dy, ! [ r- Total for the reporting period (2) $ ir it S7, 13.ContributionsOver$250.00(From Part Cand Part D) - , . • OantributionsFbceivedfrom Fblitical Cbmmittees(Part q $ All Other Contributions(Part D) $ Total for the reporting period (3) $ 4.Other R®oeiptsRafunds,Interest Earned,Returnedtecloi ETC(From Part,I4 • • Total for the reporting period .(4)• $ I V Z5 .- Total Monetary 0mtri but ions and Fepts during this reporting period(Add and $ enter amount totals from Boxes 1,2,3 and 4;also enter this amount on Page 1,Fbport .5 Cover Page,Item B 1 Z Sh1WULE II Part G In-find Gbntributions Received VAWEOVER$250 IFler IdentificationlNumber: / 4/Ate Iv Fleck S iewiet Pi/zy Full Named Cbrtributor Date[MM/DD'MY] $ 1/4,4/i Pk.CC.ILL- 1 u asr• Vo House# greet Addr Date[MM/DD✓YYYYJ $ 21 es1 2 k-san AMR a Cityekti gate Ziptbde l7v ? Date[MM/DD/YYYYJ $ Toys Name Occupation /4 9leli/ 6nployer MaiingAddress/Rindpal Description Place of Business IA n/ of (44 W tribution Fill Name of Oantributor Date[MM/DD'YYYYJ $ house# greet Addresi Date[MM/DCYYYYYJ $ City Sate Ziptbde Date(MM/DIY YYYYJ $ Biipioyer Name Occupation Employer Mailing Address/Rindpal Description Place of Badness of tbntribution Full Nameof tbntributor Dere[rinM/DOrYYYYJ $ House# Sreed Addreal Die[NI M/DCYYYYY] $ City Rate Zip Code Date[MM/DD/YYYYJ $ Employer Name Oocppation Biiployer Mailing Address/Rindpal Description Race of Business of Gbntribution Full Name of tbntributor Date[MM/DD+YYYYJ $ House# Brest Addr Date(MM/DDVYYYYJ $ City gate Zipthde Date[MM/DEVYYYYJ $ Employer Name Occupation anpioyeriMailingAddrese/Aindpal Description Place of Business of Contribution KHH)ULEII PARE F in-Kind OontributionsRxelved VALUE OF$50.01 TO$250 Filer Identification Number: Full Name of Qxitributor eh, _ Date[MM/DD'YYYYJ $ R(k,ce_ Llaase# r greetAchir � e[NI M/ YYYY] City Sate p Date[M M/DIY YYYY] $ Description of Gxitribution To 0 I if 6C5 Full Name of Contributor Date 1MM/DD&YYYYJ $ House# Sreet Addy Date[NI M/DIYYYYYJ $ City Sate asp Code Date[MM/DFYYYYY] $ Description of Contribution FuiI Name dCbntributor Date[MM/DD'YYYYJ $ Haase# greet Addresi Date[MWDLYYYYYj $ City Sate Zip Cbde Date[MM/DCYWW1 $ Desziptionof Contribution Full Name of attributor Date NW DD'YYYYJ $ Hasse# greet Addreal Date[M M/DLY YYYYJ $ City Sate 7p Cbde Date[M M/DD'YYYYJ $ Description of Contribution Full Name of Contributor Date[NI M/DD'YYYYJ $ House# $rest Addreel Date[M M/DD'YYYYJ $ City Sete 2pCbde Date[NI M/DD/YYYYJ $ Description of Contribution SCHIEDULEIII Statement of Expenditures filer identification Number: (1,014m4114C b ["fer -A,, Rr4 / 1 .To Whom Paid Date[MM/DO'YYYYJ $ $ tiYC I' A got" 136, 1� House# L e'er - 3reet Address Wjui (`ked_ Sz,t, (i� ipt d 6q it re City 5 � I Sate J Zip — . atH. 1"d4116sue, OA C WO3 fi'ocaf,1 f ,ç elbi c ...._ To Whom paid Date[MM/DIY YYYRJ $ tOt16014✓IQf 31zi i l/.�6 House# area Adclr l ..r4 sr ll1/4 k SI, DeS7ip[iOot 13q�encktire y ek,f,-ge g', i 170 13 8 ' iS, To Whom paid /J(/LINA' 1rc �e[M $3 l House# Rreet Address 4,5,i_ /4,4_ Lvy.ed_ Descrion of iq)endrt ure Oty 41-tr6 te State 4 1'9 bp To Whom Paid Date[MM/ YYYYJ $ House# Rreet Address' Description of enditure City Rate by Code To Whom Paid Date[MM/DIY YYYYJ $ House# Rreet Address' Description of Expenditure City Rate by Cbde To Whom Paid Date[M WOO'YYYYJ $ House# Rreet AddressI Expenditure Description of enditure City Sate Zip Cbde To Whom Paid Date[MM/DDYYYYYJ $ House# Rreet Addres1 Description of B penditure City Rate Zip Cbde To Whom Paid Date[MM/DIY YYY11 $ House# Rreet Addresi Description of Experditure City Rate Zip Cade 9]-IB)ULEN Statement of Unpaid Debts Use this St'ction to itemize all unpaid debts and obligations which are outstanding at the end of the reporting period. filer Identification Number: • Name of.LYeclitor Outstanding Balance of Debt Hasse Bred Addr DATEDESTINCUFFED $ c.. • [MM/DD�YYYYJr. Cy. ' - • - ,State • Code Description of„Debt • Name d aec6tor Outstanding%lance of Debt Hasse# Street Addr DATEDEBTINCURE $ INIWDO YYY] , thy , K' Rate Zip Cede Description of Debt • Name of Creditor Outstanding Balanced Debt House# Stred Addr 1YTEDEBTINWRE $ [MM/DD/YYYYJ City sate zip Cbde Description of Debt Name of Creditor Odetanding Balanced Debt House# Street Addr DATEDEBTINCUMED $ jM M/DD✓YYYYJ City Rate Tip Code Description of Debt Name of aeddor Outstanding Balance of Debt House if Street Addres1 DATEDEBTINQJFiED $ [MM/DFYYYYYJ City Sate Zip Gbde Description of Debt Name of Creditor Outstanding Balanced Debt House# Strom Adckel DATEDEBTINCUF $ PIA M/DDVYYYYJ City Sate �p Code -Description of Debt PARTA ./;aIM`d14a.4 Qintributions Rxeived From PolitieaKtfmnIttees 50.01 10$250.00 Use this Pat to itemize only contributions received from Political C onsnittees with an aggregate value from$50.01 TO$250.00 in the reporting period. Filer Identification Number S . Pill./ l ('vvt c,K.0/Y'-e to P Amount Full Name of Contributing Date MM/DIY YYYY] $ //� Committee 6ZE4 L 6 I44 - 1 31 121 MO,OD House# greet Addr L Date(MIW DIY YYYYJ $ 64 0 (-Mt 4)/ 56/eel- City aate ! Zip(ode Dale[MM/DIY YYYY] $ 6 �� �� 17013 Full Name of Oantributing Date[MM/DDrYYYYJ $ Committee 1 & ec& K. Of' ( a I / �.e� l3 .21 House# greet AdctDate RAW DIY YYYYJ $ l 'l C' ic 64d . Qty %Re blipOade Date[MM/DIY YYYY] $ Dirt 15 /NI A 1 761 i 9 Full Name of Contributing Date[MM/DDVYYYYJ $ m Comittee Q-K- e(444 4 a a `(12 1 Z©D-ao House# Street Addy Date(M M/DD+YYYYJ $ /a�3 r 02l S'- 5f ee)- N. City A/ . .k., gate VA Zip Code zees Date[MNVIYYYY DYJ $ Co Full Name of ntribute Date[MM/DD/YYYYJ $ Committee A " 1lrid-6 al4 a t ) l L Obi a House# Street Addr Date[M lit) YYYYJ $ 1, 61- 54-ded City etaif State gi Zip Code Date[MM/D[YYYYY] $ Fill!Name of Contributing ��,,,,,�� ei Date[MM/D[YYYYY] $ �/ Cbrnmittee eit-z✓ e �UQ. DQ i p�1 aSaIHouse# Street Addr � Date[MMIDD►�YYYJ $ I I Sh144Yti D/ wi City Sate 7pQ�cfe Date[MM/DLYYYYY] $ CaAl‘SCI, PA 17D 13 Full Name of tntributing Date(MM/DDrYYYYJ $ Committee �"`� k. 6sitei .7l/3l2/ /Da- toHouse# Street Address Date[MANDLYYYYYJ $ 1-7 Iwt CRy gate J<r Date[M RA/DD/MY] $ D/7(5 bit', PA 170 PART B All Other Contributions $50.01 TO$250 Use this Part to itemize ail other oontributionswith an aggregate value from $50.01 TO$250 in the reporting period. (6cdude oontributionsfrom political committees reported in Part A.) Filer Identification Number: • ‘76-)4 4 X egv 1 Full Named ibrttributor Date[MM/DD/YYYYJ $ IP C - �- 31 /24 //G ,as House# greet Ad / Date[MM/DD/YYYY] $ 2iC 5e . City C 15 Sate PA 21pCode 170 Date[MM/DIYYYYYJ $ Full Name d ibrdributor Date[MM/IXYYYYYJ .$ 51e, f-yrl'L3litic, lo.00 Mouse# greet Add Date[MM/DLYYYYYj $ f i 1012 . 5hi -. Lz4te_ . (Sty egA14%5(e &ate pA A)Code l 7o t 3 Date[MWlD'YYYYJ $ Full Name d fbntrib utor Date[WI M/DIYWWI $ Mouse# SreetAdci Date[MM/DO/YYYYJ $ City sate ZpCode Date[MM/DD/YYYY] $ Fill Name of ibntributor Date[MWDDfYYYYJ $ Mouse# Street Addy Date[M M/DIY YYYYJ $ City sate Zip Lode Date[M M/DO/YYYYJ $ Full Name of tbntritxtor Date[MM/DD/YYYYJ $ Mouse# greet Addr Date[MM/DD/YYYYJ $ thy Rate Zip Code Dale[MW DO/WWI $ 1' Full Named Contributor Date[MM/DD'YYYYJ $ Mouse# greet Ad Date[M.M/DD'YYYYJ $ City Sate 21p03de Date tMM/DIYYYYYJ ' $ I PART D All Other Oantributions Over$250.00 Use this Part to itemize ail other oontributionswith an aggregate value over$250.00 in the reporting period. (Exclude aontributionsfrom political committees reported in Part Q Fier Identification Number: Full Name of Corttributor Date[MM/D[YYYYYJ $ 1 nn Peh/t 2 a Z� •Ub House# greet Addr Dad [M ?/YYYj $ Po & i 11/ Oty d Sate A Zlptde Dale[MM/DD'YYYYJ $ U. foyer Name 4) Ocaipation 474 Bnployer Mailing Address/ principal Race of Business Full Name of attributor Dade[M M/DO,YYYYJ $ House# Sreet Addreel Date RAW DDY YYYYJ $ City gate 2iip Code Date[PAW DDf YYYYJ $ Employer Name Occupation Eiptoyer Mailing Address/ Ftindpal Race Business Full Name of O r tributor Date RAW OD/YYYY] $ House# greet Addresi Date[PAW DIY YYYYJ $ Oty Sate Zip Code Date[MM/DDQYYYYJ $ Employer Name Occupation Employer Mailing Address/ principal Race of Business Full Name of Oantributor Date[MM/DOIYYYYJ $ house# greet Addreel Date[MM/DIYYYYY] $ City Sate ZpCode Date[PAW DIY YYYY] $ Employer Name Occupation Employer Molting Address/ Rlndpat Raced&mines PART C 03 ntributions Rived From political Committees Over$250.00 Use this Part to itemize only contribution received from Political Committees with an aggregate value over$250.00 in the reporting period. IFier identification Number: Full Named Date[NI M/DD/YYYY] $ • Cbntributing tbminittee Haase# greet Addy +Date[NI M/DD/YYYY] $ City gate •rp Code Date[MMI DIYYYYNI $ Full Named Date[MM/DLYMY] $ Cbntri but i ng Cbnrtittee House# greet Addreel Date[M M/DO'YYYY] $ City gate ZipCbbde Date[At RA/DIYYYYYJ $ Fill Named Date[RAW DIY YYYYJ $ Contributing Committee House# &rest Addrell Date[MM/DLYYYYYJ $ City gate Zip Code Date[MIWDtYYYYYJ $ Full Named Date[MM/DD/YYYYJ $ Cbrdributing Cbmrrittee Hasse# Sreet Addreal Date[NI M/DD'YYYY] $ 4ty gate Zp Code Date[M M/Dd YYYYJ $ Full Name Date[MM/DIYYYYYJ • $ ContributingCommittee House# greet Address Dete[MM/DIYYYYY] $ City Sate Zip Code Date FMM/DD/YYYYJ $% Full Named Date[MM/DUYYYY] $ Contributing{bmn ttee House# greet kicires1 Date[NI M/DD✓YYYYJ $ City Sete Zip Cbde Date[MM/DD/YYYYJ $