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HomeMy WebLinkAboutFriends for Sheryl Delozier - 2021 30-Day Post Election ijit 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.gov/campaiRnfinance • ra-stcampaignfinance(a)pa.gov Unsworn Declaration 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), Non-Bid Contract Reporting Form (DSEB-504) 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. Name of Filing Committee, Candidate, or Lobbyist Reporting Cycle Name ❑ Cycle 1 ❑ Cycle 2 ❑ Cycle 3 ❑ Cycle 4 El 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 ❑ Cycle 8 ❑ 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 accompanying Campaign Finance Report is true and correct. 14b1 Signatur4 of reasurer, Candidate, or Lobbyist Date (DD/MM/YYYY) (kw h 6 ) G Printed Name Location (City/State/Country) DSEB-502R Updated 1/22/2021 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.gov/campaignfinance • ra-stcampaignfinance@pa.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 accompanying Campaign Finance Report is true and correct. frt-a(Dy-e-A 0-1q1 Signature of Treasurer, Candidate, or Lobbyist Date (DD/MM/YYYY) P1.612.41, (paw/La_ NANA4m6? ( MN. Printed Name Location (City/State/Country) DSEB-502R Updated 1/22/2021 (liii 4 1 --- - - — Commonwealth of Pennsylvania-Campaign Finance Report (Note:This report must be clear and legible.It should be typed) Filer Identification l ' Report Filed By Candidate Committee i1 ; Lobbyist I Number OV$d( (Mark X). Name of Filing Committee,Candidate or DS � t `��' Lobbyist G'LU t Street Address D Le l City ,A' (Ji p b�til 1� State VA Zip Code 1. / Type of Report(Place x under report type) 1 1-6`" Tuesday 2- 2' Friday 3-30 Day Post 4-6th Tuesday 5-2nd Friday 6-30 Day Post 7-Annual Special 2"Friday Special 30 Day 1 Pre-Primary Pre-Primary Primary Pre-Election Pre-Election Election Pre-Election Post-Election X Date Of Election Year Amendment Termination (MM/DD/YYYY) Report ; Report Summary of Receipts and From Date To Date For Office Use Only Expenditures 1, 16((g ?f (l bgbf A.Amount Brought Forward From Last F eport $ .1n n ` L„J e� B.Total Monetary Contributions and Receipts $ t�(� (From Schedule I) t( ( I 00 C.Total Funds Available $ \-'.\lt (Sum of Lines A and B) b 5 alb . b c( 111.,,, 1 • D.Total Expenditures $ 3,, (From Schedule III) ?--1.)rM - (2 E.Ending Cash Balance $ '� t 2 / p v t (Subtract Line D from Line C) ,}�3 Lt "(- F.Value of In-Kind Contributions Received $ C'3 13 (From Schedule toG( • C.3 G.Unpaid Debts and Obligations $ `- �• (From Schedule IV) Q, "_ • w 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 knowle e and belief true,correct and complete. Sworn to and subscribed before me this day of 20 I Sign@t) of Von u 1 ti eport Signature 1 � PCerrinted Name • My Commission expires -- 2)9 - 6e6 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 e-^1)71 r gnature of Candidate Signature Printed Name • My Commission expires MO. DAY YR. Area Code Daytime Telephone Number SCHEDULE Contributions and Receipts Detailed Summary Page I Filer Identification Number I �� `t Q� �ix,Y„1/r �Via ���� J" vir 1.Unitemlzed Contributions and Recelpts-$50.00 or Less per Contributor 1 Total for the reporting period (1) $ Z.Contributions of$50.01 to $250.00(From Part A and Part B) Contributions Received from Political Committees(Part A) $ All Other Contributions(Part B) $ ub. ID Total for the reporting period (2) $ b 3.Contributions Over$250.00(From Part C and Part D) Contributions Received from Political Committees(Part C) $ j Of Qb- All Other Contributions(Part D) $ 6. (b Total for the reporting period (3) $ 4.Other Receipts-Refunds,Interest Earned,Returned Checks,,ETC.(From Part E) Total for the reporting period (4) $ 0 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 i Cover Page,Item B) , PART B All Other Contributions $50.01 TO$250 Use this Part to itemize all other contributions with an aggregate value from $50.01 TO$250 in the reporting period. (Exclude contributions from political committees reported in Part A.) tiler identification Number: " P er AtilvA r i .i4v Full Name of Contributor Date[MM/DIYYYYYJ $ G i 6h4 �. ? 14llYUr€. t(o t b4 1 O0— House# 3reetAddress u} Date[MM/DD'YYYYJ $ //�� City State • 21p Dade Date[MM/DD'WYYJ $ i rA Cuiffkb1344,0 l'4 \ 117-1/), Full Name ofDartributor c Date[MM/Dal YYYYJ $ '"ii 'hrn 1-t 'Pa I t (DtA2412_ House#, ateet'Address Date[MM/ YYYY• $ .-1R:t2':. 1 t)2— ''''''' '?; W-ka 61° 6-e, aty Sate Zp Code Date[MM/DD/YYYYJ $ rat O uehb r� 111)66 Hull Name of Contributor Date[MM/DEVYYYYJ $. v; `-k House# Street Address Date[MM/DD'YYYY] $ City• Rate -bp Code Date[M M/DIY YYYYJ $ Full Name of Contributor Date[MM/DD'YYYYJ $ House,# Street Address Date[MM/DD/YYYYJ $ aty Sate ZpCode Date[MM/DD'YYYYJ $ Full Name of Contributor Date[M M/DD/YYYYJ $ House# 'Street Address Date[M M/DD/YYYY] $ aty Sate ZpCode Date[MM/DD/YYYYJ ^ $ FUII Name of Contributor Date[MM/DIYYYYY] $ ' House# Street Address Date[MM/DD'YYYYJ $ City State ZpCode Date[MM/DD/YYYYJ $ • 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 over$250.00 in the reporting period. Fll9fist iiptic410fiNumber - / d ;0. a44 C I\ hh& 1 ( PA I FUJl`Narme of K, ` DateIMM/DD/YYYYY ".$,; Contributing C6mm11tee t� rQt4 T� t 1 4 r ��^ni v .02 91 - L _ri Hofuea#� S§eet dfe§s , ,ate[M M/DD,YYYY] $,' t//`m'/v"�V/ — �0 -v l ( �r 41f fviefiegii S a e3 °Zip Coded Ybate IMM%DrD,'IYcYYYJ� t 1 7P1i`1let1079fr : t '. `,,,, 7Da_tojMM/DD/ . Y , `_$,, ICai]tribut akea1mt itfeo �� k '<' � t T,--,., :...,. ..;,,,,,,-;!., k (vitk /A . 1 ( i ;,. 1490k. rS reet Afdre :. ;?Date[MM/D _JYY,YY]; $ ,, ,,.. . !- r,.9,ty;: °_ vftb i bctz- .,,,,StetiaT 2I:_. . I�,Coder 7 ~Oafs f m_m%DD/YY.YY] 'y$r-..i.c,...‘ .,1 E!.c ht045 .,. __., _. ;71,0Niie of .tw �.- � , � . i �j �D�ie[MMIDD/+YyYYJ $3; s, �tn� �yV p' i db di00 1 �0 . `p" 11� 1 t �-� . 0D i�t " : e`t"Aiid D,ate,[MM/DD/YYY,Y]� $, Y 1-. igity r e Statel` '-Zip Coale;" Date jMM/DD ; $ f F [Var a cill `'' f Date_[MM/D . Yli. G triptitiiwebmb i teaj,. , II& NINAARt_U, /160 7 , ` ``$� H ose#° street?,' reds Date,jMM/DD/YY,<YY] -$ ' Cii;, ;"State: '',ZI ;CodeDate[MM/,D /, a 4$`t T411-434arfielor l Date"jf. PD.PIr : $) 4ofa-rl 0b#0.mri rftee /IA' 1)\ AtAt PC4 NorLs,#i' Streetpd�d%ess �Date:[MM/DDjYYiY]° ' r .'f: 0 tall"' t C].5 ,j \�A�I State'; �� {Zip;Cod e; ��� "D,ate.[MM/.DD/YYY,Y]f rSi'� °t 'F .[G a' - \�' (0,� p ,Datei[MM/DD r :; `C tilku.,i�r� o 011111e` vpc him( Vv W t /Y' ] ;, ,Mofrle�►# Streetr,Addlresa ,',Date`jMM/DD/Y,rYYY]' ,$) { p]tiz $ifate Zip:Code—- ;,Date,[M:M DD/YYYY]` $)! L. ckx4'9. : � r5 L • 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 over$250.00 in the reporting period. F►ierlden ifik-vinNumbe: 1 .. u- ./4_.;>. . 1r1-1://14 c (\ 1P, 1 '311l PA FuifNe of ;Y:.. !.Date fMM/DD/YYYY] '$T. c, ti7 .. .. ,, Qomrt�itte IA rj �/�,((1 e.S �&- �71T(� Q l . kt9-1 �oO House;"' Y Street•Address ."Date[MIVIMI /YYYY1 $� • p � 9f) tOiC )412-11 clty - — , State• -Zip Code--__ Date MM/DDIWty fey +.. fl -PA. . 1100 2— - . _ •Full Natnb Tort4 Ta:: _ .' ` I-Dato'{M /o9(y r $ ContrlutngCom0ebP �7 � o � �wV iV It 6 b b `Hous# Street Address' fA n1y//,'1/f{ ��'{{ f�/I� (/I�y{��/ i=D,ate[MM/DD/YY,YYJ ' $r: V V Si itr Cr S.tifer C 2ip dde�_ i`Da a[M�i4%DD/YYX]? $ 4..a.;}. RtIV111/1 doh 1$ltA Full Name of f?==, :;';;o. '-:Date[MI /DD/Y=XYY] I:$ :6oitrIbiti z,c mat f House ; Street`Address :iDate.[MM/DD/YYYY], ' ,$, I Y i._ - Ci_ty \ [-goo, rzip Code'-'" 1�t Date:jMM./DrD/Y,YYY]; $; sFt11 Name"`of4 - t.DafeiMM/_DD!YYI(Y)_`' $a`; GcFntrlbu#ingrcohi mate , 1,166mtiir4 Go Q tt. p�2,� �b b -House# J .StreetiAddr ' I.Date+ City;-7 /� I� StaA_M' . l'Zip Code.' . �l/p 'Date[MM/Dp/,YY:YY]t ,$. F,t 111.aine'ofF / .(1 ,/ 44/ 1�,�/ r"Date;{MMJDD/YYKYJr Ar,C lntributiogfComml ► (60A QQ'V 6 y X y11I 2 6 ti., ly ? F cor— fHpu 7- _ #' �tcee#;Addregsi D.etejMM/,DD, ,�,Y]�, $;" . ' D S al City c Ita :12 ZipCde 1 „D.ae[MMYDDIYYYY] r$:,tic,..,,,,, g � o 1�1D fi Full Nameof ._ ;DateMMDDJYYYY] `$;'Co 611,IbgCamrjtlee } 6 )k)Snv Pk v tl.(b?- �1 `ab r ouse' 'St?ee JAddress bate'[M /D/YYYY] $:`` i. ?kCity c -States' Zip Code .DateMI;[MDD/YYYY] '$,; i - ,t)o I- ^ nn.5 �� s, z 11t1ti 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 over$250.00 in the reporting period. Fller.Identifica(or►Numbeir I FuU Name of :;'..' .Date C � e [MM/DDYY•YY] 5;,otrig� .�ntiee tb( .::, Goo- eeAddrs. ,--Dte(, MD /YYY]i ,$;.� �� 3 § stc(ri � '�' e. - � ,a 'tf,giffi- 7r{y{;SW,e' `Zip Codes _Date[MM/t =n'! — t 4. iFyi f Nafrio 9f ';I,- ' ;r` MY\ • i{Mtitit �►', , Date[M MJ D/MY -$.' iC trlbuOng, e r t4 o is ,' Street Addr7ess Date[MM(Dp. ;z t $., 'tty Stae zlp�Cde �1 l DeMM%DD/ 1 ,4. t` , ��-j gAo . . t/k(D� FUiL Naane`of - 3 '- cRat.. �,e[MM/DDem1IjS , .4 .trtf u d4/C q ,( Lc.(K(9.1 - eiti ' ',HoUt e`#'' S.f�ket'Ad`dress ,,Da`te,[MM/DD/YY ] ` $. lvt � rk he _3 i F Cl `� F , ,State � Zip CodeV'T A, ( ;;Date[MM/DD/1w:YY]. Si, L i f Nut ame"o1(� 7, i.Date.[MM/oD/_YYYY]1 .$ Co � tlngCbknm(tte , QS,nr ib7. Ce-h tc.o Ia- c )050_ s l Rod, . Street?.Add ess` Date[MM%DDYY,,Yy]; $. cIt , State; 'Ai Code, ., Date[MM/DD7�YY1fY]k $,A, 'Fuf Name'of� Y t � � `�. y,� �)� ,.1 (�,, DateMMlDD/YYYY];` "$;' i ContrlbUiting#Cor)rn(tte®. K�1 UL V� l,b'�/c 4`(\ It (0(. ( . xo foal- t IX) -Stye FAddress 1 Date,[MM`/DDJ,Y:Y;YY], S CJfy l( Stake:' n "Zip.Code +Date".[M M/DD/�YY r $ - : : tiltk..90 j.i,00tf#ti ngit-omrl► e ' n n . — tN.o:` # ,Street Address i :;Date[Ni M%it 01,�D/,,.<Y] 1 -.-— n 00 Y, ' '..,.:Y : AiYit itilitt-- 661) , , .CiL ty y 1SSS'/,/�1 State,: Zip.Code-.:' Date,jMM/DD/YYYY] $: J , SCHEDULE II I N-FIND OONTRI BUTT ONS AND VAWABLE THI NGS REI EVE) USETHISSICHEDULETO REPORT ALLIN-KIND QONTRIBUTIONSOF VAWABLETHINGS DURING THE REPORTING PERIOD DETAILED SUMMARY PAGE I9entiat0mbe1 ; fifl q naS 41,04,(k (11;V131,49( I1. UNITEMuZEDIN-}aNDOONTFIBUT1ONSFECBVED-VALIJEQF$5o,00CRLEESMRCONTFWI JTOR I TOTAL for the reporting period (1) $ 2. IN-KIND DOX11TIBt1TIONSI EIVB}VALUEOF$50'.41TO$250.00(FFCMPARTF) ` I I U I ALfor the reporting period (2) $ 3. IN•IaNDOXTRIBUIION VED-VAi:(1EOVF3i$250.00(FFCM PARTG) I TOTALforythe reporting period (3) $ 600 TOTAL VAWEOFIN-KINDOONTRBUTIONSDUFtNG1HISF RTING $ PEROD(Add and enter amount totals from boxes 1,2,and 3;also enter on Page 1,Foport Cover Page,Item F) t • • 9CHB ULEII Part G In-Kind Contributions Received VALUE OVER$250 I Filer Identification Number: r • !Ac9s nh\'l(A� fOth J Full Name of Contributor ' Date[NIM/ YYY,I $ , CAMYtakbqat ICUtfAc5 , ,I,voL 10 g•-•1 I 6W---- House# Rreet Address ' Date[MM/ YYYYJ $ 6)41 City AWkSb Sate � � Tp(kid� •-: Date[MM/DOVYYYYJ -• $ Bnpioyer Name . n• Occupation ' ' Employer Mailing Address/Principal Description Place of Business of Contribution Rrll Name ofContributor . Date[MM/DD/YYYYJ. $ kouSe# Address 13reet Adds Date[NI M/DD/YY.YYJ $ •City Rate bpOode. Date 1MM/DD(YYYYJ .' $ Employer Name Occupation Employer MailingAddress/Principal Description ' Place of Business' of Contribution Full Name of.Cbntributor Date[MM/DIYYYYYJ $ House#, 9reetAcid Date[MM/DIYYYYYJ. $ City Sate ZpCode .Date[MfVl/DD/YYYYJ $, Employer Name - - Occupation Employer Mailing Address/Principal Description Place of Business of Contribution Rill Name of Contributor L Date[MM/DMYYYYJ $, House# :greet Address Date[MMIDD'YYYYJ _ $ 1 City Rate Zip(ode .- Date[M M/DOV YYYYJ . a $ Employer Name Occupation Employer Mailing Address/Principal Description Place of Business of Contribution SCHEDULE iii Statement of B penditures I Rier Identification Number: lyi -Q/Vl65' %/1(- kW UtiJ 1 (1)-e[T'"ilk l, I To Whom Paid �O 1 ,n^V�Q� Date[MM/ WYYJ $ • 9 - douse# - ---/— U lS 1 l�( l Rm Street •r+ V V ,Q) kW) (O Description of 6cpenditure I l (ll�s sate �X q6 1• li k.isy.t WtL . To Whom Paid Date 1M rt�DDdyYYYJ $ 4_� Gw�►tie�(ow►� C�,. ec Ci►�,mr�� D ' 1)-\ 2420 " +r" House# Street Addr ste Description of Eq,enditure .aty �ayit P PA- srate l�oi3 '�31V t�U.B-iPY\ To Whom Paid; flri � Wet D�diL7� Yl $ 9't �/ ;,House# 'l^ Street Address Desaiptiori-of EcPenditure - -y Cu 1 sate, TA l Chet6 To. W Whom Paid.. 1 Date[MM/DO/\ YJ." "$''•. .r.,,,--,' . _ 41,qhu-D ij-A biAtow 1011,/,11-1-• , 7,60,(ID House# steercAtibacq Description of Expenditure . aty � sate bp � � - tt.i�le '�� l�f2j r61 =0,-A[rn. To Whom Paid Date[MM/DD/YYJ $ W�G 1©12-ro 12 r'\.6b House# Street Addr . Desai iori._ ._ If' r pt of�penditureL ili.A4A Clty sat'_. 7�p �1 1: TA e C To Whom Paid - Date[M M/DD/.YYYYJ, • $ House# Street Addres1 A Description of 6Tenditure 'atY' Sate .Zip . _ . Oade To Whom Paid Date[MM/DD YYYYJ- $ . H�# Street Addre { Ep Description of enditure aty, I sate rap Code }To Whom Paid ' Date[MM/DD/YYYYJ $ House# $rest Address Description of Eipetiditure aty Sate Zip Code