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Home My WebLink AboutKeystone Taxpayers Unite - 2021 30-Day Post Election (2) 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.eov/campaignfinance • ra-stcamoaianfinance@oa.aov • 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 Ke5slorte Thcoarieirs. . Reporting Cycle Name 0 Cycle 1 0 Cycle 2 0 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 la Cycle 6 0 Cycle 7 ❑ Cycle 8 0 Cycle 9 30 Day Post-Election Annual Report 2nd Friday Pre-Special Election 30 Day Post-Special Election Part 1- 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 accompanying Campaign Finance Report is true and correct. pcoA•tr. . !3'L AL o of-a�-avaa Signature of Treasurer, C ndidate, or Lobbyist Date (DD/MM/YYYY) Scuidra In Ai eu..l-Re_ of AD) drAjQ7 Pi O SA Printed Name Location (City[State/Country) DSEB-502R Updated 1/22/2021 Commonwealth of Pennsylvania Campaign Finance Report PAGE 1 OF L (COVER-PAGE (NOTE: This report must be clear and legible. It may berCANPIDATE ed or printed in blue or black Ink.) )Fifer Identification Report '1 Number C014(MtT7EE.2 / LOBBYIST o�0/g Qo�Q a Filed by: '�( Keystone Taxpayers Unite Street Address:3908 Primrose Road City:�� State: pa Zip Code: 17025 TYPE OF 6THTUESDAY 1. 2htbFRiDAY 2. 3032AY 3. AttE4I MENT Nits . ✓ NO+ REPORT PRE-PRIMARY PRE.PRiMARY FtOSTPRIMARY REPORT? 5 TH TUESDAY 4, 2ND FRIDAY 5, 30-0AY - 6 TERMINATION YE S N O (place X to PRE-ELECflON PRE-ELECTIOt4 MST a oTioN ✓ RE1?ORT7 the right of ANNUAL T YEAR F[Cisid mettlbD• FF;APER V DISKETTE, Ey report type) REPORT o�d�i t !! x )EFK_QNE • Name of Office Sought by Candidate: DATE OF ELECTION District Office Party County tuft)-. DAY Number Code Code Code 11 D2 •r21 (SEE INSTRUCTIONS FOR CODES) _ FO R OFFICE USE ONLY Summary of Receipts MO , 'DAY YEAR. Mct: DAY YEAt3 and Expenditures from: r 10 19 2021 To MI r 1 • A.Amount Brought Forward From Last Report $ 1,937.47 B.Total Monetary Contributions and Receipts(From Schedule I) $ 0.00 *""" t..., CO L,. rn m C.Total Funds Available(Sum of Lines A and B) $1,937A7 7..1 " Ca D.Total Expenditures(From Schedule III) $ = E.Ending Cash Balance{Subtract Line D from Line C) $ 1,138.88mix C,F,Value of In-Kind Contributions Received(From Schedule II) 797 59 $0•00 C 0 G.Unpaid Debts and Obligations(From Schedule IV) $0.00 M. AFFADAVIT SECTION 4?A-1•-If this is a Corn nittee repprt;treasurer sign,here, If this Is a Candidate report,candidate sign)ere, I swear(or affirm)that this report,including the attached schedules,on paper or computer diskette,are to the beet of my knowledge and belief true,correct and complete. Sworn to and subscribed before me this ( Jt A 01, day of 20 Signature of Person Su trig Report sSMara.. Al Al etAAeIA Signature Printed Name �� My commission expires / aO 6- r y"' "t _ MO. DAY YR. Area Code Daytime Telephone Number PART 11—If this.IS a report of a Candidate'a;Authorized Committee,.candidate shall Sigh here. , • I swear(or affirm)that to the best of my knowledge and belief this political committee has not violated arty provisions of the Act of June 3,1037 (P.L,1333,No,320)es emended. Sworn to and subscribed before me this dey of 20 Signature of Candidate 1 Signature Printed Name My commission expires - - - - MO. DAY YR Area Code DaZtfine Telephone Number Page 1 pf 2 SCHEDULE III STATEMENT OF EXPENDITURES Name of filing committee or Candidate Reporting Period Keystone Taxpayers Unite From 10119/2021 To 11/22/2021 To Whom Paid taiY„A.: Amount Vistsprnt 10 20 21 $797.59 Mailing Address Description of Contribution liudsonwe9 8,Verde,the Netherlands,8928LW direct mall services City State Zip Code(Plus 4) To Whom Paid Amount $ Mailing Address Description of Contribution City State Zip Code(Plus 4) To Whom Paid Amount Mailing Address Description of Contribution • City State Zip Code(Pius 4) • To Whom Paid ", u ` ;A; Amount $ Mailing Address Description of Contribution City State Zip Code(Plus 4) To Whom Paid as ,V �' 7 { , j Amount �k:Mph„„ a �_ 1 • Mailing Address Description of Contribution City State Zip Code(Plus 4) To Whom Paid t$ ®';'; Aty41 Amount Mailing Address Description of Contribution City State Zip Code(Plus 4) To Whom Paid MAkiX.0137; ' tr=i`EARa Amount Mailing Address Description of Contribution CitY- State Zip Code(Plus 4) To Whom Paid 1i1� �D' „v Amount MailingAddress $ Description of Contribution City State Zip Code(Plus 4) PAGE TOTAL Enter Grand Total of Expenditures on Page 1, Report Cover Page, Item D. $797 59 DSEB-502(7-99)