HomeMy WebLinkAboutDean Villone for Good Communities - 2021 Annual Report TryPennsylvania Department of State
Bureau of Campaign Finance&Lobbying Disclosure
500 North Office Building,Harrisburg,PA 17120 • 717.787.5280(Option 41
www.dos.pa.gov/campaignfinance • ra-stcampaignfinance@pa.gov
Unsworn Declaration in Lieu of Sworn Statement for
Campaign Finance Statements
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 Statements. This form must be
signed by hand where a signature is required.
Name of Filing Committee, Candidate, or Lobbyist
"b_eq,`n t l Vo✓le d-v� (,ov h✓ln vAlnl `e S
Reporting Cycle Name
El Cycle 1 ❑ Cycle 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
El Cycle 6 EiCycle 7 ❑ Cycle 8 ❑ Cycle 9
30 Day Post-Election Annual Report 2nd Friday Pre-Special Election 30 Day Post-Special Election
Part I — If this form is submitted with a statement in lieu of full report by a political
committee, the treasurer must sign here. If this form is submitted with a statement in lieu
of a full report by a candidate, the candidate must sign here. If this form is submitted with
a statement in lieu of full 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 Statement is true and correct.
- V. ata,),x-- 0 Q0 a
Signature of Treasurer, Candidate, or Lobbyist Date (MM/DD/YYYY)
•
I rr! I-. V, I1one— /UeO({kf ► her IaI)o(, i°4 t •-5,A -
Printed Name Location (City/State/Country)
DSEB-503S
Updated 1/5/2022
COMMONWEALTH OF PENNSYLVANIA
CAMPAIGN FINANCE STATEMENT
File this in lieu of a full report only if aggregate receipts, expenditures, or
liabilities incurred each did not exceed $250.00 during the reporting period.
IDENTIFICATION ' ON ORTBEHALF
FILED ', :CANDIDATE - 1. ,COMMITTEE. v/ ,LOBBYIST . 3.
NUMBER ON BEHALF OF J�
NAME
EO,OFFILING COM^ �
MrrTEE,CANDIDATE OR LOBBYIST
1J - U� V 111•(vIi 6-en7r1 ifroyk6ultpI i&S
STREET ADDRESS
l 550 0 1 r p ,(Tin. Lave?
CRY STATE ZIP CODE
inaa\cua
TYPE OF REPORT NAME OF OFROE SOUGHT BY CANDIDATE ++ T�__RIC�T,�,,VN�O. PARTY DATE OF ELECTION
(CHECK ONE) / fI^ (/ (� n `� t�Jl .� .•••� MO. 'DAY • YEAR-
. . :1. '10 4)( -s V `;P 6901//;ss iMne.' _+\tkM. 4 ,&A(0..- C, II''
6TH TUESDAY':..:;y
PRE4RIMARY, `.
IC • E:ONLYY
-- - :MO. .DAY, .'YEAR'<. '.MO. ...DAY ' : .YEAR:. rn
2. DATES OF - *�%
•2ND FRIDAYTo
PRE-PRMAARY REPORTIPERM° NG O i 0 j al l p. 31. a) r- =O
30'DAir a C7 wC!
POST=PRIMARY ;'•` C5 . Pt
CASH BALANCE AT END `�
a. OF REPORTING PERIOD: $ w" Z t
6TH.TUESDAY:';.;
PRETECECTION . '�"
TOTAL AMOUNT OF FILER'S ,,(I CP
5. OUTSTANDING DEBTS OR LIABILITIES (Y/�)
2RE ELECTIioki AT THE END OF REPORTING PERIOD: $
PRErELECTIOH,'
•
•30 DAY
POT-E ECTION. AMENDMENT::
YES NO
REPORT? 7
EPORT
..ANNUAL TERMINATION: ' YES ON.:
.`, I. . \. . REPORT?.. .,
AFFIDAVIT SECTION
,, PART I-
If statement is filed on behalf of a Political Committee or Candidates's Committee,the Treasurer must sign here.
If statement is filed on behalf of a Candidate,the Candidate must sign here. 1
If statement is filed on behalf of a Contributing Lobbyist,the Lobbyist must sign here.
I SWEAR(OR AFFIRM)THAT THE AGGREGATE RECEIPTS OR DISBURSEMENTS OR LIABILITIES INCURRED DURING THE REPORTING PERIOD INDICATED ABOVE DID NOT
EXCEED TWO HUNDRED AND FIFTY DOLLARS($250.00)AND THIS REPORT IS,TO THE BEST OF MY KNOWLEDGE AND BELIEF,TRUE,CORR AND COMPLETE.
SWORN TO AND SUBSCRIBED BEFORE ME THIS L
LTV v!� / ? a�-
DAY OF 20 SSIGNATURE OF PERSONf SUBMITTING REPORT7
(-,--(/ _ Va i / on`PRINTED NAME
SIGNATURE 93 (fir/l 7
MY COMMISSION EXPIRES MO. DAY YR. DAYTIME NE NUMBER
PART II-
If statement is filed on behalf of a Candidate's Authorized Committee, Candidate must sign here. •
I SWEAR(OR AFFIRM)THAT TO THE BEST OF T. , EDGE AND BELIEF THIS POLITICAL COMMITTEE HAS NOT VIOLATED ANY PROVISIONS OF THE ACT OF
JUNE 3,1937(P.L.1333,No.320)AS ' Neibe,
e/45 or
SWORN TO AND SUBSCRIBED BEFORE TH®yco M��koR'1%7,, , C'btet4../ Aot)V1
114/"4-
AS- 470,/ n,be S.N a SIGNATURE OF CANDIDATE
DAY OF �011�U1� ' —%rr,sfnti',,/,� 4. ik: Z v G17171-Ve
1V��� '/�/ 1'�866�j3
PRINTED NAME
'
I�/1/4 b
RE 1 '"2 b1. S-7-7 k� �D
C�
MY COMMISSION EXPIRES alb . l • i 620 AREA CODE DAYTIME TELEPHONE NUMBER
MO. DAY YR.
DSEB-503(12-99) ' •