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Home My WebLink About2020 81-015 DEAN MAYNARD81-015 PENNSYLVANIA STATE ETHICS COMMISSION _r OMMONWEALTH OF PENNSYLVANIA STATEMENT OF FINANCIAL INTERESTS (717) 783-1510 •TOLL FREE 1-800-9324938 SEW (Ray.01121) PLEASE PRINT NEATLY FIRSTN AME MI SUFFIX 1= 01 LAST NAME p gtafa or gavernme) or home City Zip Code Area Code Phone -lac.(— 02 ADDRESS office (business ( " Z z w OR FINANCIAL ACCOUNT NUMBS -s • lF YOU ARE INCLUDING ATTACHMENTS, DO NOT INCLUDE ANYTHING THAT BEARS YOUR SOCIAL SECURITY NUMBER NOTE. s, mme than one box may be marked. ( See thaWctlats on page 2) 03 STATUS Check applicable box or boxe Current) E PubBc Employee ( ❑ Check this box If you ❑ Check this box we amending A ❑ Candidate (induding write-in) C ❑Pubic Otticial (Current) D l.J ❑ Public Employee (Former) if you are flNn9 an original flung as a solicitor B ❑ Nominee C ❑ Public Official (Former) D 0 held member, Commiaeloner, job title, etc.) ❑ seeking hold 04 PUBLIC POSITION OR PUBLIC OFFICE (administrator, ❑ seeking [?hold ❑ held d auNlolitY, borough, board. commission, cou nty. school dishicl, twp, ata) 06 GOVERNMENTAL ENTITY in which you arehniers en Oflldel, Employee, Candidate or Nominee (e.g.. apt, egencY. A S 1 be the same as block 4) 07 YEAR SEE INSTRUCTIONS. 06 OCCUPATION OR PROFESSION (This may information in blocks 8-16 papresents F7o-ITE] diactosure for the calendar Year listed here: Act m I r'A 08 REAL ESTATE INTERESTS (See lnstntdlons on Page 2) If NONE, chuck this box. 09 CREDITORS (See InsinWilons On Page 2) Creditor (Mame and Address) N NONE, check this box. Address , Name: check this box 10 DIRECT OR INDIRECT SOURCES OF INCOME Inducing {but not !knifed to} au employment ( UsUtrdions on page 2) If NONE, Add Names 11 GIFTS (See instructions an page 2) If NONE, check this box. Swce of Gift Address Of Sourea of GHt 12 TRANSPORTATION, LODGING,140SPITALITY (See instructions an page z) S„uree (Name and AdcYsse) Interest Rata (OFFICIAL USE ONLY) r•.* V" d Gilt 0 (P.EID --4 Cirownslerioa d�) If NONE, check this box. 13 OFFICE, DIRECTORSHIP, OR EMPLOYMENTIN ANY BUSINESS (See Instructions on page 2) if Nano, Bustnees Entity (Nemo and Address) 14 t'C -�-•� posWw Held (is., oftw. director. N ' ori e Z if NONE, check this box. FINANCIAL INTEoREB LEGAL ENTITY 1N BUSINESS FOR PROFIT (See instructions Page } Nems end Address 15 BUSINESS INTERESTS TRANSFERRED TO IMMEDIATE Business (Hans and Address) Transferee (Nems end ins unow,mu,.o.. s.14904 to rib penalties prsscribed by 18 Signature THIS F RM 113 CONSIDERED Y MEMBER (809 instructions on page c( kdwad Held (LO.. 6%. to%. ata.) If NONE, chock this box. tD { Interest Held IRdetbnft Dote Trends �g information is true and Correct to the best of saki person's KrKW4WUao. a'Ethics Act. S5 Pa.C.S. 41109(b). to suffind Ise, and the Pubilc Official and Employe i LL- CEIV 2 5 2021 mads subject atlon �� ;waicnir-NT sworfalttlirc Z Enter Current Date IP ANY BLOCK ABOVE IS NOT COMPLETED. MAKE A COPY FOR YOUR RECORDS. (3 Of 4) -<3TAI-C W",el4jp or—, IP54-iCMOL.06-11 OA HR SERVIr CENTER JUN 2 5 2021 EMPLOI,.Z, STATE ETHICS COMMISSION I//ll Date: Bates/Batch # 21 -V( 9 The PA State Ethics Commission has performed !Mhich . of your Statement of Financial Interests form filed c ndar year was to be filed in anticipation of the May 1, filing deadline. Please be advised that your form is deficient and needs to be revised because the following block(s) on the form are blank or otherwise incomplete: Block 01 T Block 02 Block 03 — The amended box is located in this block on the far right Block 04 A — ;lock 04B- 05 A — 05B— Block 06 — Block 07 — Should read (prior calendar year) Block 08 — Block 09 — �C Block 10 — List any direct or indirect sources of income of $1,300 or more (including but not limited to employers) Block 11 — Block 12 — x Block 13 —m Block 14 — Block 15 — Please sign and enter the current date at the bottom of the form Your original filing has been retained by the State Ethics Commission. To correct the above .deficiency(ies), please complete the entire enclosed blank form making all necessary corrections and checking the box in block 3 for amending a filing. If the answer to a block is "none," check the box indicating that the answer is "none." Sign and current date the form and return it to the PA State Ethics Commission, Finance Building, 613 North Street, Room 309, Harrisburg, PA 17120-0400. The correctedlamended form will then be attached to the prior filing we received. Please also file a copy of the amended form at every other location where the original form was filed and make a copy for your records. If you have any questions regarding this matter, please contact The State Ethics Commission at 717-783-1610 or toll free at 800-932-0936. Enclosure(s): A copy of your original form. Blank form(s) for your corrections (keep a copy for your records)