HomeMy WebLinkAbout2022 54-002 KEVIN MUNLEY54-002
COMMONWEALTH OF PENNSYLVANIA STATEMENT OF FINANCIAL INTERESTS PENNSYLVANIA STATE ETHICS COMMISSION
SEC-1 (Rev. 01/23) PLEASE PRINT NEATLY (717) 783-1610 • TOLL FREE 1-800-932-0936
SEE INSTRUCTIONS FOR ADDITIONAL DETAILS
01 LAST NAME FIRST NAME MI SUFFIX
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02 ADDRESS office u fines or Joy mental or ho a City State Zi Code Area Code Phone
tral^ S-1-A r'q CIl r TjvP tiC3 �7y)�ic .•7y�u
NOTE: IF YOU ARE INCLUDING ATTACHMENTS, DO NOT INCLUDE ANYTHING THAT BEARS YOUR SOCIAL. SECURITY NUMBER OR FINANCIAL ACCOUNT NUMBERS,
03 STATUS Check applicable box or boxes, more than one box may be marked. Check this
bx if you
A f _._ Candidate (including write-in) C Public Official (Current) D I___1 Public Employee (Current) E Check this box are amending
if you are filing
B Nominee C E-1 Public Official (Former) D El Public Employee (Former) as a solicitor an original filing
04 PUBLIC OFFICE OR PUBLIC EMPLOYMENT (i.e. administrator, member, Commissioner, job title, etc.) [�] seeking hold__. held
A
l seeking Lhold I ] held
B
05 GOVERNMENTAL BODY in which you are/were an Official, Employee, Candidate or Nominee (e.g., dept, agency, authority, borough, board, commission, county, school district, twp, etc.)
A F W N► i-;
- U,
B[Ld[5) T6 lo tV f�
06 OCCUPATION OR PROFESSION (This may be the same as block 4) 07 YEAR SEE INSTRUCTIONS _
Information in blocks 8-15 represents r O
e disclosure for the calendar year li ,d 60e:
08 REAL ESTATE INTERESTS involved in transactions with the commonwealth, any of its agencies, or a political subdivision If NONE, check this box;/
Fr , -, f� elakAiy sr
1 1�
09 CREDITORS TO WHOM IS OWED MORE THAN $6,500 r� i ! p If NONE, check this box
Name: an Ia.�r�l t'�Ai(1. N Address: (�� v e�"� Interest Rat 6-1 �q (i p
't,)ktc Zx-er Cie, Pb d L "� 22c..ct 4 o f b -
10 DIRECTOR INDIRECT SOURCES OF INCOME OF $1,300 OR MORE, including (but not limited to) all employment f NONE, check this box
Na e: � C�ll.t1 Address: 1 Loi<z ke Mo(* � PA (OFFICIAL USE ONLY)
11 GIFTS VALUED AT $250 OR MORE IN THE AGGREGATE If NONE, check this box
Source of Gift Value of Gift
E=
- 1=
Address of Source of Gift I Circumstances (including description) of Gift
12 TRANSPORTATION, LODGING OR HOSPITALITY WHERE ACTUAL EXPENSES EXCEEDED $650 IN THE AGGREGATE If NONE, check this box
Source Name and Address) Value
LJ-LLL
13 OFFICE, DIRECTORSHIP OR EMPLOYMENT IN ANY BUSINESS If NONE, check this box
Business Entity (Name and Address) Position Held (i.e., officer, director,
employee, etc.)
Name: Address:
14 FINANCIAL INTEREST IN ANY LEGAL ENTITY IN BUSINESS FOR PROFIT If NONE, check this box r-
Business (Name and Address)
Interest Held (i.e., 5%, 10%, etc.)
15 BUSINESS INTERESTS TRANSFERRED TO IMMEDIATE FAMILY MEMBER If NONE, check this box
Business (Name and Address) Interest Held
Relationship
Transferee (Name and Address) Date Transferred
The undersigned hereby affirms that the foregoing information is true and correct to the best of said person's knowledge, information and belief, said affirmation being made subject
to the penalties prescribed b 1 Pa.C.S 904 nsworn falsific . to authoriti nd the Public Official and Employee Ethics Act, 65 Pa.C.S.§§a11109(b).
Signature Enter Current Date �/ 2t=
S
/
THIS FORM IS CONRED DEFICIENT IF AY BLOCK ABOVE IS NOT COMPLETED. MAKE A COPY FOR YOUR RECORDS.