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Bention,Jimmy_2023-MidYearAmendment Disclosure Report Cover I ❑ Yea No Use this form for general report and committee information, must be signed and submitted along with other detailed forms. Do not use this form to update information 1. Committee Information a. Fun Name e. ID Number Committee to Elect Rev. Bention, Sr. b. Mailing Address (include City, State and Zip Code) d. Date Filed 302 Tucker Street 07/27/2023 Monroe, NC 28110 e. Phone Number 704-572-0879 2. Report Year 3. Period Start Date (mm/dd/yy) 4. Period End Date 5. Treasurer Full Name mm/ddhv Latoya L. Bention 2023 01/01/2023 06/30/2023 6. Type of Committee Check One 9. Type ofAepprt (check only one type of report ora one tate o ® Candidate C'anpaign ❑ Par1% Municipal Shte/Countr Referendum ❑ PAC ❑ Referendum ❑ Organizational ❑ Organizational ❑ Organizational Independent Joint Fundraiser ❑ Expenditure E] Joint Thirty-five da S Quarterly❑ Pre -referendum ❑ Legal Expense Fund ❑ ❑ Pre-primary Preelection ❑ First ❑ Second ❑ Final ❑ Supplemental Final 7. TM of Fund (if applicable, check one) ❑ "Booster Fund" ❑ Building Fund ❑ Pre -runoff ❑ Third ❑ Annual Scmi-annual ❑ Fourth ❑ Special ❑ Mid Yew Semi-annual ❑ Other: ❑ Year Find ® Mid Year 10. Special Report Name ❑ ❑ Final Special ❑ Year End ❑ Final ❑ Special 8. Number of Fundraisers this Report 11 11. Account Information 11. Account Information a. Financial Institution Full Name a. Financial Institution Full Name Wells Fargo b. Purpose c Account Code b. Pprposc - _ c. Account Code Election Committee 104 JUL 2 7 2023 it. Period Begin Balance d. Period Begin Balance Donations S $259.29 RECEIVED $ CERTIFICATION I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B, & 22D -22M of Chapter 163 of the NC General Statutes and that no funds are commingled with prohibited or other non -disclosed funds. I further certify that this report is complete, true and correct and that I have been trained by the NC State Board of Elections. Latoya L. Bention L. L'�� 07/25/2023 Printed Name of Signer Signature of Appointed Treasurer Date FOR OFFICE USE ONLY Delivery Method Date Received: Employee: -❑ Normal Mail Registered Mail ReY Date Postmarked: Employee: ;i /�L�il Hand Delivered /` ❑ Electronically Filed Date Scanned: _ Employee: ❑ Signer has not received mandatory training Date Data Entered: Employee: Please Note: This form cannot be used to amend committee information such as the committee address, treasurer, assistant treasurer, custodian of books information, or account information. You must amend the Statement of Organization (CRO -2 100A-E)to make committee changes. CRO -1000 NC State Board of 19ections August 2009 Amendment Detailed Summary ❑ Yes ® No Use this form to summarize all disclosure reoortine forms and to total monetary information. 1. Committee Full Name and Fund if applicable) 2. a of Report 3. ID Number Committee to Llect Rev. Bention, Sr. 2023 Mid -Year Semi Annual Start of Election Cycle: January 1, 2022 Total this Reporting Period Total this Election Cycle 4) Cash on Hand at Start S 259.39 $ 0 RECEIPTS 5) Aggregated Contributions from Individuals 6) Contributions from Individuals 7) Contributions from Political Party Committees 8) Contributions from Other Political Committees 9) Loan Proceeds 10) Refunds/Reimbursements To the Committee 11) Other Receipt Sources Ila) Interest on Bank Accounts llb) Contributions from Not -for -Profit Organizations Ile) Outside Sources of Income lid) Legal Expense Fund — Other Sources 11 e) Exempt Purchase Price Sale's iCRO-1105) (CRO -1210) (CRO -1110) (CRO -1230) (CRO -1410) (CRO -1140) (CRO -1250) (CRO -1150) (CRO -1150) (CRO -1170) (CRO -1165) $ 380 $ S 310 $ 4,100 $ $ S $ 1,750 S $ $ $ $ $ $ $ $ $ $ $ $ $ 12) ff!PFNDITURES 13) 14) 15) 16) 17) TOTAL RECEIPTS Iddd linea 5. 6, 7, 8, 9, 10, Ila. Iib. llc. Ildand Ile) Disbursements 13a) Operating Expenditures (CRO -1310) 13b) Contributions to Candidates/Political Committees (CRO -1310) 13c) Coordinated Party Expenditures (CRO -1310) Aggregated Non -Media Expenditures (CRO -1315) Loan Repayments (CRo-1420) Refunds/Reimbursements From the Committee (CRO -1320) In -Kind Contributions (CRo-1510) $ 210 $ 6,230 $ 432.48 $ 5,866.60 $ $ 300 $ S 26.59 $ $ $ $ $ $ $ $ 18) TOTAL EXPENDITURES (.4dd linea 13a. 13b, 13e, 14. 15. 16 and 17) $ 432.48 $ 6,193.19 19) 20) 21) 22) 23) 24) 25) 26) 27) 28) Cash on Hand at End , Wd 6nr> J and l2togelhee then subtract line 18) TIONAL INFORMATIlDN _- Non-MonctarN Gifts Given to Other Committees (CRO -1330) Outstanding Loans (incl. ones from other campaigns) (CRO -1430) Debts and Obligations owed By the Co Hee (CRO -1610) Debts and Obligations owedTothe Coottlitttee (CRO -1620) Account Transfers Within 4he Conn ti tejM (CRO -1710) Administrative Support lU` LGt`'�D (CRO -1710) Forgiven Loans ��G `�5 V (CRO -1440) 48 -Hour Notice Reports Sum (CRO -1120) Contributions to be Refunded (CRO -1215) $ 36.81 $ 36.81 $ $ $ $ $ $ $ $ $ $ $ I $ $ CRO -1100 NC State Board of Elections August 2008 Amendment Contributions from Individuals Pg i of i ❑ Yes ® No Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used 1. Committee Full Name and Fund if applicable) 2, ID Number Committee to Elect Rev. Bention, Sr. 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state. & rip) b. Job Title/Profession d. Comments Logistics Coordinator Latoya L. Bention 302 Tucker Street Monroe, NC 28110 c. Employer's Name/Specific Field TOV Furniture e. Election Sum to Date $ 0 L Prior g. Account Code h. Form of Payment 1. In -Kind Description j. Date (mm/dd/yyyy) K Amount ❑ 104 BankDraft N/A 05/09/2023 $ 50.00 ❑ 104 BankDraft N/A 06/12/2023 $ 60.00 ❑ S 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state. & tip) b. Job Title/Profession d. Comments Pastor Jimmy H. Bention, Sr. 302 Tucker Street Monroe, NC 28110 c. Employer's Name/Speeiac Field Temple COG IC Metrolina COGIC e. Election Sum to Date $ 20 C Prior g. Account Code It. Form of Payment I. In -Kind Description j. Date (mm/dd/yyyy) k. Amount ❑ 104 Cash N/A 03/30/2023 $ 100.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full .Name, \failing Address & Phone (include cit), state. & zip) b. Job Title/Profession d. Comments UNION NO NA �pr„?t\P3 �U� 2 i 2p23 VES c. Employer's Name/Specific Field e. Election Sum to Date $ C Prior g. Account . Form of Payment i. In -Kind Description I. Date (mm/dd/yyyy) L Amount ❑ $ ❑ $ ❑ $ 4. Total only this Page $ 210.00 5. Total of ALL CRO -1210 Pages $ 210.00 (This line must be on line 6 of Derailed Suouneq Page CRO -1100) CRO -1210 NC Stale Board of Elections April 2007 Amendment Disbursements Pg 1 of A ❑ Yes ® No Use this form to report expenditures from the committee for: operating expenses, contributions to candidate/political committees and coordinated Dartv expenditures. 1. Committee Full Name and Fund if applicable) 2. ID Number Committee to Elect Rev. Bention. Sr. 3. Type of Disbursement Please use se arae CRO -1310 forim for each tppe of Disbursement ® Operating li \penes ❑ Contributions to Candidates/Political (Conunitiecs ❑ Coordinated Pan% Expenditures 4. Payee Information El Add El Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments Campaignparmers.com PO Box 118 SNIT River, MA 01467 617-500-7251 c. Level Registered (Specify) ❑ Federal ® County: ❑ State ❑ Municipality: e. Election Sum to Date $ 551.30 L Account Code g. Form of Payment It. Purpose Code I. Date (mm/dd/yyy)) j. Amount k. Required Remarks 104 CreditCard O 01/02/2023 $15.00 Annual Renewal 104 CreditCard O 01/08/2023 $49.00 Monthly Website Fee 4. Payee Information Add Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments Campaignpartners.com PO Box 118 Still River, MA 01467 617-500-7251 c. Level Registered (Specify) ❑ Federal ® County: ❑ state ❑ Municipality: e. Election Sum to Date $ 615.30 E Account Code g. Form of Payment h. Purpose Code 1. Date (mm/ddlyyyy) J. Amount L Required Remarks 104 CreditCard O 02/08/2023 $49.00 Monthly Website Fee 104 CreditCard O 03/08/2023 $49.00 Monthly Website Fee 4. Payee Information Add Remove a. Full Name, Mailing Address & Phone ,�, ('i include city, state,& zi ^,t G(=\) • .qtr.-. b. Coordinated ('ommitlee Name d. Comments Campaignparmers.com Pc ,1,\ PO Box 118 G SNIT River, MA 01467 ��� 1 617-500-7251 G GE�v c. Level Registered (Specify) Federal ❑ County: State ❑ Municipality: e. Election Sum to Date $ 713.30 E Account Code g. Form of Payment it. Purpose Code 1. Date (mm/dd/yyyy) J. Amount k. Required Remarks 104 CreditCard O 04/082023 $49.00 Monthly Website Fee 104 CreditCard O 05/08/2023 $49.00 Monthly Website Fee 5. Total onty this Pae $ 260 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Dendled Sumnmrr Page CRO -1100 if Operating Expenses) (This line goes in line 136 of Derulled Sumararr Page CRO -1100 if Coerrib to CandidalevPolilical Comm) $ 432.48 (This line goes in line 13r of Detailed Summrrt' Page CRO-11001ffoordinaled Part), Expenditures) 7. Purpose Codes ist detailed ex enditure code in h. above) A* - Media B* - Printing C* - Fundraising D - To Another Candidate E - Salaries F* - Equipment G - Political Pany H* - Holding Public Office Expenses I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* - Other * Codes require detailed explanation in required remarks field k CRO -1310 I.,. titatelioardot Elections December 2009 Amendment Disbursements Pg 2 of 1 ❑ Yes ® NO Use this form to report expenditures from the committee for: operating expenses, contributions to candidate/political committees and coordinated party expenditures. 1. Committee Full Name and Fund if applicable) 2. ID Number Committee to Elect Rev. Bention. Sr. 3. Type of Disbursement Please use separate CRO -1310 fornis for each tpye of Disbursement ® ilperaum! Ifcpens" ❑ Cuninhution. to ( andlda(o I'A aical l mnmwcc� ❑ Cuurdinated Panv Fxpenditures 4. Payee Information Add El Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments Cam pa ign partners.com PO Box 118 Still River, MA 01467 617-500.7251 e. Level Registered (Specify) ❑ Federal ® County: ❑ State ❑ Municipality: e. Election Sum to Date $ 762.30 E Account Code g. Form of Payment It. Purpose Code i. Date (mm/dd/yyyy) j. Amount k. Required Remarks 104 CreditCard O 06/08/2023 $49.00 Monthly Website Fee $ 4. Payee Information Add Remove a. Full Name, Mailing Address & Phone - include city. state, & zip) b. Coordinated Committee Name d. Comments Speedway Wadesboro, NC c. Level Registered (Specify) ❑ Federal ® County: ❑ State ❑ Municipality: e. Election Sum to Date $ 0 E Account Code g. Form of Payment Is, Purpose Code i. Date (mm/ddlyyyy) J. Amount Is. Required Remarks 104 CreditCard O 01/06/2023 $55.52 Gas S 4. Payee Information Add El Remove a. Full Name. ?tailing Address & Phone _ include city, stat4 & zip) b. Coordinated Committee Name d. Comments Wells Fargo t` c.l> 2p13 v c. Level Registered (Specify) ❑ Federal ® County: ❑ State ❑ Municipality: e. Election Sum to Date $ E Account Code g. Form of Payment It. Purpose Code i. Dale (mm/dd/yyyy) j. Amount k. Required Remarks 104 BankDraft O 01/26/2023 $10.00 Monthly Service Fee 104 BankDraft O 02/24/2023 $10.00 Monthly Service Fee Pae $ 124.52 5. Total only this 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Summar' Page CRO -1100 if Operating Expenses) (This line goes in line 136 of Detailed Sunt any Page CRO -1100 ifConrrib to Candidares/PaNdral Comm) $ 432.48 (This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Parry Etpenditures) 7. Purpose Codes List detailed expenditure code in h. above) A* -Media B* - Printing C* - Fundraising D - To Another Candidate E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* - Other * Codes require detailed explanation in required remarks field k CRO -1310 I� date Board of Flections December 2009 Amendment Disbursements Pg 3 or j ❑ Nes ® No Use this form to report expenditures from the committee for: operating expenses, contributions to candidate/political rnmmittees and coordinated nartv exnenditures. I. Committee Full Name and Fund if applicable) 2. ID Number Committee to Elect Rev. Bention. Sr. 3. Type of Disbursement Please use se arare CRO -1310 forms for each ope of Disbursement ® Operating I'cpen+c. ❑ L unlnbulions to Candidates Political Commitee, ❑ Coordinated PartN F.rpenditures 4. Payee Information Add Remove _ a. Full Name. )tailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. (Commons e. Election Sum to Date $ 20 Wells Fargo c. Level Registered (Speci() ❑ Federal ® County: ❑ State ❑ Municipality: E Account Code g. Form of Payment It. Purpose Code L Date (mmidd/yyyy) j. Amount k. Required Remarks 104 BankDraft O 03/23/2023 $10.00 Monthly Service Fee 104 BankDraft O 04/25/2023 $10.00 Monthly Service Fee 4. Payee Information Add El Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments e. Election Sum to Date Wells Fargo c. level Registered (Specify) ❑ Federal ® County: ❑ State ❑ Municipality: $ 40 L Account Code g. Form of Payment h. Purpose Cade L Date (mm/dd/yyyy) j. Amount k. Required Remarks 104 BankDraft O 05/23/2023 $10.00 Monthly Service Fee 104 BankDraft O 06/26/2023 $10.00 Monthly Service Fee 4. Payee InformationAdd El Remove -`' a. Full Name, Mailing Address & PhoocT , -. ,` include city.state,&zi Uy"�'dt�Ft'I�- b. Coordinated Committee Name d. Comments Hazel's Coffee G� Monroe, NC ,UL Z� `N j�D c. Level Registered (Specify) ❑ Federal ® County. State ❑ Municipality: e. Election Sum to Date L Account Code g. Form of Payment h. Purpose Code 1. Date (mm/dd/yyyy) j. Amount k. Required Remarks 104 CreditCard O 01/04/2023 $7.96 Community Time $ 5. Total only this Pae $ 47.96 6. Total of ALL CRO -1310 Pages (This line gaes in line 13a of Detailed Sunrmmr• Page CRO -1100 if Operating Evpenves) (This line gaes in line 13b of Derailed Sunmmr) Page CRO -1100 if Cantil, to Candidafev/Politieul Commi $ 432.48 (This line goes in line 13c of Detailed Sunmurr Page CRO -1 /00 if Coordinated Party FVendinneq 7. Purpose Codes List detailed expenditure code in (h.) above A* - Media B* - Printing C* - Fundraising D - To Another Candidate E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses - Postage d - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* - Other * Codes require detailed explanation in required remarks field (k CRO -1310 VL Sure Board or I lemon, December 2009