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Burroughs,Weston_2022-3rd-qtr-amdAmendment Disclosure Report Cover Yes Js 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. Full Name c. ID Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX b. Mailing Address (include City, State and Zip Code) d. Date Fled 6720 OLD MONROE RD 04/02/2023 STE B146 e. Phone Number INDIAN TRAIL, NC 28079 (980)494-0780 2. Report Year 3. Period Start Date (m m/dd/yy) 14. Period End Date (mm/dd/yy) 5. Trees urer FLIT Name 2022 07 01'2022 10'22'2022 CRISTAL ROBINSON 6. Type of Committee Check One 9. Type of Report check only one type ore r1from one category) ® Candidate Campaign ❑ Partc Municipal State/County Referendum ❑ Joint Fundraiser ❑ PAC ❑ Organizational ❑ Organizational ❑ Organizational ❑ Referendum ❑ Legal Expense Fund ❑ ❑ ❑ Thirty-five day Pre-primary Pre-election Quarterly ❑ First ❑ Second ❑ Pre -referendum ❑ Final Supplemental Final 7. Type of Fund (fmPPlicable, check one) ❑ "Booster Fund" ❑ Building Fund ❑ Pre -runoff 14 Third ❑ Annual ❑ Presidential Election Year Candidates Fond Semi-annual ❑ Fourth ❑ Special ❑ NC Public Campaign Financing Fund ❑ Mid Year Semi-annual ❑ Year End 0 Mid Year 10. S pecial Report Name ❑ Other ❑ ❑ Final Special ❑ Year End ❑ Final ❑ Special 8. Number of Fundraisers this Report I 3. Account Information 3. Account Information a. Financial Institution Full Name a. Financial Institution Full Name FIRST CITIZENS BANK b. Purpose c. Account Code b. Purpose c. Account Code CAMPAIGN 100 d. Period Bolan ee d. Period Begin Balance $ %{Begin (/. $ 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 commingl with prohibited or other non -disclosed funds. I further certify that this report is complete, true and c c d that I have been trained by the NC State Board Q. 04/02/2023 Printed Name of Signer Signature of Appointed Treasurer Date FOR OFFICE USE ONLY Delivery Method Date Received: Employee: Q Normal Mail Date Postmarked: 5 a 3 Employee: /A Registered Mail ❑ Hand Delivered ❑ Electronically Filed Date Scanned: Employee: ❑ Signer has not received Date Data Entered: Employee: mandatory train in 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 -2100A -E to make committee changes. CRO -1000 NC State Board of Elections December 2007 Detailed Summa Amendment rj' ❑ Yes ®No Use this form to summarize a0 disclosure reporting fours and to total monetary in formation 1. Committee Full Name and Fund if applicable) 2. of Report 13. ID Number COMMITTEE TO ELECT WESTON BURROUGHS 2022 Third Quarter XXX-CJMD90-X-XXX Start of Election Cycle: January 1, 2621 Re Total this rtin Period Total this Election Cycle 4) Cash on Hand at Start $ 940.35 $ 0.00 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 0) Refunds/Reimbursements to the Committee 1) Other Receipt Sources I la) Interest on Bank Accounts IIb) Contributions from Not -For -Profit Organizations I lc) Outside Sources of income I Id) legal Expense Fund- Other Sources I 1 e) Exempt Purchase Price Sales (CRO -1105) (CRO -1210) (CRO -1110) (CRO -1230) (CRO -1410) (CRO -1240) (CRO -1150) (CRO -1150) (CRO -1250) (CRO -1270) (CRO -1265) $ 344.00 $ 1,620.00 $ 3,332.72 $ 6,207.72 $ 50.00 $ 100.00 $ 0.00 $ 0.00 $ 0.00 $ 1,355.59 $ 2,277,77 $ 0.00 $ $ 3,523.08 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 2) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10,11 a, I I b, I I c, I I d and I I e) $ 6,004.49 $ 12,806.39 EXPENDITURES 3) Disbursements 13a) Operating Expenditures 13b) Contributions to Candidates/Political Committees 13c)CoordioatedPartyExpenditures 4) Aggregated Non -Media Expenditures 5) Loan Repayments 6) Refunds/Reimbursements from the Committee 7) In-IGnd Contributions (CRO -1310) (CRO -1310) (CRO -1310) (CRO -1315) (CRO -1420) (CRO -1320) (CRO -1510) $ 5,655.31 $ 10,836.28 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 393.85 S 968.84 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 722.72 $ 828.31 8) TOTAL EXPINDfI'URFS (Add lines 13a, 13b, 13c, 14. 15, 16 and 17) $ 61771.88 $ 12 633.43 9) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18) $ 172.96 $ 172.96 ADDITIONAL INFORMATION 0) Non -Monetary Gifts Given to Other Committees I) Outstanding Loans (incl. ones from other campaigns) 2) Debts and Obligations owed by the Committee 3) Debts and Obligations owed to the Committee 4) Account Transfers Within the Committee 5) Administrative Support 6) Forgiven Loans 7) 48 -Hour Notice Reports Sum (CRO -1330) (CRO -1430) (CRO -1610) (CRO -1620) (CRO -1720) (CRO -1710) (CRO -1440) (CRO -1220) $ 0.00 $ 1,355.59 $ 0.00 $ 0.00 $ 0.00 S 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 8) Contributions to he Refunded (CRO -1215) $ 0.00 $ 0.00 CRO -1100 NC Sate Board of Elections August 2008 Amendment Aggregated Contributions from Individuals Page ! or I ❑ J'es IN No Optional form used to report NC Contributions From Individuals of $50 or less 1.Committeef ilName(and FLodifapplicable) 2.II)Nurnber COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information a. Amend b. Account Code c. Form of Payment d. In -Kind Description e. Date (mm/ddtyyyy) f. Amount Add 100 Debit Card 07/19/2022 $ 5.00 ❑ Remove Add 100 Debit Card 08/16/2022 $ 5.00 ❑ Remove Add 100 Debit Card 09/19/2022 $ 5.00 [3 Remove rr—Add 100 Debit Card 09/10/2022 $ 10.00 C] Remove TT—Add 100 Debit Card 09/11!2022 $ 20.00 ❑ Remove A10 ❑ Remove 100 Debit Card 09/11/2022 $ 25.00 Add 100 Debit Card 08/07/2022 $ 25.00 E] recmovc Add 100 Debit Card 07/16/2022 $ 5.00 11 Remove Add 100 Debit Card 08/16/2022 $ 5.00 ❑ Remove Add 100 Debit Card 09/16/2022 $ 5.00 ❑ Remove Add 100 Debit Card 10/16 /2022 $ 5.00 ❑ Remove Add 100 Debit Card 09/15/2022 $ 25.00 13 Remove Add 100 Debit Card 09/10/2022 $ 10.00 ❑ Remove Add 100 Debit Card 07/16/2022 $ 50.00 ❑ Remove Add 100 Debit Card 09/12/2022 $ 10.00 ❑ Remove Add 100 Debit Card 09/10/2022 $ 50.00 ❑ Remove Add 100 Debit Card 09/11/2022 $ 50.00 ❑ Remove Add 100 Debit Card 09/10/2022 $ 25.00 13 Remove Add 100 Debit Card 07/25/2022 $ 3.00 C] Remove ET—Add 100 Debit Card 08/25/2022 $ 3.00 ❑ Remove Add 100 Debit Card 09/25/2022 $ 3.00 [3 Remove 4. Total only this Page $ $344.00 5. Total of ALL CRO -1205 Pages $ $344.00 (This line must be online S ojDetalled Summary Page CRO -1100) CRO -1205 NC State Board of Elections April 2007 Amendment Contributions from Individuals Pg of I1 ❑ Yes ® No Use this fotmto 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 WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments BUSINESS OWNER CAROLINA BANWELL 1128 Queens Rd CHARLOTTE, NC 28207 c. Finployer's Name/Specific Feld NEED COMPANY NUMBER e. Election Sum to Date $ 100.00 L Prior g. Account Code h. Form of Payment I. In -Kind Description j. Date (mm/dd/yyyy) k. Amount ❑ ]no Debit Card 08/31/2022 $ 100.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, 'hailing Address & Phone (include city, state, & zip) b. Job 7111e/Prufession d. Comments RESUME WRITER CHRISTINE BONFARDINO WILKINS 408 Strearnside Ln MARVIN, NC 28173 c. Employer's Name/Specific Feld SELF-EMPLOYED e. Election Sum to Date $ 100.00 I. P, �,r e. account Code h. Form of Payment I. In -Kind Description j. Date (mm/dd/yyyy) k. Amount m 100 Credit Card 03/24/2022 $ 50.00 F1100 Debit Card 09/10/2022 $ 50.00 ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments NOT EMPLOYED JIM BURROUGHS 916 White Oak Dr WARNE, NC 28909 c. Employer's Name/Specific Field NOT EMPLOYED e. Election Sum to Date $ 80.00 I". Prior g. Account Code It. Form of Payment i. In -Kind Description J. Date (an m/dd/yyyy) k. Amount ® 100 Credit Card 03/16/2022 $ 10.00 ® 100 Credit Card 04/16/2022 $ 10.00 ® 100 Credit Card 05/16/2022 $ 10.00 4. Total only this Page $ 150.00 5. Total of ALL CRO -1210 Pages (This line must be on fine 6 oirDetailed Summary Page CRO -1100) $ 3,332.72 CRO -1110 NCV ate Board of Elections April 2007 Contributions from Individuals Amendment Pg 2 of 11 ❑ lies ® No Use this font 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 WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (Include city, state, & zip) In. Job Title/Profession it. Comments NOT EMPLOYED JIM BURROUGHS 916 White Oak Dr WARNE, NC 28909 c. Employer's Name/Specific Field NOT EMPLOYED e. Election Sum to Date $ 80.00 I. Prior g. Account Code h. Form of Payment I. In -Find Description j. Date (mm/dd/yyyy) k. Amount ® 100 Debit Cud 06/16/2022 $ 10.00 ❑ 100 Debit Card 07/16/2022 $ 10.00 ❑ 100 Debit Card 08/16/2022 S 10,00 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. (nm nieuls NOT EMPLOYED JIM BURROUGHS 916 White Oak Dr WARNE, NC 28909 c. Employer's Name/Specific Field NOT EMPLOYED e. Election Sum to Date $ 80.00 f. Prior g. Account Code h. Form of Payment i.In-Find Description I. Date (mm/dd/yyyy) k. Amount ❑ 100 Debit Cud 09/16/2022 $ 10.00 ❑ 100 Debit Card 10/16/2022 $ 10.00 ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) It. Job Ttle/Profession d. Comments NOT EMPLOYED PAM DEMARIA 1108 Hunters Trail Dr INDIAN TRAIL, NC 28079 c. Employer's Name/Specific Field NOT EMPLOYED e. Election Sum to Date $ 325.00 f. Prior g. Account Code h. Form of Payment i. In -Kind Description j. Date (mm/dd/yyyy) k. Amount ❑ 100 Debit Cud 07/17/2022 $ 50.00 ❑ 100 Debit Card 09/05/2022 $ 50.00 ❑ $ 4. Total only this Page $ 140.00 5. Total of ALL C110-1210 Pages (This fine must be on fine 6 ofAelailed Summary Page CRO -1100) $ 3,332.72 CRO -1110 NC Statc Board of Elections April 2UU7 Contributions from Individuals Amendment Pg 3 of 1I ❑ les ® No Use this form to report individuaIcon tributions over$50 or contributions under S50 if form CRO 1205 is not used 1. Committee Poll Name and Fund if applicable) 2. to Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-C1MD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments Tax consultant DEBORAH ELLIS 2540 Surveyor General Drive WAXHAW, NC 28173 c. Finployer's Name/Specific Field Navolio & Tallman e. Election Sum to Date $ 125.00 f. Prior g. Account Code h. Form of Payment I. In -Kind Description j. Date (mm/dd/yyyy) k. Amount ❑ 100 Debit Card 09/24/2022 $ 125.00 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession it. Comments ONLINE TUTOR ERIN EWART 1513 CALDER DRIVE INDIAN TRAIL, NC 28079 c. Employer's Name/Specific Field BOOKNOOK e. Election Sum to Date $ 95.00 f. Prior g. .Account Code h. Form of Payment i. to -Kind Description I. Date (mm/dd/yyyy) k. Amount m 100 Credit Card 04/17/2022 $ 10.00 m 100 Credit Card 05/17/2022 $ 10.00 ® 100 Debit Card 06/17/2022 $ 10.00 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address &]'hone (include city, state, & zip) b. Job 7itle/Profession it. Comments ONLINE TUTOR ERIN EWART 1513 CALDER DRIVE INDIAN TRAIL, NC 28079 c. Employer's Name/Specific Field BOOKNOOK e. Election Sum to Date $ 95.00 f. Prior g. Account Code h. Form of Payment I. In -Kind Description I. Date (in m/dd/yyyy) k. Amount ❑ 100 Debit Card 07/17/2022 $ 10.00 100 Debit Card 08/17/2022 $ 10.00 ❑ 100 Debit Card 09/10/2022 $ 25.00 4. Total only this Page $ 170.00 5. Total of ALL CRO -1210 Pages (This line must be on line 6 ojDetalled Summary Page CRO -1100) $ 3,332.72 CRO -1210 NC State Board of Flections April 20U7 Amendment Contributions from Individuals Pg 4 of 11 ❑ Yes ® No Use this fonnto report individual contributions over $50 or contributions under$50 if form CRO 1205 is not used 1. Committee Full Name andFundif applicable) 2. ID Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments ONLINE TUTOR ERIN EWART 1513 CALDER DRIVE INDIAN TRAIL, NC 28079 c. Employer's Name/Specific Feld BOOKNOOK e. Election Sum to Date $ 95.00 L Prior g. Account Code h. Form of Payment I. In -Kind Description j. Date(mm/ddlyyyy) k.Amount ❑ 100 Debit Card 09/17/2022 $ 10.00 ❑ 100 Debit Card 10/17/2022 $ 10.00 ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments NOT EMPLOYED MERRY FRISBY 265 W Madison St MONTICELLO, FL 32344 c. Employer's Name/Specific Feld NOT EMPLOYED e. Election Sum to Dau $ 100.00 f. Prior g. Account Code h. Form of Payment I. In -Kind Description I. Date(mm/dd/yyyy) k. Amount ❑ 100 Debit Card 09/05/2022 $ 100.00 ❑ $ ❑ $ 3. Contributor Information ❑ \dd ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession it. (bmments NOT EMPLOYED DANIEL HANNUM 4116 Hoffineister Dr WAXHAW, NC 28173 e. Employer's Name/Specific Feld NOT EMPLOYED e. Election Sum to Date $ 70.00 f. Prior g. Account Code h. Form of Payment i. In -Kind Description j. Date (mm/ddlyyyy) k. Amount 19 100 Credit Card 04/06/2022 $ 10.00 ® 100 Credit Card 05/06/2022 $ 10.00 ® 100 Debit Card 06/06/2022 $ 10.00 4. Total only this Page $ 120.00 5. Total of ALL CRO -1210 Pages (This line must be online b of Detailed Summary Page CR0.7I00) S 3,332.72 CRO -1210 NC State Board of Elections April 2007 Amendment Contributions from Individuals Pg 5 of 11 ❑ Its ® No Use this formto report individual contributions over $50 or contributions under$50 ifform CRO 1205 is not used 1. Committee Full Name and Fund if applicable) 12. In Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession it. Comments NOT EMPLOYED DANIEL HANNUM 4116 Hofftneister Dr WAXHAW, NC 28173 c. Employer's Name/Specific Field NOT EMPLOYED e. Election Sum to Dale $ 70.00 f. Prior g. Account Code It. Form of Payment i. In -Kind Description j. Date (mm/dd/yyyy) It. Amount ❑ 100 Debit Card 07/06/2022 $ 10.00 ❑ 100 Debit Card 08/06/2022 $ 10.00 ❑ 100 Debit Card 09/06/2022 $ 10.00 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state. & zip) b. Job Title/Profession d. Comments NOT EMPLOYED DANIEL HANNUM 4116 HOtlmeister Dr WAXHAW, NC 28173 c. Employer's Name/Specific Field NOT EMPLOYED e. Election Sum to Date $ 70.00 I. Prior g. Account Code It. Form of Payment I. In -Kind Description j. Date (mm/ddlyyyy) k. Amount ❑ 100 Debit Card 10/06/2022 $ 10.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments NOT EMPLOYED STEPHANIE KARAFFA 1907 Crestgate Drive WAXHAW, NC 28173 c. Employer's Name/Specific Feld NOT EMPLOYED e. Election Sum to Date $ 175.00 I. Prior g. Account Code h. Form of Payment i.In-Kind Description j. Date (in m/dd/yyyy) k. Amount ❑ 100 Debit Card 07/16/2022 $ 25.00 ❑ 100 Debit Card 09/16/2022 $ 25.00 ❑ 100 Debit Card 10/16/2022 $ 25.00 4. Total only this Page $ 115.00 5. Total of ALL CRO -1210 Pages (This line must be on line 6 of Detailed Summary Page CRO -1100) $ 3,332.72 CRO -1210 NC State Board of Elections April 2007 Amendment Contributions from Individuals Pg 6 of 11 ❑ Yes No Use this fortnto report individual contributions over $50 or contributions under$50 if form CRO 1205 is not used 1. Committee bull Name and Fiend if applicable) 2. m Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-C)MD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession it. Comments ATTORNEY STEPHEN MARTIN 405 Alueio Ct. WESLEY CHAPEL, NC 28104 c. Employer's Name/Specific Field CARDINAL INNOVATIONS e. Flection Sum to Date $ 383.41 f. Prior g. Account Code h. Form of Payment i. In -Kind Description I. Date (mm/dd/v)yy) k. Amount ❑ 100 In -Kind DOOR HANGERS 09/29/2022 $ 383.41 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, flailing Address & Phone (include city, state. & zip) b. Job Tttle/Profession it. Comments NOT EMPLOYED BARBARA MCLAUD 222 Wood Lake Dr. MONROE, NC 28110 c. Employer's Name/Specific Feld NOT EMPLOYED e. Election Sum to Date $ 150.00 I. Prior g. Account Code h. Form of Payment I. In -Kind Description I. Date (mm/dd/yyyy) k. Amount m 100 Credit Card 05/06/2022 $ 50.00 ❑ 100 Debit Card 08/29/2022 $ 50.00 ❑ 100 Credit Card 10/01/2022 $ 50.00 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments PHYSICIAN SANDEEP PATEL 1205 Thistledown Ct MATTHEWS,NC 28104 c. Employer's Name/Specific Feld EventusWholeHealth e. Election Sum to Date $ 1,283.83 I. Prior g. Account Code h. Form of Payment i. In -load Description j. Date (mm/dd/yyyy) k. Amount ❑ 100 Debit Card 08/03/2022 $ 200.00 ❑ 100 Debit Card 08/30/2022 $ 350.00 ❑ 100 Debit Card 09/10/2022 $ 100.00 4. Total only this Page $ 1,133.41 5. Total of ALL CRO -1210 Pages (This fine mast be on line 6 of Detailed Summary Page CRO -1100) $ 3,332.72 CRO -1110 NC State Board of Elections Aprd2007 Amendment Contributions from Individuals Pg 7 of 11 ❑ A'es ® No 'FV.u..v v , 4IJV a wuu � IXv ,aw o uUi uxu 1. Committee Full Name and Fund ifapplicable) 2. ED Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information [3 Add [3 Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job'litle/Profession d. Comments PHYSICIAN SANDEEP PATEL 1205 Thistledown Ct MATTHEWS, NC 28104 c. Employer's Name/Specific Feld Eventus WholeHealth e. Flection .So n, to Date $ 1,283.83 f. Prior g. Account Code It. Form of Payment i. In -Kind Description j. Date (mm/ddtyyyy) it. Amount ❑ 100 In -Kind 2 BAGS OF CANDY FOR TRUNK OR TREAT 09/29/2022 $ 33.83 ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Hailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments NOT EMPLOYED TINA PERRERO 2101 Lark Trail Rd MONROE, NC 28110 c. Employer's Name/Specific Feld NOT EMPLOYED e. Election Sum to Date $ 150.00 f. Prior g. account Code It. Form of Payment ].In -Kind Description I. Date (mm/dd/yyyy) Is. Amount ❑ 100 Debit Card 09/01/2022 $ 150.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) It. Job Title/Profession d. Comments NEED THIS FARILYN READEN 1300 MALLORY LANE WAXHAW, NC 28173 c. Employer's Name/Specific Feld NEED THIS e. Election Sum to Date $ 60.00 I. Prior g. Account Code It. Form of Payment 1. In -]God Description I. Date (mm/dd/yyyy) it. Amount ❑ 100 In -Kind STAMPS 0929/2022 $ 60.00 ❑ $ ❑ $ 4. Total only this Page $ 243.83 5. Total of ALL CRO -1210 Pages $ 3,332.72 (This line must be on line 6 oJDerailed Summary Page CRO -1700) CRn_1710 N( State Board of Elections Aord 2007 Amendment Contributions from Individuals Pg s Of !I ❑ Yes ® No Use this form to report individual contributions oxer 550 or contributions under $50 if form CRO 1205 is not used 1. Committee Phil Name and Fund ifapplicable) 2.InNumber COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include cit, state, & zip) b. Job 7ltle/Professiou d. Comments NEED THIS JENNIFER RUBEN 1006 MEADOW VISTA DRIVE MARVIN, NC 28173 c. Employer's Name/Specific Field NEED THIS e. Election Sum to Date $ 55.48 f. Prior g. Account Code It. Form of Payment I. In -Kind Description I. Date (mm/dd/yyyy) k. Amount ❑ 100 In -Kind CANDY FOR TRUNK OR TREAT 09/29/2022 $ 55.48 ❑ $ 3. Contributor Information ❑ Add ❑ Retttove a. Full Name, Nlailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments PHYSICIAN KATIE SHAW 9824 Saddle Ave WAXHAW,NC 28173 c. Employer's Name/Specific Field VALLEY EMERGENCY e. Election Sum to Date $ 310.00 C Prior g. Account Code h. Form of Payment i. in -Kind Dcseription j. Date (mm/dd/yyyy) k. Amount ❑ 100 Debit Card 07/17/2022 $ 25.00 ❑ 100 Debit Card 08/17/2022 S 25.00 ❑ 100 Debit Card 09/17/2022 S 25.00 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession it. Comments PHYSICIAN KATIE SHAW 9824 Saddle Ave WAXHAW, NC 28173 c. Employer's Name/specific Field VALLEY EMERGENCY e. Election Sum to Date $ 310.00 f. Prior g. Account Code h. Form of Payment 1.ln-Kind Description j. Date (in m/dd/yyyy) k. Amount ❑ 100 Debit Card 09/27/2022 $ 100.00 ❑ 100 Debit Card 10/17/2022 $ 25.00 ❑ $ 4. Total only this Page $ 255.48 5. Total of ALL CRO -1210 Pages (This line must be on line 6 of Detailed Summary Page CRO -1100) $ 3,332.72 CRO -1210 NC State Board of Elections April 2007 Amendment Contributions from Individuals Pg `/ 0r I I ❑ lea ® 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 Rind if applicable) 2. ID Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, flailing Address & Phone (include city, state, & zip) It. Job Title/Profession d. Comments EXECUTIVE ASSISTANT KRYSTYNSMITH 9113 Amsberg Drive Suite 600 WAXHAW, NC 28173 c. Employer's Name/Specific Field AMWINS GROUP INC e. Election Sum to Date $ 70.00 f. Prior g. Account Code It. Form of Payment I. In-IGnd Description j. Date (mm/dd/yyyy) it. Amount ® 100 Credit Card 06/01/2022 $ 25.00 ❑ t00 Debit Card 07/01/2022 $ 5.00 ❑ 100 Debit Card 08/01/2022 $ 5.00 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession it. Comments EXECUTIVE ASSISTANT KRYSTYNSMITH 9113 Amsberg Drive Suite 600 WAXHAW, NC 28173 c. Employer's Name/Specific Field AMWINS GROUP INC e. Election Sum to Date $ 70.00 f. Prior g. Account Code It. Form of Payment 1. In -Kind Description I. Date (mm/dd/yyyy) it. Amount ❑ 100 Debit Card 09/01/2022 $ 5.00 ❑ 100 Debit Card 09/11/2022 $ 25.00 ❑ 100 Debit Card 10/01/2022 $ 5.00 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) It. Job Title/Profession d. Comments NOT EMPLOYED LAUREN SUPPES 2115 Coatsdale Lane MATTHEWS, NC 28104 c. Employer's Name/Specific Field NOT EMPLOYED e. Election Sum to Date $ 840.00 f. Prior g. Account Code It. Form of Payment 1.In-IGnd Description j. Date (mm/ddlyyyy) k. Amount ❑ 100 Check 07/25/2022 5 740.00 ❑ $ ❑ $ 4. Total only this Page $ 785.00 5. Total of ALL CRO -1210 Pages (This line must be online 6 of Detailed Summary Page CRO -1100) $ 3,332.72 CRO -1110 NC State Board of Elections Aprd 2007 Amendment Contributions from Individuals Pg 10 of 11 ❑ res IN No Use this form to report individual contributions over $50 or contributions under$50 if form CRO 1205 is not used 1. Committee FLIT Name and Fund if applicable) 2. ID Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Nailing Address & Phone (include city, state, & zip) b. Job Titie/Profession it. Comments NEED THIS STACYSWANSON 8107 SKYE LOCHS DRIVE WAXHAW, NC 28173 c. Employer's Name/Specific Field NEED THIS e. Election Sum to Date $ 190.00 f. Prior g. Account Code h. Form of Payment i. In -Kind Description j. Date (in m/dd/yyyy) k. Amount ❑ 100 In -Kind TOYS. BAGS, CANDY FOR TRUNK OR TREAT 09/19/2022 $ 190.00 ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Nlailing Address & Phone (include city, state, & zip) b. Job Tille/Professiun it. Comments OFFICE MANAGER JULIE WESLAKE 513 Pine Needle Ct MATTHEWS, NC 28104 c. Employer's Name/Specific Field TerraSource Valuation LLC e. Election Sum to Date $ 55.00 f. Prior g. Account Code h. Form of Payment i. In -Kind Description I. Date (mm/dd/yyyy) k. Amount ® 100 Credit Card 03/16/2022 $ 5.00 m 100 Credit Card 04/16/2022 $ 5.00 m 100 Credit Card 05/16/2022 $ 5.00 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Nailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. out men is OFFICE MANAGER JULIE WESLAKE 513 Pine Needle Ct MATTHEWS, NC 28104 c. Employer's Name/Specific Field TerraSource Valuation LLC e. Election Sum to Date $ 55.00 f. Prior g. Account Code h. Form of Payment i. in -Kind Description I. Date (mm/dd/rvyy) k. Amount m 100 Credit Card 06/16/2022 $ 10.00 ❑ 100 Debit Card 07/16/2022 $ 10.00 ❑ 100 Debit Card 09/16/2022 $ 10.00 4. Total only this Page $ 210.00 5. Total of ALL CRO -1210 Pages (This line must be online 6 ojDetailed Summary Page CRO -1100) $ 3,332.72 CRO -1210 NC Sate Board of l lecuons April 2007 Amendment Contributions from Individuals Pg 11 of I 1 ❑ 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 ifapplicable) 2.IDNumber COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Trtle/Proression d. Comments OFFICE MANAGER JULIE WESLAKE 513 Pine Needle Ct MATTHEWS, NC 28104 c. Finployer's Name/Specific Field TerraSource Valuation LLC e. lection Sum to Date $ 55.00 L Prior g. Account Code It. Form of Payment i. In -Kind Description j. Date (mmlddtyyyy) k. Amount ❑ 100 Debit Card 10/16/2022 $ 10.00 ❑ $ 4. Total only this Page $ 10.00 5. Total of ALL CRO -1210 Pages (This line must be online 6 oJDetailed Summary Page CRO -1100) $ 3,332.72 CRO -1210 NC State Board of Elections April 2007 Amendment Contributions from Political Party Committees Pg I of ❑les ® No l Ise this form to report contributions from a political party 1. Committee FLIT Name and Fund if applicable) 2. ID Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Comments Union County Democratic Party 201 North Main Street Monroe MONROE, NC 28112 e. Election Sum to Date $ 100.00 d. Account Code e. Form of Payment f. In -Fund Description g. Date (mm/dd/yyyy) h. Amount 100 Check 07/13/2022 $ 50.00 tal only ties Page $ 50.00 tal of ALL CRO -1220 Pages$50.00 Fline must be on line 7 ofDetailed Summary Page CRO -1100) CRO -1220 NC State Board of Flections April 2007 Amendment Refunds/Reimbursements To the Committee Pg I of 2 ❑ 1 e ® No Use this form to report refunds received by the committee or reimbursements fora previous expenditure. 1. Committee Full Name(and Flndifapplicable) 2.I1DNumber COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, &zip) d. Type of Committee g. Comments Candidate PAC ❑ Referendum ❑ Party AMAZON 440 Terry Avenue North SEATTLE, WA 98109 e. Level Registered (Specify) It. Original Expenditure Date U Federal County: ❑ State ❑ Municipality: 10/13/2022 L Original Expenditure Amt $ 47.50 b. Job 7i tic /Profession It. Employer's Name/Specific Field if. Purpose 1j. Election Sum to Date NO LONGER NEEDED $ 471.43 k. Account Code ILForm of Payment m.ln-Kind Description o. Date (mm/dd/yyyy) o.Amount 100 Electric Funds Tran 10/ 13/2022 $ 47.50 3. Contributor Information ❑ Add ❑ Remove a. FLIT Name, Mailing Address &Phone (include city, state, & zip) d. Type of Committee g. Comments Candidate PAC ❑ Referendum ❑ Party AMAZON 440 Terry Avenue North SEATTLE, WA 98109 e. Level Registered (Specify) h. Original Expenditure Date Federal 13 County: ❑ State ❑ Municipality: 09/16/2022 i. Original Expenditure Amt $ 17.04 b. Job Title/Profession c. Employer's Name/Specific Field L Purpose 1j. Election Sum to Date NO LONGER NEEDED $ 471.43 k. Account Code 11. Form of Payment Im. In -Rind Description o. Date (mm/dd/yyyy) o. Amount 100 Electric Funds Tran 10/17/2022 $ 17.04 3. Contributor Information ❑ Add ❑ Remove a. Full Name, flailing Address & Phone (include city, state, & zip) d. Type of Committee g. Comments Candidate E3 PAC ❑ Referendum ❑ Party AMAZON 440 Terry Avenue North SEATTLE, WA 98109 e. lxc Registered (Specify) h. Original Expenditure Date U Federal U County: ❑ State ❑ Mmicipality: 04/17/2022 i. Original Expenditure Amt $ 34.13 b. Job ntle/Profession 1c. Employer's Name/Specific Feld L Purpose j. Election Sum to Date NO LONGER NEEDED $ 471.43 k. Account Code 11. Form of Payment Im. In -Kind Descriptionn. Date (mm/dd/yyyy) o. Amount 100 Electric Funds Tran 10,117/2022 $ 34.13 4. Total only this Page S 98.67 5. Total of ALL CRO -1240 Pages (This line must be online 10 ofDelailed Summary Page CRO -1100) $ 2'277.77 CRO -1240 NC State Board of Elections December 2007 Amendment Refunds/Reimbursements To the Committee Pg z of 2 ❑ Its IN No Use this form to report refunds received by the committee or reimbursements fora previous expenditure. 1. Committee Full Name and Fund if a icable 2. ID Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Rernove a. Full Name, Mailing Address & Phone (include city, state, & zip) d. Type of Committee g. Comments Candidate E3 PAC ❑ Referendum ❑ Party EVENTFULLY YOURS 2627 KILMARNOCK COURT MATTHEWS, NC 28105 e. Level Registered (Specify) h. Original Expenditure Date 0Federal 0 County: ❑ State ❑ Municipality: 09/12/2022 I. Original Fxpenditure Amt $ 743.50 It. Job Title/Profession c. Employer's Name/Specific Field f. Purpose j. Election Sum to Date PAYPAL - EVENT DID NOT HAPPEN $ 321.75 k. Account Code 11. Form of Payment m.In-IGnd Description n. Date (mm/dd/yyyy) o. Amount 100 1{lectric Funds Iran 09/29/2022 $ 743.50 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, &zip) d. Type of Committee g. Comments Candidate PAC ❑ Referendrun ❑ Party PCSIGNS.COM 2534 COMMERCE BLVD CINCINNATI, OH 45241 e. Level Registered (Specify) h. Original Expenditure Date Federal County: 13 State 13 Municipality: 09/28/2022 L Original Expenditure Amt $ 1,435.60 It. Job Title /Profession C. Employer's in /Specific Field L Purpose j. Election Sum to Date INCORRECT PURCHASE $ 1,435.00 it. Accou at Code I. Form of Payment m. In- Kind Description n.Dote(mm/dd/yyyy) o. Amount 100 Debit Card 09/282022 $ 1,435.60 F. "Total this Page $ 2,179.10 5. Total of ALL CRO -1240 Pages (T/tis line must be online 10 ojDeloiled Summary Page CRO -1100) $ 2,277.77 CRO -1240 NC State Board of Flections December 2007 Amendment Disbursements Pg i of 4 ❑ yes ® No Use this fonnto report expenditures fromthe committee for operating expenses, contributions to candidate/political consnittees and coordinated party expenditures 1. Committee Full Name and Fund ifapplicable) 2.IDNumber COMMITTEE TO ELECT WESTON BURROUGHS - 3. Type of Disbursement (Please use separate CRO -1310 forms for each tune of Disbursement.) IM Operating Expenses Contrfbmiortsto CandiditePohncal Committees Coordinated Parte Expenditmo 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Com miltee Name d. Comments AMAZON 440 Terry Avenue North SEATTLE, WA 98109 c. Level Registered (Specify) Federal County: ❑ State ❑ Municipality: e. Election Sum to Date $ 471.43 L Account Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) j. Amount k. Required Remarks 100 I Debit Card O 10/18/2022 IS 53.36 YARD SIGN STAKES is 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments EAST FRANK SUPERETTE & KITCHEN 209 EAST FRANKLIN ST MONROE, NC 28112 c. Level Registered (Specify) Fcdcral U County: ❑ State ❑ Municipality: e. Election Sum to Date $ 84.55 f. Account Code Ig. Form of Payment h. Purpose Code it. Date (mm/dd/yyyy) j. Amount k. Required Remarks 100 1 Debit Card O 09/19/2022 $ 84.55 PARTY MEET THE 4. Payee Information ❑ Add ❑ Remove a. Full Natne, Mailing Address & Phone include city, state, & zi b. Coordinated Committee Name d. Comments EVENTFULLY YOURS 2627 KILMARNOCK COURT MATTHEWS, NC 28105 c. Level Registered (Specify) UFederal U County: ❑ State ❑ Municipality: e. Flection Sum to Date $ 321.75 L Account Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) j. Amount 1k. Required Remarks 100 Electric Funds Tran O 09/12/2022 IS 743.50 1 FESTIVAL CONTRACTOR 5. Total only this Page $ 881.41 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses) (This line goes in line 13b of Detailed Summary Page CRO -1100 ifContrib to Candidates/Political Comm) (This line goes in line 13c of Detailed Samnmry Page CRD -1100 if Coordinated Parry Expenditures) $ 5,655.31 7. Purpose Codes (Gist 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 re uiredremarks field(k) CRO -1310 NC State Board of Elections December 2009 Amendment Disbursements Pg 2 of 4 ❑ Its ® No Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political committees and coordinated party exrenditures 1. Committee Full Name and FLpd i I a icable 2. ID Number COMMITTEE TO ELECT WESTON BURROUGHS 3. Type of Disbursement (Please use separate CRO -1310 forms for each type ofDisbursement ) JN Operating Expenses C'ontribmions to C'andidates/Political Committees U Coordinated Partx Expenditures 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city. state, & zip) b. Coordinated Committee Name d. Comments c. Level Registered (Specify) Federal Comty: ❑ State ❑ Mmicipali(q-. META PLATFORMS, INC 1601 WILLOW ROAD MENLO PARK, CA 94025-1452 C. Level Registered (Specify) Federal County: ❑ State ❑ Municipality: e. Election Sum to Date g. Form of Payment $ 115.00 nt Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) j. Amount k. Required Remarks 00 rt Debit Card A 10/01/2022 $ 10.00 PROMOTE WEBSITE 00 Debit Card A 10/03/2022 $ 10.00 PROMOTING WEBSITE 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments META PLATFORMS, INC 1601 WILLOW ROAD MENLO PARK, CA 94025-1452 c. Level Registered (Specify) U Federal 0 Comty: ❑ State ❑ Mmicipality: e. Election Sum to Date $ 115.00 f. Account Code g. Form of Payment h. Purpose Code L Date (mm/dd/yyyy) j. Amount k. Required Remarks 100 Debit Card A 10/06/2022 $ 15.00 PROMOTING WEBSITE 100 Debit Card A 10'06!2022 $ 15.00 PROMOTE WEBSITE 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments META PLATFORMS, INC 1601 WILLOW ROAD MENLO PARK, CA 94025-1452 c. Level Registered (Specify) Federal Comty: ❑ State ❑ Mmicipali(q-. e. Election Sum to Date $ 115.00 f. Account Code g. Form of Payment h. Purpose Code Ii. Date (mm/dd/yyyy) j. Amount lk. Required Remarks 100 Debit Card A 10/092022 $ 15.00 1 PROMOTE WEBSITE 100 Debit Card A 10/09/2022 $ 15.00 PRMOTE WEBSITE 5. Total only this Page $ 80.00 6. Total of ALL CRO -1310 Pages (This line goes in line 13a ojDelailed Summar Page CRO -1100 if Operating Expenses) Tlris line ( goes in tine 136 ojDerailed Summnq� Page CRO -1 ijConlrib (u Cnndidales/Polilical Comm) (This lingoes in line 13c of Derailed Summary Page CRO -1100 if Coordinated Parry Expenditures) 5 5,655.31 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 re uired remarks field NC State Board o f Elections December 2009 Amendment Disbursements Pg 3 of 4 ❑ Yes ® No Use this formto report expenditures from the committee for operating expenses, contributions to candidate/political committees and coordinated party expenditures 1. Committee DLII Name and Fund if applicable) 2. ID Number COMMITTEE TO ELECT WESTON BURROUGHS =- Type of Disbursement (Please use separate CRO -1310 farms for each tune oilDisbursement.) 13. Operat ing ExpensesU Contribmionsto Candidates/Political Committees U Coo rdinat ed Part Expenditures 4. Payee Information ❑ Add ❑ Remove a. Full Nance, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments META PLATFORMS, INC 1601 WILLOW ROAD MENLO PARK, CA 94025-1452 c. Level Registered (Specify) Federal Count}. ❑ State ❑ Municipality: e. Election Sum to Date $ 115.00 L Account Code g. Form of Payment h. Purpose Code I. Date (mm/dd/yyyy) I. Amount k. Required Remarks 100 Debit Card A 10/17/2022 S 25.00 FACEBOOK ADS 4. Payee Information ❑ Add ❑ Remove a. Full Name. Mailing, Address & Phone (include city, state, & zip) b. Coordinated Committer Name d. Comments OFFICE DEPOT 5107 SOUTH BLVD CHARLOTTE, NC 28217 e. Level Registered (Specify) Federal County: ❑ State ❑ Municipality: e. Election Sum to Date $ 56.83 f. Account Code Ig. Form orpayment 1h.Purposc Code i. Date (mm/dd/yyyy) Ii. Amount Ik. Required Remarks loo Debit Card I B 08/15/2022 $ 56.83 1 PAPER 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments PCSIGNS.COM 2534 COMMERCE BLVD CINCINNATI, OH 45241 c. Level Registered (Specify) Federal County: ❑ State ❑ Municipality: e. Dection Sum to Date $ 1,435.00 I. Account Code g. Form of Pavment h. Purpose Code I. Date (mm/dd/yyyy) j. Amount Ik. Required Remarks 100 Debit Card B 09/19/2022 $ 1,435.00 PLASTIC SIGNS 100 Debit Card B 09/28/2022 $ 1,435.60 1 PLASTIC SIGNS 5. Total only this Page $ 2,952.43 6. Total of ALL CRO -1310 Pages (This line goes in line 13n of Detailed Summary Page CRO -1100 if Operating Rvpenses) (This line goes In line 136 of Detailed Sumnmry Page CRO -1100 ifContrib to Candidates?blitical Comm) (This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Part), Expenditures) $ 5,655.31 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 re uiredremarks field(k) CRO -1310 NC State Board of Elections December 2009 Disbursements Amendment Pg 4 of 4 ❑ 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. II) Number COMMITTEE TO ELECT WESTON BURROUGHS - 3. T of Disbursement (Please use separate CRO -1310 forms for each tPpe of Disbursement.) Operative Expenses Cont ribm ions to Candidat es/Pol ideal Comm it lees U Coordinated Party Expenditures 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments SAM'S CLUB 11425 CAROLINA PL PKWY PINEVILLE, NC 28134 c. Level Registered (Specify) E3 Federal U County: ❑ State ❑ Municipality: e. Election Sum to Date $ 278.72 f. Account Code g. Form of Payment h. Purpose Code L Date (mm/dd/yyyy) j. Amount k. Required Remarks 100 I Debit Card O 07/05/2022 $ 64.26 CANDY FOR k- AIN v ANSI NU 4. Payee Information ❑ Add ❑ Remove a. Full Nance, Mailing Address & Phone (include cit', state, & zip) h. Coordinated Committee Name d. Comments VICTORYSTORE.COM 5200 SW 30th Street DAVENPORT, IA 52802 c. Level Registered (Specify) Federal U County: ❑ State ❑ Municipality: e. Election Sum to Date $ 1,373.14 L Account Code g. Form of Payment Is. Purpose Code L Date (mm/dd/yyyy) j. Amount k. Required Remarks 100 Debit Card B 10/10/2022 $ 1,373.14 SIGNS Is 4. Payee Information ❑ Add ❑ Remove a. Full Name,Mailing Address&Phone include city, state, & zip) b. Coordinated Committee Name d.Comments VISTAPRINT 275 Wyman Street WALTHAM, MA 02451 c. Level Registered (Specify) UFederal U County: ❑ State ❑ Municipality: e. Election Sum to Date $ 304.07 CAecount Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) j. Amount k. Required Remarks 100 Debit Card B 07/17/2022 $ 187.55 POSTCARDS 100 Debit Card B 09/06/2022 $ 116.52 POSTCARDS 5. Total only this Page $ 1,741.47 6. Total of ALL CRO -1310 Pages (This line goes in line Iia of Detailed Summary Page CRO -1100 if Operating Expenses) (This line goes in line 136 of Detailed Summary Page CRO -1100 ifContrib to Candidates/Political Comm) (This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures) $ 5,655.31 7. Purpose Codes (List detailed expenditure code in (h.) above) A* - Media B* - Printing C* - Fundraising D- To Another Candidate E - Salaries P - 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 re uiredremarks field(k) CRO -1310 NC State Board of Elections December 2009 Amendment Aggregated Non -Media Expenditures Page i _or 2 ❑ Yes ® No Optional form used to report NC Non -Media Expenditures of $50 or less. 1"i" -:alb , COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Payee Information a. Amend b. Account Code c. Form of Payment d. Purpose Code e. Date (mm/dd/yyyy) f. .Amount g. Required Remarks =Add 100 Electric Funds Tran K 07/07/2022 $ 7.13 BANK FEE El Remove =Add 100 Electric Funds Tran K 07/072022 $ 7.13 BANK FEE ❑ Remove Add too Electric Funds Tran K 07/112022 $ 2137 BANK FEE ❑ Remove Ad 100 Electric Funds Tran K 08/052022 $ 3.15 BANK FEE El Remove =Add ❑ 100 Electric Funds Tran K 08/092022 $ 10.94 BANK FEE Remove Add ❑ 100 Electric Funds Tran K 09/062022 $ 12.53 BANK FEE Remove Add ❑ too Electric Funds Tran K 09/092022 $ 29.64 BANK FEE Remove Add ElRemove loo Draft K 10/122022 $ 37.32 BANK FEE Add ❑ Remove 100 Debit Card B 08/122022$ 35 75 CLEAR DOOR R BAQF Add too Debit Card O 09/162022 $ 1704 FESTIVAL TOOLS ❑ Remove Add 11 too Debit Card O 10/092022 $ 27.04 STAKES Remove Add 100 Debit Card O 10/132022 $ 47.50 YARD SIGN STAKES ❑ Remove Add 100 Debit Card B 09/302022 $ 22.16 GRAPHIC DESIGN ❑ Remove Add 100 Debit Card O 09/262022 $ 8.55 FOOTBALL TICKETS ❑ Remove WH Add 100 Debit Card O 10/072022 $ 7.00 TICKETS TO A GAME ❑ Remove =Add 100 Check O 10/11/2022 $ 8.55 FOOTBALL GAME ❑ Remove TICKET Add 100 Debit Card O 09/302022 $ 10.00 ADVERTISING - ❑ Remove INTE ET Add 100 Debit Card O 10/192022EVENT $ 6.44 SUPPLIES ❑ Remove =Add 100 Debit Card O 09/162022 $ 4 27 DECORATIONS FOR [3 Remove BOOTH Add 100 Debit Card O 04'0'0" S 832 FESTIVAL TOOLS ❑ Rem ,,I 4. Total only this Page 331.83 5. Total of ALL CRO -1315 Pages g 393.85 (This line maxi be on line lJ ojDe(ailed Sunimaty Page CRO -1100) 6. Purpose Codes(List detailed expenditure code in d above B* - Printing C* - Fundraising D - To : 110flICr Candirlatc F - Sabric F* - Equipment G - Political Part\ H* - Holding Public OfficeExpens I- Postage J - Penaltes Bice Expenses (1` -Donations to Legal Expense Fund O* - Other * Codes require detailed explanation in required remarks field CRO -/315 N(State Boardof Elections December 2009 Non -Media Expenditures Page _2 _„f 2 Amendment Aggregated p _ __ ❑Yes ® No Optional form used to report NC Non -Media Expenditures of $50 or less. 1. Committee FYtll Name (and Fund if applicable) COMMITTEE TO ELECT WESTON BURROUGI IS 12. ID Number XXX-CJMD90-X-XXX 3. Payee information a. Amend b.Account Code le. Form of Payment Id. Purpose Code le. Date (mm/dd/yyyy) L Amount g. Required Remarks Add ❑ Remove 100 Debit Card O 10/19/2022 $ 32.25 EVENT SUPPLIES Add ❑ Remove 100 Debit Card O 10'21 %2022 $ 29.77 EVENT SUPPLIES 4. Total only this Page $ 62.02 5. Total of ALL CRO -1315 Pages (This line nurse be nn line 14 of Demilerl Sumnmry Page ('RO-1lllll) $ 393.85 6. Purpose Codes List detailed expenditure code in d above B* - Printing C* -Fundraising I) - Io Another Candidate E - Salaries F* - Equipment (i - Political Parte H* - Holding Public Office Expenses , - i- Postage J - Penalties K* - Office Expenses Q* - Donations to Legal Expense Fund O* - Other * Codes require detailed explanation in required remarks field CRO -131 S NC State Board of Elections December 2009 Amendment In -Kind Contributions Pg 1 of 2 ❑ Yes ® No Use this form to report non -monetary contributions, donations, goods or services provided to the committee or fund. COMMITTEE TO ELECT WESTON BURROUGHS 3. Contributor Information ❑ a. Full Name, Mailing Address & Phone (include city, state, & zip) STEPHEN MARTIN 405 Alucio Ct. WESLEY CHAPEL, NC 28104 IS* a77Ini!I:Hq:79 3. Contributor Information a. Full Name, Mailing Address & Phone (include city, state, & zip) SANDEEP PATEL 1205 Thistledown Ct MATTHEWS, NC 28104 12 BAGS OF CANDY FOR TRUNK OR TREAT 3. Contributor Information a. Full Name, Mailing Address & Phone (include city, state, & zip) FARILYN READEN 1300 MALLORY LANE WAXHAW. NC 28173 I STAMPS XXX-C1MD90-X-XXX Add ❑ Remove Candidate Party PAC Referendum d, Other Receipt Source L Date (mm/dd/y; 09/29/2022 Add ❑ Remove b. Type of Contributor C. Individual ❑ Candidate ❑ Party ❑ PAC ❑ Referendum d ❑ Other Receipt Source If. Date (mm/dd/y; 09/29/2022 Add ❑ Remove b. Type of Contributor C. Individual ❑ Candidate ❑ Party ❑ PAC ❑ Referendum d ❑ Other Receipt Source L Date (mm/dd/y. 09/29/2022 omments Election Sum to Date $ 383.41 yy) g. Fair Market Amount $ 383.41 omments Election Sum to Date $ 1,283.83 yy) g. Fair Market Amount $ 33.83 a Comments Election Sum to Date $ 60.00 yy) g. Fair Market Amount $ 60.00 4. Total only this Page $ 477.24 5. Total of ALL CRO -1510 Pages S 722.72 (Ibis line must be online 17 ojDetailed Summary Page CRO -1100) CRO -MO NC State Board of Elections December 2007 Amendment In -Kind Contributions Pg 2 of 2 ❑ Yes ® No Use this form to report non -monetary contributions, donations, goods or services provided to the committee or fund. Use CRO -1215 if In -Kind Contributions were or will be refunded within 7 days. 1. Committee Full Name and Fund if applicable) 2. ID Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Contributor Information ❑ Add ❑ Remove a. Full Name. Mailing .Address & Phone (include city, state, & zip) b. Type of Contributor c. Comments IM Individual ❑ Candidate ❑ Party ❑ PAC ❑ Referendum ❑ Other Receipt Source JENNIFER RUBEN 1006 MEADOW VISTA DRIVE MARVIN, NC 28173 d. Election Sum to Date $ 55.48 e. Description f. Date(mm/dd/yyy)) g. Fair Market Amount CANDY FOR TRUNK OR TREAT 09/29/2022 $ 55.48 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Type of Contributor c Comments IM Individual ❑ Candidate ❑ Party ❑ PAC ❑ Referendum ❑ Other Receipt Source STACY SWANSON 8107 SKYE LOCHS DRIVE WAXHAW, NC 28173 it. Election Sum to Date $ 190.00 e. Description f. Date (mm/dd/yyyy) g. Fair Market Amount TOYS, BAGS, CANDY FOR TRUNK OR TREAT 09/19/2022 $ 190.00 $ 4. Total only this Page $ 245.48 5. Total of ALL CRO -1510 Pages (This line must be on line 17 ofDelailed Summary Page CRO -1100) $ 722.72 CRO -1510 NC State Board of Elections December 2007 Outstanding Loans Amendment Pg I of 2 ❑ les ® No Use this form to report any outstanding loans received during a previous reporting period and until the loan is paid in full. 1. Com iifteeFullName(and Fundifapplicable) 2. ID Number COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. fender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments TRAINING & OPERATIONAL EXCELLENCE MANAGE WESTON BURROUGHS 6720 OLD MONROE RD STE B 146 INDIAN TRAIL, NC 28079 (980) 494-0780 e. Start Date (mm/dd/yyy c. Employer's Name/Specific Feld 12/23/2021 MEINEKE CAR CARE f. End Date (mm/ad/yyyy) g. Rate 1h. Security Pledged ji. Original Loan Amount j. Remaining Loan Balance a/o N/A $ 5.99 $ 5.99 k. Full Name of Lending Institution 1. Loan Number 3. Lender Information ❑ Add ❑ Remove a. Full Name, :flailing Address & Phone (include city, state, & zip) b. Job Tine/Profession it. Comments TRAINING & OPERATIONAL EXCELLENCE MANAGE WESTON BURROUGHS 6720 OLD MONROE RD STE B 146 INDIAN TRAIL, NC 28079 (980) 494-0780 e. Start Date (mm/dd/yyyy) c. Employer's Name/Specific Feld 12/23/2021 MEINEKE CAR CARE L End Date (mm/dd/yyyy) g. Rateh. Security Pledged if. Original Loan Amount j. Remaining Loan Balance % $ 99.60 $ 99.60 k. Full Name of Lending Institution I. Loan Number 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Joblitle/Profession d. Comments TRAINING & OPERATIONAL EXCELLENCE MANAGE WESTON BURROUGHS 6720 OLD MONROE RD STE B 146 INDIAN TRAIL, NC 28079 (980) 494-0780 e. Start Date (mm/dd/yyyy) c. Employer's Name/Specific Feld 12/23/2021 MEINEKE CAR CARE f. Fid Date (mm/dd/yyyy) g. Rate 1h. Security Pledged ji. Original Loan Amount j. Remaining Loan Balance % N/A $ 200.00 $ 200.00 k. Full Name of Lending Institution I. Loan Number 4. Total only this Page $ 305.59 5. Total of ALL CRO -1430 Pages (This line must he on line 11 of Delalled Summary Page CRO -1100) $ 1,355.59 CRO -1430 NC State Board of Elections December 2007 Outstanding Loans Amendment Pg 2 of 2 ❑ lies ® No Use this form to report any outstanding loans received during a previous reporting period and until the loan is paid in full. 1. Committee Full Name and Fund ifa icable 2.toNumber COMMITTEE TO ELECT WESTON BURROUGHS XXX-CJMD90-X-XXX 3. Leader Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments TRAINING & OPERATIONAL EXCELLENCE MANAGE WESTON BURROUGHS 6720 OLD MONROE RD STE B 146 INDIAN TRAIL, NC 28079 (980) 494-0780 e. Start Date (m m/dd/yyyy) c. Employer's Name/Specific Field 01/10/2022 MEINEKE CAR CARE f. End Date (m m/ad/yyyy) g. Rate h. Security Pledged It. Original Loan Amount j. Remaining Loan Balance $ 1,050.00 $ 1,050.00 k. Full Name of Lending Institution I. Loan Number 4. Total only this Page $ 1,050.00 5. Total of ALL CRO -1430 Pages (This line must be on line 11 gfDelailed Summary Page CRO -1100) $ ),355.59 CKU-1430 NL. state Board of Elections December 2007