Burns,Robert_2023-35-Day-report-coverDisclosure Report Cover Amen
v sure°® No
Use this form for general report and committee information, crust be signed and submitted along with other detailed fours.
Do not use this form to update information.
1. Committee Information
a. Full Name
c. to Number
COMMITTEE TO ELECT ROBERT BURNS
It. Mailing Address (include City, State and Zip Code)
d. Date Filed
4211 SECREST SHORTCUT ROAD
MONROE, NC 28110
10/04/2023
e. Pbooe Number
(704)622-7063
2. Report Year
13. Period Start Date (mm/ddlyy)
14. Period End Date (mmiddlyy)
I S. Treasurer Fall Natne
2023
0U01/2023
09/26/2023
ROBERT BURNS
6. of Committee (Check One)
9. Type
of Re rt check only one type o re ortfromonecategIn)
® Candidate CampaiEm ❑ Part>
Municipal
State/County
Referendum
O Joint Fundraser ❑ PAC
❑
Organizational
❑ Organizational
❑ Organizational
❑ Referendum ❑ Legal Expense Fund
®
❑
❑
'f hirty-five day
Pre-primary
Pre-election
Quarterly
❑ First
Q Second
❑ Pre-refinenduon
0 Final
❑ Supplemental Final
7, Type of Fund (ijapplicable, check one)
❑ "Booster Fund"
❑ Building Fund
❑
Pre -runoff
0 Third
[3 Annual
❑ Presidential Election Year Candidates Fund
Semi-annual
0 Fourth
❑ Special
❑ NC Public Campaign Financing Fund
❑
Mid Year
Semi-annual
❑
Year End
Q Mid Year
10. Special Report Name
❑ Other.
❑
❑
Final
Special
0 Year End
[:] Final
0 Special
8. Number of Fundraisers this Re rt
0
3. Account Information
3. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
FIRST CITIZEN BANK
IL Purpose
c. Account Code
s
as Account Code
FOR CAMPAIGN
1Mr—CEIVED
RELATED ACTIVITY
l'
OCT 0 4 20223
d. Period Begin Balance
d. Period Begin Balance
$
0.00
s
nip a.- r
CERTIMAT10N
I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B& 22D -22M of
Chapter 163 ofthe NC General Statutes and that no funds are commingled with prohibited or other non -disclosed
funds. 1 further certify that this report is complete,
tete at rrect and that I have been trained by the NC State Board
apt( -E- (FjvT,ng
10/04/2023
Printed Name of Signer
S at Appointed Treasurer Date
FOR OFFICE l6EONLY
Date Received: I0/-1123
Employee: Delivery Method
❑ Nomal Mail
Date Postmarked:
Employee- ❑ Registered Mail
EXHand Delivered
Date Scanned: /
Enployee:[3 Electronically Filed
4W
Date Data Entered:
13Signer has not received
Employee:
mandatory training
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- to make committee changes.
CRa7000 NC State Board of Elections December 2007