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Elam,Edwin_2024-2nd-QtrAmendment Disclosure Report Cover Yes m Use this form for general report and committee information, must be signed and submitted along wi other dei ' e forms Do not use this form to update information. 1. Committee Information a. Full Name c. ID Number b. Mailing Address (include City, State and Zip Cod d. Date Filed �A,> a ��r�wOk, ��z� z� z / f n '�lx A -A --j A/' e. Phone Number 2. Repurl Tear 3. Period Start Uatc onnJddly}} 4. Pcriod End Date'oum/dd"" 5.-1 reasm'er Full Nunn, 6. Type of Conunitleg-(Check Ones 9. Type of Report ( cher/: unh l , r , "e_ , y'reporr Irrnn , ..r -nc qon J lair Campa,gn © Pun) Municipal Slate/Count} Referendum Pends AC Referendum ❑ Organizational 1] Organi aoonal Organindonal independent Expenditure Joint Fundraiser ❑ Thirty-five day Quarterly Pre -referendum Legal Expense Fund O Pre-primary ® Frst Final ❑ Pre-election ©P pre -runoff Second Thi d © Supplemental Final © Annual 7. Ty of Fund ftrpp(icnb(e, check one) ❑ 13o,.,ter Fund Semi-annual Fourth Special Building Fund Mid Year Semi-annual © Year End © Mid Year 10. Special Report Nano ❑ 011ier- Final ❑ Special 0 Year End f3�1'inal 8. Number of Fundraisers this Report ;;;, © d 11. Account Information- -:_; �,- � 11. .Account Information - a. Financial Institution Full Name &JIr•i a. Fiuwund Institmlon Pull N:uue Q uNA C b. Purpose c. Account Code h. Purp ,se - c. Account Code /�e� �J E C E I V E D d. Period Begin Balance d. Periad Begin Balance _HE CERTIFICATION 1 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 comtni th hib' o er non -disclosed funds. I further certify that this report is c��onTlete, true and correct and that 1 hav een u ' y the ate Bo d of Elections. 1,3 L `A //0 Printed Name of Si net Signature of Appointed Treasurer Date FOR OFFICE USE ONLY I, (a c Delivery Method Dale Received: Employee: 0 Normal Mail Date Postmarked: Employee: Registered Mail Hand Delivered Date Scanned: Employee: Electronically Filed ❑ Date Data Entered: Employee: Signer has not received mandato 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 -E) to make committee changes. CRO -1000 NC Stale Board of Elections August 2008 rAmendment Detailed Summary 1❑ Yes No Use this form to summarize all disclosure reoortine forms and to total monetary information 1 Committee Full Name (and Fund if applicable) 12. Type of Report. 3. ID Number Start of Election Cycle: Janua y 1, Reporting Total this Period Total this Election Cycle 4) Cash on Hand at Start $ $ ®o RECEIPTS 5) Aggregated Contributions from Individuals 6) Contributions from Individuals 7) Contributions from Political Party Committees 8) Contributions from Other Political Committees (CRO -1205) (CR04210) (CRO -1220) (CRO -1230) $ $ $ $ 66 $ $ $ $ 9) Loan Proceeds (CRO -1410) $ $ 10) Refunds/Reimbursements to the Committee (CRO -1240) $ $ 11) Other Receipt Sources Ila) Interest on Bank Accounts 1 Ib) Contributions from Not -For -Profit Organizations 11 c) Outside Sources of Income (CRO -1250) (CRO -125/) (CRO -1250) $ $ $ $ $ $ 1 Id) Legal Expense Fund - Other Sources (CRO -1270) $ $ 11 e) Exempt Purchase Price Sales (CRO -1265) $ $ 12)TOTAL RECEIPTS (Add lines 5.6,7,8,9,10,1 la.l lb,l lc,l Id and Ile) $ $ r� EXPENDITURES 13) Disbursements 13a) Operating Expenditures (CRO -1310) 13b) Contributions to Candidates/Political Committees (CRO -1.110) 13c) Coordinated Party Expenditures (CRO -1372) $ $ $ $ (� $ $ $ 14) Aggregated Non -Media ExM GN FINANCF 15) Loan Repayments jUL 10 2024 6) Refunds/Reimbursements from the Committee (CRO -1315) (CRO -1420) (CRO -1320) $ $ $ $ $ 17) In -Kind Contributions RECENEU (CRo-151o) $ $ 1 w 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ $ 19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18 $ t^` ADDITIONAL INFORMATION O) Non -Monetary Gifts Given to Other Committees 1) Outstanding Loans (incl, ones from other campaigns) 2) Debts and Obligations owed by the Committee 23) Debts and Obligations owed to the Committee 4) Account Transfers Within the Committee 25) Administrative Support (CRO -1330) (CRO -1430) (CRO -1610) (CRO.1620) (CRO -1720) (CRO -1710) $ $ $ $ $AN $ $ 6) Forgiven Loans 7) 48 -Hour Notice Reports Sum 8) Contributions to be Refunded (CRO -1440) CRO 112o) (CRO -1215) $ $ $ $ $ $ CRO -1100 NC State Board of Elections Auguvl 2008 Amendment Contributions from Individuals Pg or � ❑ Yea ® N,, Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1 20> is not (1,;J 1. Confntittee Full Name (and Fund if applicable) L /oil L �uwrY,t�.�c2 2. ID Number 3. Contributor Information ❑ Add ❑ Remove it. toll Mow. flailing Address & Phone (include city, state, & zip) b. Job Title/Profession rr 3,A tes �ZA I T u c. Employer's Name/Spec(eciDc Field — a�,s.pLLlrp P-1 reAI ec q lr .``ri Ips d. 1.'om ,a"t, DANrt,'s AA 6SRr % �Sca ff ll*AJJ'4C ?doff SMlfti t:, C'd Qr /VUN fC ,e/ e. Election Som to Date $ / Qo O, L Prior ° g. Account Code b. Formof Payment 1. In -Kind Description J. Date (mmldd/yyyy) k Amount $ UUC1.aN vY1QC� Ji/ aj ❑ $ ❑ 5 3. Contributor Infm-utation ❑ Add ❑ Remove it. Full Name, Mailing Address & Phone (include city, state,&zip) lV , I (/ I" `' % W p r n �, qO(O &I�1A((J.1 Q1t C2 V �// ] b. Job Tille(Profession d. Cunun em, c. Employer's Name/Specific Field — D- � t� �I e. Election Sum to Date $ S0.? d-1 f. Prior ° g, Account Codeh. Form of Payment - K i. In -Kind Description J. Date (mmlddtyyyy) k Amount - _ 2/2 _ oc $ S °° ° , , r,T $ ❑ S 3, Contributor Information Jul ❑ Add ❑ Rclllo., o. I ull Name, (Mailing Address & Phone (include city, stale, & zip)REGEN Q 4q MR (3 0 371 1r C ZV73 It. Jolt Till,,/I'rofl.rsi nn tzlT I /d d. Commcnly c. Employer's Name/Specific Field e. Election Sum to Date $ 100,E f. Prior g. Account Code It. Form of Payment i. In -Kind Description J. Date (mWdd/yyyy) it. Amount ❑ $ ❑ $ 4. Total only this Page $ 5. Total of ALL CRO -1210 Pages $ / 66-0 (Thiv line must bean line h of Detailed Summary Page CRO -1 100) CRO -1210 NC Stale Roan) of El"two., April 2007 'Amendment Contributions from Individuals Pg _�_ of K Yes No_ _ Use this form to report individual contributions over $50 or contributions under $50 if form RO 11_05 is not u ed I: Committee Full Name (and Fund if appli able) 2. ID Number 3. Contributor Information ❑ Add ❑ Remove a. Full Name. Mailing Address & Phone (include city, state, & zip) (' 1 /{{ sv M M2 � e (�/ Cy 23V E, Ca*a W A)4h atA/ /\/L 2-P 73 b. Job Title/Profession d. Conunents N (CS e c Employer's N peciDe Field Employer's '�`°f— e. Election S®to Date $ r7 �—U , CJS% f.Prior ❑ g. Account Code h. Form of Payment c'�` i. In -Kind Description j. Date (mm/dd/yyyy) 5 02 wZ h. Amount $ r r/� ❑ $ 3. Contributor Information ❑ Add , ❑ Remove a. Full Name, Mailing Address & Phare (include city, state, & zip) It. Job Title/Profession f - n d. Comments �—t`Q0114l 4e /1/l•�Qo�j �.lG ZP//d c. Employ is Na>a/Specitic Field re -1 e. Election Sum to Date $ Z4Z, f.Prlor ❑ g. Account Code. h, Form of Payme t _ tion �'��I �fRD _ _ Date (mm/dd/ J. 3'yyy) _ �S o 202 k. Amount $ Z°1� I � M CFcr,l'l IGN FINANCE ❑A 10 2024 $ ❑ REDPEIVED S 3. Contributor Information ' '" ' -❑ Add "?'❑°Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) /�,, - /.wA M A6 e N 2633 �D M� ��� o / „.(f9Aq,,11sj 2 y// b. Job Title/Profession s Ired d. Comments c Employer's Name/Sponc Field t /e e. Etectfoa Sum to Date $ -2 f. Prior g. Account Code h. Form o/ff Payment i. tn.Kind Description j. Date (tmn/dd/yyyy) K Amount ❑ $ 4. Total only this Page o 5. Total of ALL CRO -1210 Pages (This line must be on line 6 of Detailed Summary Page. CRO -1100j CKU4210 NC State Board of Elecrm,, April 2007 \mendosal Contributions from Individuals Pg ae ❑ yes Na Use this form to report individual contributions over $50 or contributions under S50 if form CRO I _OS isnot used 1. Committee Full Name (and Fund if applicable) 2. ID_ Number 3.. Contributor Information ❑ Add ❑ Remove a. Full Name, flailing Address & Phone (include cite, state, & zip) j A NA // 2 (L 152Z/ My B r / C 2- k// v b. Job Title/Profession C/e0f< d. Continents c. Employer's Name/Specific Field LJAl�ar f So"j y�l'I e. Election Sum to Dale $ l 'Ti.) , . Prior g. Account Code h. Form of Payment i. In -Kind Description J. Date (nwVdd/yyyy) k Amount ❑ ❑ S 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) ec _— J`'\ e //7 ' nJ y/ i1 P ,I //V7 l--GA+�/ b. Joh Title/Profession d. Comments c. Employ NameJSpeciFic Field Goy",j Fiala` e.Elecdon Sumto Date $ y� — f. Prior g. Account Code h. Form of Payoeat C4tCkllQN GOUN"' I. lo -Kind Description j. Date (mrn/dd/yyyy) k Amount 1 ❑ CAMPAIG I FINAN' 5 ❑ JUL I U 70P $ 3. Contributor Information' ME LEIAdd ❑Remove "` a. Full Name, Mailing Address & Phone - "' (include city, state, & zip) Illi ,&ARA bC, /�t Wrl,,XAa w _ f� �Y' b. Job Title/Professhm j2eticP d. Comments c. Employers Na's me/Specific Field 2cJi,J a Election Sum foDate $ �/sf. o Prior ❑— g. Account Code h. Form of Payment I. In -Kind Description j. Date (mrWdd/yyyy) k Amount $ ❑ $ ❑ 5 4: Total only this Page S ( 7 5. Total of ALL CRO -1210 Pages (This line must be on Hae 6 of Detailed Summary Page:CRO-tt00) $ sg r CRU -1210 NC State Board of Elections April 2007 of [Amendment Contributions from Individuals Pit T 10 Yes ❑ No Use this form to report individual contributions over $50 or contributions under $50 if form 40 1205 is not used 11 Sommittee Full Name' (and Fund if applicable) 2. [D Number 3' , Cptributor Information Add Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) G(A ,u ,f b. Jet) Title/Prafess10� a C d. Comments c. Employer's Name/Specific Field f A, C -k- I. e. Election Sum to Date $ 14 3. I. Prior g. Account Code It. Form of Payment I. In -Kind Description I. Date (nam/ddlyyyy) it. Amount El -f1OX12,- Zil $ 2 $ ❑ $ 3, Contributor Infourouption a. Full Name, Mailing Address & Phone (include city, state, & zip) c� 4.,-4 Z_ A— .�r'Y— / 2- p. 0 P L -U A,;,eh O-ij /V C b. Job TitletProfesdon d. Comments c. Employer's Name/Specifle Field e. Election Sum to Date $ •U-3 f. Prior ❑ g. Account Code It. Form of Payment I.In-Kind Description Date (nunldcYyyyy) ILAmount 7. C -A ❑ $ 13 Contributor Informadi ❑ Add ❑ Rcnw�,- a. Full Name, Mailing Addrtsb,flroflr (include city, state, & zip) .Job unI111,11t, JUL 10 2024 RECEIVEDa. c. Employer's Name/Specific Field Election Sam to Date I'. Prior 13 g.account Code h. Form of Payment i. In -Kind Description j. Date (nun/dd/yyyy) Jr. Amount $ r_1 $ El $ 4. Total wily this Page 5. 'Total of ALL CRO -1210 Pages (This line must be on fine 6 of Velailed Summary Page, CRO -1100) CRO4216 NCCS1111c 1-1111 ! F11111"mv Apfil 2007 /...._.-_-1 Disbursements Pg of Amendment _ ❑ Yes Nn Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political committees andcoonlinated a ex nditures 1 :omtmttee' ull Name (au{l Fund if applicable) a 2, iD Number 3. Tope of Disbursement (Please a use separate CR -1310 forms for each rine of Disbursement.) -i"" lGnnmiuees ❑ C(Wrtdm.aed Pum Ex a-ndllurr- 4. Payee Information ❑ Addy. Remove �(=° a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Coordinated Committee Name d. Comments tle� es �, C9,e ` ^` Vo I 'I e fj C c. Level Registered (Spec!! ) ❑ Federal ounty: ❑ State ❑ Municipality: e. Election Sum to Dale $ / � f. Account Code g. Form of Payment LYIt11� h. Purpose Code la Date ( ddlyyyy) 3"Z __ J. Amount $ k Required Remarks _ nJ 4 Payee Information " ❑ Add L3 Remove a. Full Name, \tailing Address & Phone (include city, state, & zip) It. Coordinated Committee Name" d. Gnnments _ s t fee_ J O / c. Level Registered (Speclty Federal array: ❑ State 13Municipality: e.ElmtionS to Da $ 7 !. account Code g. Form o! Payment h. Purpose Code 1. Date (mmiddlyyyy) j. Amount k. Required emarks 202 $ $ 4' Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include tin'. state. & zip! - 20211 Ry: `' F t ( C r� E . F (', F I V b. Coordinated Committee None d. C'onunrnb, c. Level Registered (Speciry) [3FederalCount ❑ State ❑ Municipality: e. Election Sum to Date $ f. Account Code g. Form of Payment h. Purpose Code i. Date (nutdddlyyyy) j. Amount k. Required Remarks Is 5. Total only this Page,. G. Total of ALL CRO -1310 Pages ("this line goes in line 13a of Delailed Summary Page CRO -1100 if Opemling Expenses) (This Une goes in line lab of Detailed Summary Page CRO -11001f Contrib to Candidates/Political Comm) (This line nes in lice 13c of Detailed Summary Page CRO -1100 if Coordinated Par( F.x endiotrrs) t f 7. Purpose Codes' (List detailed expenditure code in. (h.) above) A* - Media B* - Printing C* - Fundraising D - To Anothcr Candidate E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses I - Postage .1 - Penultie, K* - Office Expenses Q* - Donation to Legal Expense Fund O* Other Codes require detailed explanation in required remarks ficid (10 CRO -1310 NC Scan t3ozrd n Pia; lion, I �o�_an11b, Amendment In -Kind Contributions Pg --L or Q Ya Use this form to report non -monetary contributions, donations, goods or services provided to the committee or fund. I ke CRO -I' 15 if In -Kind Contributions were or will he refunded within 7 dav, 1. Corrunittee Fu1[,,Nt6fie(and Fund if applicable) 2. ID Number 5 3. Contributor Infair*ion El Add 11 Remove a. Full Name, Mailing Address & Phone (include city, state, & zip)huhvual jj IJ W) AK�J' It, -,)'j, L'V b. Type or Contributor aud,diac 0 Party PAC [3 PAC [301her Receipt Source c. Comments d. Election Sum to Date $ 9 7, e. Description F. Date (mm/dd/yyyy) g. Fair Market Amount 1 Contributor Information 0 Add [3 Remove a. Full Name, Mailing Address & Phone (include M3, state, & zip) UNION GOUN' CAMPAIGN FINANCE 4U6 1 U 215h b. Type of Contributor 13 fildi,id,i] Qcandidate Q Party E3 PAC E3 Referendum Cj Other Receipt Source c. Cononents d. Election Sum to Date $ e. Description f. Date (rmn/dId/yyyy) g. Fair Market Amount RECEIVED $ 3. Contributor Information 0 Add 0 r,Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Type of Contributor [3 Individual - 0 Candidate 13 Party Q PAC 0 Referendum [3 Other Receipt Source c-. Comments d. Election Sum to Date $ e. Description f. Date (mi/dd/yyyy) g. Fair Market Amount 14. Total only this Page $ 3� 5. Total of ALL CRO -1510 Pages (This fine must be on fine 17 of Detailed Summary PageCRO-1100)$ CRO -1510 N( S,,itc B.a,d of Elections December 2007