Holtey,Elizabeth_2023-35-DayAmendment
Disclosure Report Cover p V. p 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 uodate information.
1. Committee Information
. Full Now
c. ID Number
Elizabeth Holley
3JM453
. Mailing Address (Include qty, Stafe and Zip Code)
d. Date Filed
5017 Woociview Lane
Weddington, NC 28104
-7 �� 3
e. Phone Number
(917) 531-4433
2. Report Year
3._ Period Start Date (ntmldmyy) Period End Date 15.
Treasurer Fall Name
2023
T.
aOa q a� aoa3
Elizabeth Coble-Holtey
of Committee Check One
9. Type of Report (c/reek onlyone type of report from one category)
❑X Candidate Campaign Party
Municipal
Stafe/Comty,
Referendum
PAC El Referendum
Organizational
Organizational
Organizational
Independent Expenditure ❑ Jnim Fundraiser
Thirty-five day
Quarterly
Pre -referendum
Legal Expense Fund
Pre-primary
First
❑ Final
QPre-election
Pre -runoff
r3 Second
C) Third
E] Supplemental Final
Annual
7. Type of Fund_ (ifopplieuble. <'heeA one
Booster Fund
Building Fund
Semi-annual
Mid fear
r3 Fourth
Semi-annual
Special
Other
Year End
Final
special
Mid Year
Year End
[3 Final
❑ Special
10.$ Report Name
Number of Fundraisers this Report
11. Account Information
11. Account Information
. Financial Institution Full Name
SouthState Bank
a. Financial Iastifudo ,f, ,�� �'
o ,
. Purpose
c. Account Code
b. Purpose
t Cod
/ / A
/-'ti L�
Campaign
lections
d. Period Begin Balance
�•mdaoo —
od Begin Balance
Union
$
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 commingled with prohibited or other non -disclosed funds. I further certify that this
report is complete, true and correct and that 1 have been trained by the NC State Board of Elections.
Elizabeth Coble-Holtey
Printed Name of Signer Sfgnaturc of Appointed Treasurer Date
FOR OFFICE USE ONLY
Date Received: f Employ Delivery Method
❑ Normal Mail
Date Postmarked: Employee: ❑ R gistered Mail
and Delivered
Date Scanned: / Employee: ectronically Filed
Date Data Entered: ( ' Employee: E3 Signer has not receivedmandatory train
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 -21 OOA-E) to make committee changes.
URU-10M) NC State Board of Elections August 2008
Amendment
Detailed Summary ❑ Yes1 N„
Use this form to summarize all di,i lo,ure reporting forms and to total monetary information
11. Committee Full Name (and Fund ifapplicable)
T of Re
13.IDN
vt�E
3JMyS3
Start of Election Cycle: January 1,
Total this
Reporting Period
Total this
Election Cycle
4) Cash on Hand at Start
$
$
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
l lb) Contributions from Not -For -Profit Organizations
11 c) Outside Sources of Income
1Id) Legal Expense Fund - Other Sources
Ile) Exempt Purchase Price Sales
(CRO -1205)
(CRO -1210)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -125U)
(CRO -1150)
(CRO -1150)
(CRO -1170)
(CRO -1265)
$
$
$ %j J(Q • a
$
$
$
$
$
$ 3 377
$
$
$
$
$
$
$
$
$
$
$
$
$
12)TOTAL RECEIPTS (Add lines 5,6.7,8,9,10,1 Ia. l l b. l l c, l l d and l Ie)
$o.00 36Sa•
$
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (CRO -1310)
13b) Contributions to Candidates/Political Committees (CRO -1310)
13c) Coordinated Party Expenditures (CRO -1310)
14) Aggregated Non -Media Expenditures (CRO -1315)
15) Loan Repayments (CRO -1420)
16) Refunds/Reimbursements from the Committee (CRO -1320)
17) In -Kind Contributions (CRO -1510)
$
3/0 D
$
$
$
$
$ c
$
$ 3 _
$
$
$
$
$
$
18) TOTAL EXPENDITURES (Add lines 13a, 13b. 13c. 14, 15, 16 and 17)
$0.00
$
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line I S
$ 0.00 h
$
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
3) Debts and Obligations owed to the Committee
24) Account Transfers Within the Committee
5) Administrative Support
6) Forgiven Loans
48 -Hour Notice Reports Sum
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRO -1620)
(CRO -1720)
(CRO -1710)
(CRO -1440)
(CRO -2220)
$
$
$
$
$
$
$
$
$
$
$
Contributions to be Refunded
(CRO -1215)
$
$
UKU-I1W NC State Board of Elections August 2008
Reset Form
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Amendment
Loan Proceeds Pe —1 a L ❑ Yes`� No
Use this form to report proceeds from a loan and loan endorsers information
3. Lender Information
. Full Name, Mailing Address & Phone
(include city, state, & zip)
&r d $eT<1 ATE
3 TM yS 3
Add ffRemove
b. Job Tine/Profession Id. Comments
of ( b� vv oW V �C//l! �' " `� a Employer's Name/Specific Field
e. Start Date (dd/yyyy)
k eD 61 NhToN, NC -51114 M��uirz�w6o� 7 �4 aDa 3
f. End Date (mmlddlyyyy)
6/;Mc67TE, Nc
. Rate h. Security Pledged i. Acrnunt Code . Form of Payment L Amo®t
% 1$ 3 3oa
. Full Name of Lending Insntutim on. Loan Number
4.EndorserS/Makers Mee people who guarantee the loan.)
. Full Name. Mailing Address & Phone
(include city, state, & zip)
E m 6T fE
sloi WMDV1G-%.j 6J�Ne
jV60DMl61WI PC 41 b q
(include cirv. state. &
Full Name, Mailing Address & Phone
. (include city, state, & zip)
Job Title/Profession c. Employer's Name/Specific Field
%41 101�74-L
Percentage e. Amount
rh $
OCT 0 3 2023
%I$
e. Amount
�r $
5. Total of ALL CRO -1410 Pages
$
(This line must be on line 9 of Detailed Summary Page CRO -1100) I
CRO -1410 NC SLuc Boaul of Flection. April 2007
Amendment
Disbursements Pg —L of 13Y. to No
Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated party expenditures
.Committee FA Name (andFond If applicable) _
,Eua�C � DL-r�y
2. Number
3Ti� �{S3
Type of Disbtn sement (Please use separate CRO -7370 forms for each type of Disbursement.)
— - urs
Operating Expensex C,mutbutwns n. (m"fidates/Palitwal Conunmecs Qwnlinated Pan, Es. ndlmues
Payee Information 10 Add Remove
a. Full Name, Mailing Address & Phone
(include city,, & zip)
b. Coordinated Committee Name
d. Comments
/00 -YG'V
state,
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c. Level Registered (Spedty)
Federal EICounty:
❑ State ❑ Municipality:
t. Election Sum to Date
1 $
1
. Account Code IS. Form of Payment
Its, Purpose Co
Date (mmlddlyyyy)
P. Amount
k Requited Remarks
1 Peslr
796 aa;Z3
$ 5377•a
loo S/6N.S
Is
I
4. Payee Information JW Add Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
/V G\/ - lnV RIV B�� Cf/ , �G
It. Coordinated Committee Name
d. Comments
c. Level Registered (Specify)
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❑ State ❑ Municipality:
e.Eiecdon Sumto Date
$
_. Acco nt Code
g. Form of Payment
h. Purpose Code
It. Date (®lddlyyyy)
. Amount
k Regdred Remarks
N2
Is
4. Payee Information Add U Remove
. Full Name, Mulling Address & Phone
(include city, state, & zip)
It. Coordinated Committee Name
d. Comments
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❑ State ❑ Municipality:
C. Elecdon Sam to Date
f.:\ecount Code
g. Form of Payment
It. Purpose Code
it. Date (mm/ddlyyyy)
j. Amountk
$ , `�a`
Required Remarks
CMP14-l61V SUs. C"D
Is
I
5. Total only this Page
$
6. Total of ALL CRO -1310 Pages
i 7 his line goes in line 13a of Derailed Summary Page CRO -1100 if Operating Expenses)
( 7his line goes in line 13b of Derailed Summary Page CRO -1100 ifConfrib to CandidateslPolifical Comm)
(This liner goes in line Lie of Derailed Summary Page CRO -1100 if Coordinated Partv Expenditures)t-
$
e
. Purpose Code& (List detailed expenditure code in (h.) above)
A* - Media B* - Printing C* - Fundraising D - To Another Candidate
E - Salarie+ F* - Equipment G - Political Party H* - Holding Public Office Expenses
- Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* Other
* Codes remithre detailed ex lanation in required remarks field k
CRO -1310 NC State Board of Election. December 2009
y
2� tons
Disbursements
Amendment
Pg of _ ❑ Yes ❑ No
Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated oariv expenditures
Committee ame (a ad ap cable)
C)LTE
ID Number
3�Mbursement
_(Pkaseuse .separate CRO -1310 forms for each type of Disbursement )x cone. Conmhuw.n. in C.mJidute*/Rdilical Conuniln•en Cundinutui Part Ex •nditure,
FName,
matioD Add Remove
Mailing Address &Phone
(include city, slate, & zip)
6. Coordinated Committee Name
-
d. Comments
CNIAA/6�
l RAlkIWAL
V/��ts/Tt4 /PA i NT. ,Ct oM
b&K11V0To/V Nlt4
/
c. Level Registered (Specify)
Federal County:
❑ State ❑ Municipality:
e. Elation Sam to Date
. Accouat Code
2
1g.FormofPayment 1h. Purpose Code
1. Date (mmlddlyyyy)
b. Amount
V' 63
1k. Required Remarks
D lISYNIX23
4. Payee Information Add El Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
/t dM M.�6 • /
(M/�fYTFrTlTi4L��
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T H�2r25
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a Election Sum to Date
. Account Code
g. Form of Payment
1h. PurposeCode
t Date (ttttdddlyyyy)
. Amount
k Required Remarks
g
4. Payee Information Add L3 Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
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2
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g. Form of Payment
It. Purpose Code
i. Date (mmlddlyyyy)
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ISD- �
k Required Remarks
P/km -/kkrl
5
5. Total only this Page
$Ir
h. Total of ALL CRO -1310 Pages
l hie line goes in line 13a of Detailed .Summary Page CRO -1100 if Operating Expensed
i (his line goes in line 13b of Detailed Summary Page CRO -1100 ifContrib to CandidateslPolitical Comm)
(lbi.c line Ears in line /Jr of Detailed .Summon• Page CRO -1 100 if Coordinated Pally Expenditures)
0
IOn
. 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 He - 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 wired remarks field k
CRO -1310 NC State Board of Elections December 2009
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luawpuawN-
Refunds/Reimbursements From the Committee Pg or Amendment
❑ Yes
❑ No
Use this form to report refunds/reimbursements, including contributions returned to the contributor.
1. Committee Fall Name to Fund If applicable) _ 2. ID Number
- LI ZkBE a_T� 3?m 4.53
3. Payee Information 0 Add 0 Remove
. Full Name, Mailing Address & Phone
I include city, siatq & zip)
d. Type of Committee
h. Original Receipt Dale
UrCaml.dat. ❑ PAC
Referendum ❑ Party
ZR❑
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e. Level 'I
1. Recelpt Amount
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❑ stale Municipality:
$ '200 - —
L Purpose Code
. Election Sam to Date
b. Job Tiae/Professionc.
Employer's Name/Specific Field
g. Comments
IL Account Code
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. Form of Payment
Im. Required Remarks
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3 8 �4�3
o. Amoum
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$ a0o' 00
3. Payee Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
(Include city, state, &zip)
d. Tvpe of Committee
❑ Candidate PAr'
❑ Referendum ❑ Pant
h, Original Receipt Date
e. revel Registered
13 Pederal counly.
❑ Slate ❑ Municipality:
L Original RecNpt Amount
$
E Purpose Code
. Election Sam to Date
Job Title/Profession
C. Employer's Name/Specific Field
g. Comments
L Account Code
. Form of Payment
Im. Required Remarks In. Date (mm/dd/yyyy) o. Amomt
$
3. Payee Information ❑ Add 0 Remove
. Full Name, :Nailing Address & Phone
(include city, state, & sip)
d. Type of Committee
It. Original Recelpt Date
L3Candidate PAC
❑ Referendum E3 Party
a Level Registered
1. Ori "t
13Fcci_cr_Ai___0County:
❑ State ❑ Municipality:
$ t3 2p
C 1
L Purpose Code
. Ekv io Sum to Date
$ 3n%a
.Job TitWProfes,ionc.
Employer's Name6pee is Field&Comments
V_ Account Code
. Form of Pa) mem
m. Required Remarks _ n. Date (rnnJddlyyyy)
jo.Amound
$
. Total only this Page i S
5. Total of ALL CRO -1320 Pages $
(This line muss Kean lute 16of Demifed Summary Pae CR04106)
6. Purpose Codes (List detailed disbursement code in (f) above)
L - Returned to Contributor M - Overpayment for Service N - Exceeded Contribution Limit
P* - Reimbursement of In -Kind O* Other
* Codes re uire detailed ex lanation in rermired remarks
CRO-1320 NC Slur nwrd til' fileclions Decemher 2007