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Holtey,Elizabeth_2023-Pre-electionAmendment Disclosure Report Cover ❑ Yes1yy No Use this form for general report and committee information, must be signed and submitted along with other detatted forms. Do not use this form to uodate information. 1. Committee Information . Full Name �oI TVy c. 11) Number 3TML{s'3 . Mailing Address (include City, State and Zip Code) d. Date Filed ZIP 60F,> [ E'7 /C) a7 IVO- kJ66J) //V 67 tNf /V ` l /� � e. Phone Number i '111-53/— gg3.3 . RRR"rt Year 3 period Start Date (mtdddlpy) 4. Period End i o a3 Date unciddiltvyl Boa 3 15. Treasurer Full Name 16LIZ46eVco6LE -Noir ?oa 3 q 2oa 3 . Tvpe of Committee (Check One 9 Type of Report (check only one type of reporlfrorn one category) Candidate Campaign ® Part Municipal Slate/Count_ _ Referendum PAC ❑ Referendum ❑ Orgunit,om it ❑ Orgunmauonal © Organizational Independent Expenditure r] Joint Fundraiser ❑ Thirty-fivedal Quarterly ❑ Pre -referendum QLegal Expense Fund Pre-primary ❑ First ❑ Final Pre-election Pre -runoff ❑ Second r] 71rird ❑ Supplemental Final ❑ Annual 7. Type of Fund I ifopplicahle. check Orel __- Booster Fund .Semiannual Fourth Special ❑ Building Fund ❑ Mid Year Semi-annual Year End ❑ Mid Year 10. SpmW Report Name Other: Final special ❑ Year End ❑ Final ❑ .Special . Number of Fundraisers this Re rt 11. Account Information 11. Account Information . Financial Instlmdon Full Name a. Financial Institution Full Name ,soU STt4TE b. Purpose c. Account Code It. P c. ecomt Code �1 OCT 3 0 2023 d. tkriod Begln Baianee d. Period Begin Balance $ 3y�, �3 Union Go. Board of Electio s$ 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 theNSC State Board of Elections. 4U7ADep CoBLC—Wk_r'CY ill rliL-o" o a� aW Printed Name of Signer Si mature P A ointed "treasurer Date FOR OFFICE USE ONLY Date Received: /� 3 Employee: Delivery Method ❑ Normal Mail Date Postmarked: Employee: Date Scanned: '2 Employee: Registered Mail Hand Delivered Electronically Filed Date Data Entered: Employee: ❑ Signer has not received 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 -21 OOA-E) to make committee changes. CRO -1000 NC Slate Board of Elections August 2008 Detailed Summary 13 s No Use this form to summarize all disclosure re otlin L forms and to total monetary information 1. Committee Full Name (and Fund if applicable) 12. Type of Report 3. ID Number 1214 C cx-r6q PRE - ae raw 3TM S3 Start of Election Cycle: January 1, Total this Reporting Period Total this Election Cycle 4) Cash on Hand at Start $3U, 73 1 $ RECE1ffS 5) Aggregated Contributions from Individuals (CRO -1205) 6) Contributions from Individuals (CRO -1210) 7) Contributions from Political Party Committees (CRO -1220) 8) Contributions from Other Political Committees (CRO -1230) 9) Loan Proceeds (CRO -1410) 10) Refunds/Reimbursements to the Committee (CRO -1240)$ 11) Other Receipt Sources Ila) Interest on Bank Accounts (CRO.1250) llb) Contributions from Not -For -Profit Organizations (CRO -1250) 11c) Outside Sources of Income (CRO -1250) lld) Legal Expense Fund - Other Sources (CRO -1270) Ile) Exempt Purchase Price Sales (CRO -1265) $ $ $ g $ $ $ $ $ r $ $ $ $ i $& $ $ 12)TOTAL RECEIPTS (Add lines 5, 6,7, 8, 9, 10,11 a, l l b, I l c, I I d and l l e) $A-.ec 1,234,231 $ EXPENDITURES 13) Disbursements 13a) Operating Expenditures (CRO -1310) $ 13b) Contributions to Candidates/Political Committees (CRO -1310) $ 130 Coordinated Party Expenditures (CRO -1310) $ 14) Aggregated Non -Media Expenditures (CRO -1315) $ 15) an Repayments (CRO -1420) $ 16) Refunds/Reimbursements from the Committee (CRO -1320) $ 17) In -Kind Contributions (CRO -1510) $ �6. a 3 $ $ $ $ $ $ $ 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c. 14. I5, 16 and 17) $x,00 $ 19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18 $ 0.00 � 1731 $ ADDITIONAL INFORMATION 20) Non -Monetary Gifts Given to Other Committees (CRO -1330) 21) Outstanding Loans (incl. ones from other campaigns) (CRO -1430) 2) Debts and Obligations owed by the Committee (CRO -1610) 3) Debts and Obligations owed to the Committee (CRO -1620) 4) Account Transfers Within the Committee (CRO -1720) 5) Administrative Support (CRO -1710) 2 6) Forgiven Loans (CRO -1440) 7) 48 -Hour Notice Reports Sum (CRO -2220) $ $ 3 3Qd ,7 $ $ $ $ $ $ $ $ $ ) Contributions to be Refunded (CRO -1215) $ $ CRO-lIW NC State Buanl of Elections August 2008 Amendment Contributions from Individuals Pg or L ❑ ,'es 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 . Contributor Information ❑ Add Remove . Full Name. Mailing Address & Phone (include city, state, & zip) b. Job Tidea'rofesAou d. Comments f� A , /'/l'I([}( clic- �T X017 kf06DO WheQ41 Lsq/ll� Aj6Lb1 N&T6N1 Afc ( I r7) 531- c{L f 3 3 c Employer's Namdbpecitic Field H �6u3 ,LP Cllkl2Lo Aic e.Election SumtoDate I $ f. Prior g. Account Code h. Form of Payment I. In -Kind Description J. Date (num/dd/yyyy) k Amount ❑ ❑ Mtl0 1 3 $ $ 3. Contributor Information ❑ Add Remove a. Fail Name, Mailing Address & Phone (include dty, OCT 3 0 2023 Union Co. Board of Elections b. Job Title/Profewdon d. Comments a Employer's Name/Speelfic Field G Election Sum to Date $ r. Prior g. Attromt Code h. Form of Payment L In -Kind Descrip ion J.Ilate (mm/dd/yyyy) Is Amount ❑ $ ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove . Fail Name, Mailing Address & Phone (include city. state, & zip) b. Job Title(Profemion d. Comnrents a Employer's Name/Spectac Field e. Election Sam to Date . Prior g. Account Code h. Form of Payment L In -Kind Description J. hate (mm fd;v- y ) K Amount ❑ $ ❑ $ 4. Total only this Page $1, 236. a 5. Total of ALL CRO -1210 Pages (This line must he online 6 of Detailed Summary Page CRO -1100) / CRO -1210 NC State Owrd of Elections April 2007 J Amendment In -Kind Contributions Pg L of I ❑ 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 tf aMicab 12. ID Number — 3. Contributor Information Add Remove a. Full Full Name. Mailing Address & Phone (include city, state, & zip) b. Type of Contributor c. Continents Individual Candidate ❑ Party [3E3 PAC Referendum L3 Other Receipt Source e4k6k Ct4XA&__ P03 Lia �S 07, &y S617 �d V/� l,�N� yJEAD 1N 77r0d, NC 4?bb f 17) -631-4/x/33 d. Election Sum to Date $ •. Description _ 1414/1_lr�eb A46c- reds f. Date (mmlddlyyyy) g. Fair Market Amount $1l,234ra3 _`71;171903 $ $ 3. Contributor Information Add Remove a. Full Name. Mailing Address & Phone (include city, state, & zip) D- rte. • OCT 3 0 2023 Union Co. Board of Elections b. Type of Contributor Individual ❑ Candidate ❑ P: ry, ❑ PAC ❑ Referendum ❑ Other Receipt Source c. Comments d. Election Sum to Date $ . Description f. Date (mmldd/yyyy) g. Fair Market Amount $ 3. Contributor Information ❑ Add Remove a. full Name, Mailing Address & Phone (include city, state, & zip) -. b. Type of Contributor ❑ Individual ❑ Candidate. ❑ Party ❑ PAC ❑ Referendum ❑ Other Receipt Source c. Comments d. Election Sum to Date $ e. Description f. Date (mWdd/yyyy) g. Fair Market Amount 4. Total only this Page $1, 4736.,R3 5. Total of ALL CRO -1510 Pages (This line must he on line 17 of Deladed Summary Page CRO -7/00) $ CRO -1510 NC Scuc u,,,nd nl t-1,mo,,, December 2007 Amendment - M Outstanding Loans Pg —L of L- 13 Y., %+ 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 if applicable) - a. m Number 314 qS-3 r5 l zAyeTil /-k 7"E 3. Lender Information ❑ Add "' ❑ Remove a. Full Name. Mailing Address & Phone I include city, stale, & zip) b. Job'fitle/Profession P?R61AL it. ( onmtenta - -- CLl2.4BET� LTE .-D I r/ W C/J V IEW t!�E �/ �r �r 'L w�ll� e2r0 NI, Nc �C?lt) ( 91?) ,3/- e. start Data (mm/ddo c. Employer's Name/SpeciFc Field R - q/a�/aoa3 /� I',� nCt�W&C-4)W103 C.(.P f. End Data(saWddfyyri) g.Rate h. Security Pledged i. Original Loan Amount J. Remaining Loan Balance Af,¢ $ 31 3oaZ.17 k. Full Name of Lending Institution L Loan Number 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Professiou d. Comments RECEIVEDe. OCT 3 02023 Union Co. Board of Elections Start d)Inte (nnnldd/yyyy) c. Employer's Name/Specific Field E End Date (mmi'ddlyyyy) g. Rete h. Security Pledged i. Original Loan amount j. Remaining Loan Balance $ %n 1 k. Full Name of Lending. Inatitudon 1. Loan Number 3. Lender Information ❑ Add Remove o. Full Name. Mailing Address & Phone 1 include city, state, & zip) b. -Job Title/Profession d. Comments - - - -- e. Start Date (mmlddlyyyy) c Employer's NametSpecilIc Field E End Date (mm/ddlyyyy) . Rate h. Security Pledged ji. Original Loan Amount j, Remaining Loan Balance % $ $ Full Name of Lending Institution L Loan Number 4, Total only this Page $ 5_ Total of ALL CRO -1430 Pages (This Gae mus! be on l/nr 27 ofDemiled Summary Page CRO -1100) )' $ CR04930 NC State Board of Election. December 2007