Holtey,Elizabeth_2023-PreElection-amendDisclosure Report Cover meyd�tent xa
Use this fort 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
. Full Name
c. ID Number
- - --�Ll Z�4 gCTi / l���TE
3TM�T3
. Malting Address (include City, State and Vp Code)
d. Date Filed
61/,WD lE-G�/ E 3 / q ao ay
/J &.butt&T Nf N(f @ b a. Phimi Number
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2. Report Xaa[ 3' a Motfd _ surer- _
"�T3 a? and6.A
e) _ -
9. Type o_ _ Repot check
on,one t} pe of rem
n fromone category)
Candidate Campaign Pany
Municipal
State/County
Referendum
PAC 13Referendum
❑ organizan nal
0 Ofganiz tional
E] Organisational
❑ Independent Expenditure E3 Joint Fundraiser
[3 Thirty-five day
Quarterly
Q Pre -referendum
❑ Legal Expense Fund
13 Pre-primary
❑ First
13 Final
Pre-election
Pre-mnoff
Second
Third
Q Supplemental Final
13 Annual
Z' d fnppfi<¢thfe,checkane)
71 Boaster Fund
Semi-annual
r] Fourth
Special
❑ Building Fund
E3 Mid Year
Semi-annual
r] Year End
❑ Mid Year
10. Special Report Name
❑ ngnr.
Final
Special
❑ Year End
❑ Final
S. Number or Fundraisers this Report
❑ Special
11. Account Information
11. Account Information
a. Financial Institution Fnll Name
a. Financial Institution Full Name
L 4- c k
. Purpose
a Account Code
n. Purpose
c. Aceomtt Code
d. Period Begin Balance
d. Period Begin Balance
R F C E i V F L.I
_ —
$ -
$ 3: '?3
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 farther certify that this
report is complete, true and correct and that I have been trained by the NC State Board of Elections.
e Zgee::�rel &&'r /�� /�f/ 3 aoa
Printed Name of Sit 51griatune of Appoiitagd Tre surer I Date
FOR OFFICE USE ONLY
Date Received: 3-� Employee:Delivery Method
❑ Nmoral Mail
Date Postmarked: Employee: Registered Mail
Hand Delivered
9
Electronically Filed
Date Scanned: Employee:
❑ Signer has not received
Date Data Entered: Employee: 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 -21 00A -E) to make committee changes.
CRO -1000 NC State Baud of Elections August 2008
Detailed Summary Yes ❑
Pee-c-c�cTon/ � 3TM45'3
IStart of Election Cycle: January 1, I po
'" ""' `V"" ""' I
Rerting Period Election Cycle
4) Cash on Hand at Start I$ , , $
5) Aggregated Contributions from Individuals (CRO -1205)
6) Contributions from Individuals (CRO -1210)
7) Contributions from Political Party Committees (CRO -1220)
w
$
2
$ / a 36, � 3
$
$
$
8) Contributions from Other Political Committees (CRO -1230)
$
$
9) Loan Proceeds (CRO -1410)
$
$
0) Refunds/Reimbursements to the Committee (CRO -1240)
$
I $
1) Other Receipt Sources
17) In -Kind Contributions (CRO -1510)
$ 4, a , a3
Ila) Interest on Bank Accounts (CRO -1250)
$
$
llb) Contributions from Not -For -Profit Organizations (CRO -1250)
$
$
Ile) Outside Sources of Income (CRO -1250)
$
$
l Id) Legal Expense Fund -Other Sources (CRO -1270)
$
$
Ile) Exempt Purchase Price Sales (CRO -1265)
$
$
12) TOTAL RECEIPTS (Add lines 5,6.7,8,9.10,1 la.1 lb,l lc,l Id and lie
$ „�. / -a
$
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)
$ 4, a , a3
$
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$ ,2 3
$
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$ '3 1 %,15
$
20) Non -Monetary Gifts Given to Other Committees (CRO -1330) $
1) Outstanding Loans (incl. ones from other campaigns) (CRO -1430) $ 3 pa
- -
2) Debts and Obligations owed by the Committee (CRO -1610) $
23) Debts and Obligations owed to the Committe6)NION C $
24) Account Transfers Within the Committee J (CRO -1720) $
25) Administrative Support
O)
$
$
26) Forgiven Loans
$
$
7) 48 -Pour Notice Reports Sum
7ceo-2220)
$
$
28) Contributions to be Refunded
(CRO -1215)
$
$
a nv-e i w ii . arae ooaru or cmcnons August 2UUa