Horn,Craig_2022-Year-end-reportAmendment
Disclosure Report Cover ❑ Yes dNo
Use this form for general report and committee information, must be signed and submitted along with other detai ed forms.
Do not use this form to undate information.
1. Committee Information
a. Full Name
c. ID Number
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b. Mailing Address (include City, State and Zip Code)
d. Date Filed
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e. Phone Number
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2. Report Year
3. Period Start Date (mm/dd/yy
4. Period End Date (mm/dd/yy)
5. Treasurer Full Name
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6. Type of Committee Check One
9. Type of Report
(check only one type of report from one category)
[Candidate Campaign ❑ Party
Municipal
StateJCounty
Referendum
❑ PAC ❑ Referendum
❑ Organizational
❑ Organizational
❑ Organizational
❑ Independent Expenditure ❑ Joint Fundraiser
❑ Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pre-primary
❑ First
❑ Final
❑ Pre-election
❑ Pre -runoff
Semi-annual
❑ Second
❑ Third
❑ Fourth
❑ Supplemental Final
❑ Annual
❑ Special
7. Type of Fund (if applicable, check one)
❑ Booster Fund
❑ Building Fund
❑ Mid Year
Semi-annual
[/ Year End
❑ Mid Year
10. Special Report Name
❑ Other:
❑ Final
❑ Special
❑ Year End
❑ Final
❑ Special
8. Number of Fundraisers this Report
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
— —
------------
----------------
b. Purpose
c. Account Code
b. Purpose
. ccount Code
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)AN 18 '21-023
d. Period Begin Balance
d. Period Begin Balance
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ark
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 trai b e NC State Bo d of Elections.
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Printed Name of Signer SignaWreAf
Appointed Treasurer bate
FOR OFFICE USE ONLY
Date Received: /9 Employee:
Delivery Method
❑ Normal Mail
Date Postmarked: Employee:
Registered Mail
Hand Delivered
Date Scanned: Employee:
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 -2100A -E) to make committee changes.
CYTO -1000 NC State Board of Elections August 2008
Detailed Summary
Ilse this fnrm to cnmmnri7P all diQ0]
Amendment
❑ Yes
1. Committee Full Name (and Fund if applicable)
2. Type of
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Report4V
3. ID Number
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Start of Election Cycle: January 1, 1 v -;1 1
Total this
ReportingPeriod
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
1lb) Contributions from Not -For -Profit Organizations
llc) Outside Sources of Income
lld) Legal Expense Fund - Other Sources
lle) Exempt Purchase Price Sales
(CRO -1205)
(CRO -1210)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$
$
$
$
$
$
$
$
So a U
$
$
$
$
$
$
$
$
$
$
$
$
$
$
12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9,10,11a,llb,11e,l ld and Ile)
$
EXPENDITURES
13) Disbursements
13a) Operating Expenditures
13b) Contributions to Candidates/Political Committees
13c) Coordinated Party Expenditures
14) Aggregated Non -Media Expenditures
15) Loan Repayments
16) Refunds/Reimbursements from the Committee
17) In -Kind Contributions
(CRO -1310)
(CRO -1310)
(CRO -1310)
(CRO -1315)
(CRO -1420)
(CRO -1320)
(CRO -1510)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$
$
` i.'
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$
$
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ADDITIONAL INFORMATION
20) Non -Monetary Gifts Given to Other Committees (CRO -1330)
21) Outstanding Loans (incl. ones from other campaigns) (CRO -1430)
22) Debts and Obligations owed by the Committee (CRO -1610)
23) Debts and Obligations owed to theE1V � ` 1620)
24) Account Transfers Within the Committee z720)
5) Administrative Support JAN 18 2023CRO-mo)
26) Forgiven LoansUiiiot� ®��� EleCT 0-1440)
27) 48 -Hour Notice Reports Sum (CRO -2220)
$
$
$
$
$
$
$
$
$
$
$
28) Contributions to be Refunded
11TA i IAA
(CRO -1215)
$
$
a,nv-11 vv NC State Board of hiections August 2008