Kamolnik,Colleen_2022-3rd-qtrDisclosure Report Cover E3 Yes 1 I 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 uridate information.
1. Committee Information
. Full Name
c. ID Number
Colleen Kamolnik for BOE District 1
. Melling Address (include City, State and Zip Code) _ _ _
d. Date Filed
721 Archie Ln
10/31/2022
Monroe, NC 28112
e. Phone Number
704.296.4564
2. Report Year
3. Period Start Date (®dr[dyy) 4. Period End Date (mm/adyy)_
5. Treasurer Full Name
2022
07/01/22 110/22/22
Colleen McBride Kamolnik
6. Type of Committee (Check One)
9. Type of Report (check
only one type of
one category)
® Candidate Campaign ❑ Party
Municipal
State/Couaty
—from
Referendum
❑ PAC ❑ Referendum
❑ Organizations]
❑ Organiutional
❑ Orga utional
❑ Independent Expenditure ❑ Joint Fundraiser
❑ Thirty-five day
Quarterly
❑ Pre referendum
❑ legal Expense Fund
❑ Pre-primary
❑ First
❑ Final
❑ Pre-election
❑ Pre-mnoff
❑ Second
® Third
❑ Supplemental Final
❑ Annual
7. Type of Fund (if applicable, check one)
❑ Booster Fund
Semi-annual
❑ Fourth
❑ Special
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year Find
❑ Mid Year
10. Special Report Name
❑ other.
❑ Final
❑ Special
❑ Year Fad
❑ Final
-
8. Number of Fundraisers this Report
0
❑ Special
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Am clad Institution Full Name
American Bank
b. Purpose
a A Code
b
c. Account Code
1
OCT 31 2022
it. Period Begin Balance_
d. Period Begin Balance
campaign funding
$436.48
Union Co. Board o; EleCliunS
$
CERTIFICATION
I certify that the Committee or Fund is in compliance with al provisions of Article 22A, 22B & 22D -22M of Chapter 163
of the NC General Statutes and that no funds are co p
hi 'ted or otheractn-disclosed funds. I farther Certify that this
report is complete, nue and correct and that I have bee ' ed y
late Board of Elections.
10/31/2022
Colleen McBride Kamolnik
Printed Name of Signer Signature of Appoinod Treasurer Date
OR OFFICE USE ONLY
Date Received: / Employee:
C r Delivery Method
❑ Normal Mail
L3 Registered Mail
Date Postmarked: Employee:
Hand Delivered
Date Scanned: Employee:
❑ Electronically Filed
Data Entered: Employee:
[eived
C] gnerDate
manndator ory not
ining
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 State Board of Mections August 2008
Detailed Summar '11eO`
Y 0 Q Yes d No
Use this form to summarize all disclosure renortine forms and to total mnnetary information
1. Committee Full Name (and Fund if applicable)
Colleen Kamolnik for BOE District 1
2. Type of Report
2022 Third Quarter
Number
Start of Election Cycle: January 1, 2019
Total this
Period
Total thisReporting
Election Cycle
4) Cash on Hand at Start
is
436.48
is 0.00
RECEIPTS
5) Aggregated Contributions from Individuals
6 i Contributions from Individuals
7) Contrilm dons from Political Party Committees
8) Contributions from Other Political Committees
(CRO -1205)
(CRo-121o)
(CRo-122o)
(CRO -1230)
$
$
$ 300.00
$ 2229.00
$ 250.00
$ 617.58
$
$
9) Loan Proceeds
10) Refunds/Reimbursements to the Committee
11) Other Receipt Sources
lla) Interest on Bank Accounts
11b) Contributions from Not -For -Profit Organizations
11c) Outside Sources of Income
tld) Legal Expense Fund - Other Sources
lle) Exempt Purchase Price Sales
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8,9,10,1 laj lb,1 Ic,l Id and l le
$
550.00
$ 2846.58
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (CRO -1310)
13b) Contributions to Candidates/Political Committees (CRa1310)
13c) Coordinated Party Expenditures (CRO -1310)
14) Aggregated Non -Media Expenditures (CRO -1315)
15) Loan Repayments (CRO -1420)
16) Refunds/Rehnbursements from the Committee (CRO -1320)
17) In -Kind Contributions ww-i51o)
$
367.75
$ 1795.12
$
$
$
$
$ 252.10
$ 655.83
$
$
$
$
$ 250.00
$ 279.00
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)1
$
869.85
$ 2729.95
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$
116.63
$ 116.63
ADDITIONAL INFORMATION
0) Non -Monetary Gifts Given to Other Committees (CRoa330)
1) 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 the C6mrrF Wf E 1620)
24) Account Transfers Within the Committees nye (CRO.1720)
25) Administrative Support '' �4(CRO-1710)
26) Forgiven Loans ,,!on Co. Board of ElectiorkTRO.1440)
7) 48 -Hoar Notice Reports Sum — (CRO -2220)
8) Contributions to be Refunded (CRO -1215)
$
$
$
$
$
$
$
$
$
$
$
5
CRO -1100 NC State Board of Elections August 2008
Contributions from Individuals pg 1 or 1 Amendment
❑ Yes ® No
Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used
1. Commiltce_Fplt Name (and Fund if applicable)
Colleen Kamolnik for BOE District 1
2. ID Num_be_ r
3. Contributor Information ® Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
Barbara Harrison
2001 Belleforest Ct
Waxhaw, NC 28173
b. Job Tide/Profession
Retired
d. Comments
a Employer's NamdSpedtic Field
e. Election Sam to Date
$ 200.00
f.Prior
❑
g. Account Code
1
b. Form of Payment
online
I. In -Kind Description
J. Date (mmtdd/yyyy)
07/11/22
k Amount
$ 200.00
❑
$
❑
$
3. Contributor Information ❑ Add Remove
a. Full Name, Mailing Address & Phone
(include city, state, &zip) _
Colleen McBride Kamolnik
721 Archie Ln
Monroe, NC 28112
b. Job Tide/Profession
d. Comments
Accountant
c Employer's Name/Specific Fleld
Self
e. Election Sum to Date
$
f.Prior
❑
g. Account Code
1
h. Form of Payment
online
i. In -Kind Description
J. Date (;Wddlyyyy)
10/15/22
It. Amount
$100.00
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, stale, & zip)
RECEIVED
b. Job Tide/Profession
d. Comments
c. Employer's Name/Specific Field
e. Election Sam to Date
f.Prior
❑
g. Account Code
WT6rmofPa3mcnt
i. In -Kind 5;i- bn
J. Date (menddlyyyy)
k Amount
$ _
❑
$
❑
$
4. Total only this Page $ 300.00
5. Total of ALL CRO -1210 Pages $ 300.00
(This line must be on fine 6 ofDelailed Sammary Page CRO -1100)
CRO -1210 NC State Board of Elections April 2007
Contributions from Political Party Committees pg 1
Use this form to report contributions from a political party
1. Committee Full Name (and Fund It applicable)
Colleen Kamolnik for BOE District 1
2. Ill Number
3. Contributor Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
Melissa Merrell for County Commissioner
2603 Albatross Ln
Stallings, NC 28104
b. Continents
c. Election Sum to Date
$ 250.00
d. Account Code
e. Form of Payment
I. In -Kind Description
S. Date (mmldd/yyyy)
h Amount
1
In -Kind
Union GOP Mailer
09/17/22
$ 250.00
$
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Comments
c Election Som to Dau
d. Accoml Code
a Form of Payment
L In -Kind Description
g. Date (mmtdd/yyyy)
h. Auomt
3. Contributor Information ❑ Add ❑ Remove
Phone
a. Full Name, Mailing Address t&t�
(include city, scans ylc ittR E D
((''fit i v 3++1 2w
,•n Go BOd`d of Elections
d
b. comments
c Election Sum to Date
$
. A=unt Code
e. Form of Payment
f. In Kind Description
g. Dad (mmlddlyyyy)
h. Amount
4. Total only this Page 250.00
5. Total of ALL CRO -1220 Pages s 250.00
(This line musf be online 7 of Detailed Summary Page CRO -1100)
CRO -1220 NC State Board of Elections April 2007
Disbursements Pg 1 or 1 p t ® No
Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated party expenditures
1. Committee Full Name (and Fund If applicable)2.
ID Number
Colleen Kamolnik for BOE District 1
3. Type of Disbursement (Please use separate CRO -1310 forms for each tune of Disbursement.)
ElOperating Expenes ❑ Conmhutions to Candidatec/Political Committees ❑ Coordinated Pam Expendaures
4. Payee Information ® Add ❑ Remove
a. Full Name, Mailing Address & Phone
b. Coordinated Committee Name
d. Continents
(include city, state, As zip)
VistaPrint
c. Level Registered (specify)
UFedml ❑ crummy:
❑ State ❑ Municipality:
275 Wyman St
Waltham, MA 02451
e. Election Sam to Date
website <www.vistaprint.com>
$ 76.85
. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy) P. Amount It. Required Remarks
1
debit card
B
08/25/2022 $ 76.85 ICUStorn handouts/cards
I Is
d. Payee Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
b. Coordinated Committee Name
d. Comments
(include city, state, & zip)
Office Max
c. Level Registered (Specify)
1030 W Roosevelt Blvd
Monroe, NC 28110
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Electlon Sam to Date
website <www.officedepot.com>
$ 511.43
. Account Code
g. Form of Payment
h. Purpose Cade
L Date (mmlddlyyyy)
J. Annual
k. Regalred Remarks
1
debit card
B
08/10/2022
$237.52
custom handouts
1
debit card
B
1 08/25/2022
$ 53.38
1 custom handouts
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
Is. Coordinated Committee Name
it. Comments
(include city, state, & zip)
1\ I E
c. Level Registered (Specify)
om
Fe_deral ❑ Cty.
(( C L
r� E 1 V
❑ State ❑ Municipality:
-
e. Election Sam to Date
OCT 31 2022
$
. Account Code
g. Form of Payment h Code
1. Date (mm/dd/yyyy)
J. Amount
JIL Required Remarks
$
IP GO. Odt
$
5. Total only this Page
$ 367.75
6. Total of ALL CRO -1310 Pages
(This fine goes in line Ida of Detailed Summary Page CRO -1100 if Operating Expenses)
(This line goes in line lab of Detailed Summary Page CRO -1100 if Contrib to Candidates/Political Comm)
$
367.75
(This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures)
7. 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 H* - Holding Public Office Expenses
I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* Other
* Codes re uire detailed eirolanation in re aired remarks field k
CRO -1310 NC State Board of Elections December 2009
Aggregated Non -Media Expenditures Page1 of 1 AD } dmen❑t No
Optional form used to report NC Non -Media Expenditures of $50 or less.
1. Cominittee FuH Name (and Fundapplicable)
2. ID number
Colleen Kamolnik for BOE District 1
3. Payee Information
. Amend
b. Account Code
c. Form of Payment
d. Purpose Code
e. Date (mm/dd/yyyy)
f. Amount
g. Required Remarks
❑ Add
❑ Remove
1
draft
O
08/31/22
$ 15.00
bank fees
Add
❑ Remove
1
draft
O
09/30/22
$ 15.00
bank fees
Add
❑ Remove
1
debit card
O
07/02/22
$ 29.00
website expense
Add
❑ Remove
1
debit card
O
08/03/22
$ 29.00
website expense
Add
❑ Remove
1
debit card
O
09/06/22
$ 29.00
website expense
Add
❑ Remove
1
debit card
O
10/03/22
$ 29.00
website expense
Ll Ada
[I Remove
1
debit card
K
07/19/22
$ 25.00
software expense
Lj Add
❑ Remove
-Add
1
debit card
K
08/19/22
$ 25.00
software expense
❑ Remove
1
debit card
K
09/19/22
$ 25.00
software expense
Add
❑ Remove
1
debit card
K
10/19/22
$ 25.00
software expense
Add
1
draft
C
07/11/22
$ 6.10
merchant fees
❑ Remove
Add
$
❑ Remove
Add
$
❑ Remove
Add
$
❑ Remove
Add
D
$
❑ Remove
—
Add
$
Ll Remove
T
Add
$
❑ Remove
Addn
75-Fe,0
$
❑ Remove
Add
$
❑ Remove
Add
$
❑ Remove
4. Total only this Page
$ 252.10
5. Total of ALL CRO -1315 Pages
$ 252.10
(This line must be on Gee 14 o Deariled Summary Page CRO -/700
6. Purpose Codes (List detailed expenditure above)
B* - Printing C* - Fundraising D - To Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
I - Postage J - Penalties K* - Office Expenses Q* - Donations to Legal Expense Fund
O* - Other
*Codes re uire detailed ex lanation in re aired remarks field
CRO43I5 NC State Board of Flections December 2VO9
Amendment
In -Kind Contributions Pg 1 of 1 ❑ 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. Corrattee Fall Name (s Chuld if applicable)2.
ID Number
Colleen Kamolnik for BOE District 1
3. Contributor Information ❑ Add ❑ Remove
a. Full Name. Mailing Address & Phone
b. Type of Contributor
c. Comments
(include city, state, & zip)
❑ Individual
Melissa Merrell for County Commissioner
® Candidate
❑ Party
2603 Albatross Ln
❑ PAC
Stallings, NC 28104
❑ Referendum
d. Election Sum to Date
❑ Other Receipt Source
$ 250.00
e. Description
f.Date (umV"yyyy)
g. Fair bfarlim Amount
09/17/2022
$ 250.00
Union GOP Mailer
$
$
3. Contributor Information ❑ Add E3Remove
. Full Name, Mailing Address & Phone
Is. Type of Contributor
c. Comments
(include city, state, & zip)
❑ Individual
❑ Candidate
❑ Party
❑ PAC
❑ Referendum
d. Election Sum to Date
❑ Other Receipt Source
$
. Description
L Date (oan ddlyyyy)
g. Fair Market Amount
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, 1118 1 r �y/�t—t'
b. Type of Contributor
c. Comments
(include cit, J TM t— D
❑ Individual
OCT 31 2022
❑ Candidate
❑ Party
❑ PAC
Union Co Maid ofElectiom
❑ Referendum
❑ Other Receipt Source
d. Election Sum to Date
$
r. De.cription
LDab (mm/dd/).>v)
g. Fair luarket Amount
$
$
4. Total only this Page $ 250.00
5. Total of ALL CRO -1510 Pages $ 250.00
(This fou must be on Ras 77of DRaUed Summary Page CRO -1100)
CRO -1510 NC State Board of Elections December 2007