Kamolnik,Colleen_2022-4th-qtrDisclosure Report Cover Amendment
0 Yes.. ISI 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 tmriste. infnmintinn
. Committee Information
. FrillName
1a.
c. ID Number
Colleen Kamolnik for BOE District 1
Mailing Address (include City, State and Zip Code)
d. Date Filed
_
721 Archie Ln
_
01/03/2023
Monroe, NC 28112
e. Phone Number
704.296.4564
2. Report Year 3. Period Start Date (mm/dd/yy) 4. Period EndDa�mn✓dd/y� 5. T reasmr Full Name
2022 10/23/22 12/31/22 Colleen McBride Kamolnik
6. Type of CommitteeAgeck One) 9. Type of Report (check only one e o re ort om one catego�r r)
_
® Candidate Campaign ❑ Party Municipal State/County Referendum
_
❑ PAC ❑ Referendum ❑ Organizutional ❑ Organizational ❑ Organizational
❑ Independent Expenditure ❑ Joint Fundraiser ❑ Thirty-five day Quarterly ❑ Pre -referendum
❑ Legal Expense Fund ❑ Pre-primary ❑ First ❑ Final
❑ Pre-election ❑ Second ❑ Supplemental Final
7. a of Fund ((f applicable, check one) ''h'. ❑ Pre -runoff ❑ Third ❑ Annual
❑ Booster Fund Semi-annual $] Fourth ❑ Special
❑ Building Fund ❑ Mid Year Semi-annual
❑ Year End ❑ Mid Year 10. Siiecfal Re ' rt Name
❑ Other: ❑ Final ❑ Year End
8. Number of Fundraisers this Report' _." ❑ Special ❑ Final
0 ❑ Special
11. Account Information
11.'Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
American Bank
b. Purpose
r- Account Code
b. Purpose
c. Account Code
1
d. Period Begin Balance
d. Period Begin Balance
$ 116.63
$
campaign funding
CERTIFICATION
I certify that the Committee or Fund is in compliance with all appligAble pr visions of Article 22A, 22B & 22D -22M of Chapter 163
of the NC General Statutes and that no funds aretowi pro ' or other non dsclesed funds. I further certify that this
report is complete, true and correct and that I have bwn train t to Board of ctions,
Colleen McBride Kamolnik
Printed Name of Signer Signature of Appointed Treasurer Date
FOR OFFICE USE ONLY
Date Received: 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 g
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 [Hake co " " ` e "" o , A
CRO -1000 NC State Board of Electionsr"R _ i' V 'LAMMWZUU15
AVID �2�
Detailed Summary
Use this form to summarize all disclosure reporting forms and to total monetary information
Amendment
13 Yes ( Nu
1. Committee _Full Name (and Fund if app ca le)
Colleen Kamolnik for BOE District 1
2. Type of Report_ _ 3. _ - umber
2022 Fourth Quarter
Start of Election Cycle: January 1, 2019
Total this
Reporting Period
Total this
Election Cycle
4) Cash on Hand at Start
$ 116.63
$ 0.00
RECEIPTS _
5) Aggregated Contributions from Individuals (CRO -1205) $ $
6) Contributions from Individuals (CRO -1210) $ 1272.07 $ 3501.07
7) Contributions from Political Party Committees (CRO -1220) $ 1225.00 $ 1842.58
8) Contributions from Other Political Conunittees (CRO -1230)
$
$
9) Loan Proceeds (CRO -1410)
10) RefunddReimbursements to the Committee (CRO -1240)
$
$
$ 83.70
$ 83.70
11) Other Receipt Sources
Ila) Interest on Bank Accounts (CRO -1250)
11b) Contributions from Not -For -Profit Organizations (CRO -1250)
$
$
$
11c) Outside Sources of Income (CRO -1250)
$
$
ld) Legal Expense Fund - Other Sources (CRO -1270)
Ile) Exempt Purchase Price Sales (CRO -1265)
$
$
$
$
12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8,9,10,11 a,1 1b,1 1c,1 ld and I le)
$2580.77
$5427.35
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (CRO -1310) $ 2544.14 $ 4339.24
13b) Contributions to Candidates/PoUticat Committees (CRO -1310) $
$
13c) Coordinated Party Expenditures (CRO -1310) $
$
14) Aggregated Non -Media Expenditures (CRo-mm $ 74-00
—
$ 729.83
15) Loan Repayments (CRO -1420) $
$
16) Refunds/Reimbursements from the Committee (CRO -1320) $
17) In -Kind Contributions (CRO -1510) $
$
$ 279.00
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15,16 and 17) $ 2.618.14
$ 5348.09
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18 $ 79.26
$ 79.26
ADDITIONAL INFORMATION
20) Non -Monetary Gifts Given to Other Committees (CRO -1330) $
1) 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)
24) Account Transfers Within the Committee (CRO -170)
25) Administrative Support (CRO -1710)
$0,00
$
$
$
$
6) Forgiven Loans (CRO -1440)
27) 48 -Hour Notice Reports Sum (CRO -2220)
28) Contributions to be Refunded (CRO -1215)
$
$
$
$
n ..
CRO -1100
NC State Hou Qro4uoE I VE
JAN 0 5 2 -
Onion Co. Board of Elections
.5��
JAN 0 5 2022
Union Co. Board of Elections
Amendment
Contributions from Individuals Pg 1 of 1 ❑ Yes ®N
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 applicab a
Colleen Kamolnik for BOE District 1
2. ID Number
3. Contributor Information ® Add ❑ Remove
a. Full Name, Dlailing Address & Phone
(include city, state, & zip)
Colleen McBride Kamolnik
721 Archie Ln
Monroe, NC 28112
b. Job Title/Profession
d. Comments
Accountant
c. Employer's Name/Specific Field
Self
e. Election Sum to Date
$ 2372.07
f. Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
❑
1
online
11/07/2022
$ 912.07
❑
1
online
11/07/2022
$ 360.00
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
c. Employer's Name/Specific Field
e. Election Sum to Date
$
f. Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
❑
1
$
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
c. Employer's Name/Specific Field
e. Election Sum to Date
$
f. Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
$
❑
❑
$
❑
$
4. Total only this Page I $ 1272.07
5. Total of ALL CRO -1210 Pages s $ 1272.07
(This line must be online 6 of Detailed Summary Page CRO -1100)
CRO -1210
NC State Board of Elections:
JAi",,i 0 5 2023
Union Co. Board of Elections
April 2007
JAN 0 5 2022
Amendment
Contributions from Political Party Committees Pg!of 1 ; ❑ Yes ® No
Use this form to report contributions from a political party
1. Committee Full Name (and Fund if applicable)_
Colleen Kamolnik for BOE District 1
2. ID Number
3. Contributor Information ❑ Add ❑ Remove
a. 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
$ 1475.00
d. Account Code
e. Form of Payment
f. In -Kind Description
g. Date (mm/dd/yyyy)
h. Amount
1
check
11/15/2022
$ 1225.00
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Comments
c. Election Sum to Date
$
d. Account Code
e. Form of Payment
f. In -Kind Description
g. Date (mm/dd/yyyy)
h. Amount
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Comments
c. Election Sum to Date
$
d. Account Code
e. Form of Payment
f. In -Kind Description
g. Date (mm/dd/yyyy)
h. Amount
$
$
$
4. Total only this Page $ 1225.00
5. Total of ALL CRO -1220 Pages
(This line must be on line 7 of Detailed Summary Page CRO -1100)
$ 1225.00
CRO -1220
NC State Board of Electio®E C E I V D
JAN 0 5 2023)
Union Co. Board of Elections
L: %_/ L:Aphf 200
JAN 0 5 2022
Union Co. Board of Elections
Refunds/Reimbursements To the Committee Pg 1 ,Amendment Nn
of 1 �®
Use this form to report refunds received by the committee or reimbursements for a previous expenditure.
1. Committee Full Name (and Fund if applicable)
Colleen Kamolnik for BOE District 1
2. ID Number
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
Engage Voters US
44 S Broadway, Suite 100
White Plains, NY 10601
d. Type of Committee
❑ Candidate ❑ PAC
❑ Referendum ❑ Patty
g. Comments
refund for
messaging error
e. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
h. Original Expenditure Date
11/07/2022
i. Original Expenditure Amt
$ 912.07
b. Job Title/Profession
c. Employer's Name/Specific Field
f. Purpose
j. Election Sum to Date
Marketing
A
$ 830.79
k. Account Code -
1
1. Form of Payment
m. In -Kind Description
n. Date (mm/dd/yyyy)
11/17/2022
o. Amount
$ 81.28
electronic
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
Intuit
quiekbooks.intuit.com
d. Type of Committee
❑ Candidate PAC
❑ Referendum ❑ Party
g. Comments
prorated subscription
e. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
h. Original Expenditure Date
10/19/2022
i. Original Expenditure Amt
$ 25.00
b. Job Title/Profession
c. Employer's Name/Specific Field
f. Purpose
O
j. Election Sum to Date
$ 197.58
k. Account Code
1. Form of Payment
electronic
m. In -Kind Description
n. Date (mm/dd/yyyy)
11/17/2022
o. Amount
$ 2.42
1
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
d. Type of Committee
❑ Candidate ❑ PAC
❑ Referendum ❑ Party
g. Conunents
e. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
h. Original Expenditure Date
i. Original Expenditure Amt
$
b. Job Title/Profession
c. Employer's Name/Specific Field
f. Purpose
j. Election Sum to Date
$
k. Account Code
1. Form of Payment
m. In -Kind Description
n. Date (mm/dd/yyyy)
o. Amount
$
4. Total only this Page $ 83.70
5. Total of ALL CRO -1240 Pages $ 83.70
(This line must be on line 10 of Detailed Summary Page CRO -1100)
CRO -1240
NC State Board of Elections
HECEi r V ED
December 2007 D
JAN 0 5 202"2
.IAN 0 5 2023 Union Co. Board of Elections
Disbursements Pg 1 of 1 ❑ Amendment Yes ® No
Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated Darty 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 type of Disbursement.)
® Operating Expenses ❑ Contributions to Candidates/Political Committees Coordinated Party Expenditures
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
WIXE
1700 Buena Vista Dr, PO BOX 1 007
Monroe, NC 28111
c. Level Registered (Specify)
❑ Federal County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 360.00
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
1
check
A
11/07/2022
$ 360.00
radio ads
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Engage Voters US
44 S Broadway, Suite 100
White Plains, NY 10601
c. Level Registered (Specify)
❑ Federal County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 830.79
f. Account Code
1
g. Form of Payment
debit card
h. Purpose Code
A
i. Date (mm/dd/yyyy)
11/07/2022
j. Amount
$ 912.07
k. Required Remarks
robo calls & texts
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
Colleen Kamolnik
721 Archie Ln
Monroe, NC 28112
b. Coordinated Committee Name
d. Comments
repayment of
media expenses -
see CRO -1610
c. Level Registered (Specify)
Federai county:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 1272.07
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/vyyy)
j. Amount
k. Required Remarks
1
check
A
11/15/2022
$ 1272.07
repay media expenses
$
5. Total only this Page
$ 2544.14
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses)
(This line goes in line 13b of Detailed Summary Page CRO -1100 if Contrib to Candidates/Political Comm)
(This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures)
$ 2544.14
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 require detailed explanation in required remarks field k fes,
CRO -1310 NC - 4 -December mug
State oar o Elections - ' -
JAN 0 5 202;
Union Co. Board of Elecfior.s
�mendmcnt
Aggregated Non -Media Expenditures 1,11ge_1 or j 1_p Yes ® No
Optional form used to report NC Non -Media Expenditures of $50 or less.
1. Comnuttee Full Naine (and Funaapplicable) 2. W Number
Colleen Kamolnik for BOE District 1
3. Payee, Information
Account Code
c. Form or Payment
d. Puq>ose Code
e. Dale (mmIdd/yyyy)
f. Amount
g. Requlred Remarks
rAmendb.
1
draft
O
10/31/2022
$ 15.00
bank fees
1
draft
O
11/30/2022
15.00
bank fees
Lj Add
❑ Remove
1
draft
O
12/30/2022
$ 15.00
bank fees
Add
❑ Remove
1
debit card
O
11/03/2022
$ 29.00
website expense
Add
❑ Remove
$
Add
❑ Remove
$
ZI Add
❑ Remove
$
Add
❑ Remove
$
Add
$
❑ Remove
Add
$
❑ Remove
Add
$
❑ Remove
Add
$
❑ Remove
Add
$
❑ Remove
Add
$
❑ Remove
Ej Add
$
❑ Remove
Add
$
❑ Remove
Add
$
❑ Remove
Add
$
❑ Remove
Lj Add
$
❑ Remove
Ur Add
$
❑ Remove
4. Total only this Page
$ 74.00
5. Total of ALL CRO -1315 Pages $
(This line must be on line 14 o Detailed Sumrna Fa e L"RO.1100) 74.00
b. Pgruose Codes aist detailed ex enditure code in 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 I{* -_Office Expenses ' , Q* - Donations to Legal Expense Fund.
O* - Other
* Codes require detailed explanation in required remarks field (g)
CR0-1315 NC State Board of Elections December 2009
Union Co. Board of Elections
Debts and Obligations Owed By the Committee Pg 1 of 1 Amendment El ❑ No
Use this form to report any unpaid debts or obligations owed by the committee, to include campaign credit card purchases.
1. Committee Full Name (and Fund if applicable)
2. ID Number
Colleen Kamolnik for BOE District 1
3. Creditor Information
Add L1 Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
Note: All payments made toward debts should be listed on form CRO -
1310 with the payee listed as this creditor.
Colleen Kamolnik
721 Archie Ln
Monroe, NC 28112
b. Description of Creditor
To cover media spend
c. Beginning Balance
d. Total Amount Paid
e. Total Amount Incurred
$ 1272.07
f. Remaining Balance
$ 0
$ 1272.07
$ 0
g. Incurred Debts (what the committee received this period)
gl. Purchase Place Full Name, Mailing Address & Phone
(include city, state, & zip)
WIXE
1700 Buena Vista Dr, PO Box 1007
Monroe, NC 28111
-
g2. Date (mm/dd/yyyy)
g3. Amount
11/07/2022
$ 360.00
g4. Purpose Code
g5. Required Remarks -
A
Radio Ads
gl. Purchase Place Full Name, Mailing Address & Phone
(include city, state, & zip)
g2. Date (mm/dd/yyyy)
g3. Amount
11/07/2022
$ 912.07
Engage Voters US
44 S Broadway, Suite 100
White Plains, NY 10601
g4. Purpose Code
g5. Required Remarks
A
Robo Calls & Texts
gl. Purchase Place Full Name, Mailing Address & Phone
(include city, state, & zip)
g2. Date (mm/dd/yyyy)
g3. Amount
$
_
g4. Purpose Code
g5. Required Remarks
gl. Purchase Place Full Name, Mailing Address & Phone
(include city, state, & zip)
g2. Date (mm/dd/yyyy)
g3. Amount
$
g4. Purpose Code
g5. Required Remarks
gl. Purchase Place Full Name, Mailing Address & Phone
(include city, state, & zip)
g2. Date (mm/dd/yyyy)
g3. Amount
$
g4. Purpose Code
g5. Required Remarks
4. Total only this Page
(This should be the sum of all items 'g3.' from this page)
$ 1272.07
5. Total of ALL CRO -1610 Pages
(This line must be on line 22 of Detailed Summary Page CRO -1100)
Z
6. Punose Codes List detailed ex enditure code in 4.
A* - Media B* - Printing C* - Fundraising
E - Salaries F* - Equipment G - Political Party
I - Postage J - Penalties K* - Office Expenses
* Codes require detailed explanation in required remarks field (g5.)
D - To Another Candidate
H* - Holding Public Office Expenses
O* - Other
CRO -1610 NC State Board of Elections y ` ; reoruary tui 1
JAS 0 5 252
Union Co. Bmd of Elections