King,Michele_2022-YearEndAtneudinen
Disclosure Report Cover y ` �o
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 uodate information.
1. Committee Information
Full Name
c. 11) Number
MaWuQ Addr's (laciude Cily, 81x4 and zip Code)
d. Date Flied
8 oa 2t�t n sfc -
U r a7 -Jo a3
D V A Yt 0t
Phone Nmsber
7uu-'7qi 3 s
tract
3. Period Start Date (mWM1yy)-14._Pgrtod
0'1-01-aOa�
Epd late
�Oa�
la-31-�4aa
(Check One)_- -
9. TyFe�ort (check
--- -
only am hPe n
rt are ry
---- -
Co[Ca>a
andidate Campaign o Party
Municipal
State/County
-—
Retereodom
❑ PAC ❑ Referendum
--
❑ Organizadonal
❑ Organizational
❑ Organizational
❑ Independent Expenditure ❑ Joint Fundraiser
❑ Thirty-five day
Quarterly
❑ Pre referendum
❑ Legal Expense Fund
❑ Pre-primary
❑ First
❑ Final
❑ Pre-election
❑ Pre -runoff
❑ Second
13Third
❑ Supplemental Final
❑ Annual
of Fmd , ekedow)
-•_Typ ..--Wapplicall
❑ Booster Fund
Semi-annual
❑ Fourth
❑ Special
❑ Building Fund
❑ Mid Year
Semi-annual
❑Year End
❑ Mid Year
_`Nitme
16. 111000
Other:
❑ Final
❑ Special
❑ Year End
❑ Final
. Number of Fundrabm dds Rqwt
❑ Special
11. Account IDtormstlon
1L AmUnt h6r=dlon
. Financial Institution Fall Name
a. Financial Institution Full Name
. Purpose
a Account Code
b. Purpose
a Aerount Code
Cantpai
I
I IV
ICERTIFICATION
a. _
Be
Period _ Begla Balance
a. Period 8egio B.mnce
tunki,
$
$
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 the NC State Board of Elections.
L -Cots
d 2 3
Printed Name of Signer Signature of A in reasurer 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: [3 Signer has not receivedmandatory train
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 hrb 9tak;�ent of Organization (CRO -2100A -E) to make committee changes.
CKU-1001/ NC State Board of Elections August 2008
Amen
Detailed Summary r-3 Yes No --
I Tse this form to summarize all disclosure renortinn forms and to total monetary information
1. Committee Full Name (and Fund if applicable)
Start of Election Cycle: January 1, PQTotal
dem
this
Reporting Period
Total this
Election Cycle
4) Cash on Hand at Start
$
$ 1
RECEIPTS
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 -1470)
10) Refunds/Reimbursements to the Committee (CRO -1240)
11) Other Receipt Sources
Ila) interest on Bank Accounts (CRO -1250)
lib) Contributions from Not-For-Proflt Organizations (CRO -1250)
Ile) Outside Sources of Income (CRO -1250)
lid) Legal Expense Fund - Other Sources (CRO -1270)
Ile) Exempt Purchase Price Sales (CRO -1265)
$
S
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
S
$
$
$
$
12)TOTAL RECEIPTS (Add lines 5,6,7,8,9,10,1 la,l lb.l lc,l Id and lle)
$
$
EXPENDITURES
3) Disbursements
M) Operating Expenditures — (CRO -1310)
13b) Contributions to Candidates/PoNdcal Committees (CRO -1310)
13c) Coordinated Party Expenditures (CRO -1310)
--- -- -----
4) Aggregated Non -Media Expenditures (CRO -1315)
$
$
$
$
$
$
$
$
S) Loan Repayments (CRO -1420)
6) Refunds/Reimbursements from the Committee (CRO -1320)
77 In -Sind Contributions (CRO -1510)
$
$
$
$
$
$
8) TOTAL EXPENDITURES (Add linea 13a, 13b, 13c, 14, 15, 16 and 17)
$
$
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$
$
DITIONAL INFORMATION
20) Non -Monetary Gifts Given to Other Committees (CRO -1330)
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 Committee (CRO -1620)
Amount Transfers Within the Committee (t RO.1720)
5) Administrative Support (CRO -1710)
Forgiven Loans -�—`. (CRO -1440)
7))48 -Hour Notice Repilos Sum (CRO -2220)
) Contributions to be Refunded — - (CRO -1215)
$
$
$
$
$
$ $
$ $
$ $
I $ $
CRO -1100 NC State Board of Elections August 2008