King,Michele_2023-MidyearDisclosure Report Cover one yes®d° a°`0,4, 1
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 update information.
Committee Information
Full Name
Ob11 v Ott 41
_
MNmber
C TM � �-
MaBing Addeo® (indrde City, State orad Zip )
d. Date Flied
6Z . -arAN-4 l4-(6tsed-
1'�t..oYl,W�- NC 281l�
7-")-8- 2na3
e.PbemNumber
c 4'7Al G34#5
3. Perlad Spit Date
4. Period End Dabs
S. Treawrer FW Name
of Committee Check One
9. Type
of R ort
check only one we o ie ortftwes one Date on i
❑2e didatc Campwge ❑ Party
❑ PAC ❑ Referendum
❑ Independent Expenditure ❑ Joint Pundraiser
❑ Legal Expense Pund
MWILCIP&I
a organiradmal
❑ Thirty-five day
❑ P -m -ay
❑ Pre kctim
❑ Pre-mnoff
Serni-annual
m� Mid Year
❑ Year End
❑ Fnal
❑ special
statecowlty
Referendum
❑ Org -mdoml
Quarterly
❑ First
❑ Seeoad
❑ Third
❑ Pounh
Semi-auuuel
❑ Mid Year
❑ Year End
❑ Fnal
❑ special
❑ Owmimtioeet
❑ Pr =fcrmdmn
❑ Feral
❑ Supplemental Foal
13 Annual
❑ special
p: d (ifappftcaW check one)
Booster Fund
❑ Building Fund
❑ other:
10. Spechd Report Name
& Number of F undrablers this
11. Account Information
11. Amount Information
F mmelal Ian Fell Now �`
(�U�iYI 6 L(�Y�K—
x. Fbnmchd tmtltat m FO Nome
. PmVme
c. Account Code
b. Pmpme
r!.
,.. `tc
0,"
U�� f3 j
I
d. Period Beam Balance
d. Period Begin Balance
a 1 •?,tP
a
CE CATION
I certify that the Corr udttee or Pund is in compliance with all applicable provisions of Article 22A, 22B At 2213-22M 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 end correct and that I have been trained Zd!NC State Board of Elections.
VN107-��- �3
Printed NameWf Signer Si re f A m reasurer Date
R OFFICE USE ONLY
Date Received: Employee:
Date Postmarked: Employee:
Date Scanned: r Employee:
Date Data Entered: Employee:
Delivery Method
❑ Normal Mail
❑ Registered Mail
❑ Hand Delivered
❑ Electronically Filed
[3 Sig tl has not received
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 than
CRO -1000 NC State Board off Election Augur 2008
Detailed Summary p
Use this form to summarize all disclosure renortinn forms and to total monetary information
I. Committee Full Name Fund R applicable)
2, of
rt
3. ID Number
J
d- zp�
tart of Election Cycle: January 1, ILATotal
Rewrting
this
Period
Total this
Election C cls
4) Cash on Hand at Start
$
1 Ll . l (o
$
CEIPTS
5) Aggregated Contributions from Individuals
t) Contributions from Individuals
7) Contributions from Political Party Committees
8) Contributions from Other Poli" Committees
9) Loan Proceeds
0) Refunds/Reimbursemmb to the Committee
1) Other Receipt Sources
(C101205)
(c10ut0)
(CR01220)
(CR01230)
(C101410)
(CR01240)
$
$
$
$
$
$
$
$
$
$
$
$
Ila) Interest on Bank Accounts
11b) Contributions from Not -For -Profit Organizations
110 Outside Sources of Income
11d) Legal Expense Fund - Other Sources
11e) Exempt Purchase Price Sales
(0101250)
(52:01250)
(0801350)
(LEO JY/0)
(CR01365)
$
$
$
$
$
$
$
$
$
$
2) TOTAL RECEIPTS (Add limes 5,6,7,8,9,10,1 la.1 lb,1 lc,1 Id and t le
$
$
XPENDITURES
3) Disbursements
13a) Operating Expenditures (020.1310)
136) Contributions to Candidates/Political Committees (CRO.1310)
13c) Coordinated Party Expenditures (emu -1310)
4) Aggregated Non -Media Expenditures XWO.1315)
5) Loan Repayments (CRO -1420)
6) Refunds/Reimbursements from the Committee (CRO -1320)
7) In -Kind Contributions (CR01510)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
8) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c,14, 15, 16 and 17)
$
$
9) Cash on Hand at End (Add lines 4 and 12 together, then subtract line I8
$
$
DITIONAL INFORMATION
0) Non -Monetary Gifts Given to Other Committees
1) Outstanding Loans (incl. ones from other campaigns)
Debts and Obligations owed by the Committee
23) Debts and Obligations owed to the Committee
24) Account Transfers Within the Committee
5) Administrative Support
6) Forgiven Loans
40-Hoor No" Reports S®
(C101330)
(CRO -IM)
(CRO.1670)
(CRO -1620)
(CR01720)
(0101210)
(CR0.1440)
(CR02220)
$
$
$
$
$
$
$
$
$
Contributions to be ReGmded
(C101215)
$
JUL
(:X(04100 NC Stale Board of Elections
U*n Co. Board 01 ElecWm
Anpst 2008