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Merrell,Melissa_2022-3rd-qtr-amendUse 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. I. Con rnittee Information . Full Name c. ID Number Me-(', s --Tc, Merrell 5 m"7 V . Mailing Address (include City, State and Zip Code) d. Date FUW 2603 AL(DdLAws5 Ln• 11/v1 2-022 sArG\l:ngs I I'IG Z$I�[� �thmeNmber fi 3• 2 -747 - cJ Re rt Year 3. Period Start Date (e®Iddyy) 4. Period End Date ( ) 5. Treasurer Fall Name Zoz_"L o71o1'LoLZ ID�ZZ/ZoLZ _ Mel•6S4.Me7l—eI 6. Type of Committee (Check Onel 9. Type of Report_ (check only one type of report from one category) Eg Candidate Campaign ❑ Pany Municipal state/County 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 ❑ Second 0 Third ❑ Supplemental Final ❑ Annual . Type of Fuad (if applicahk, check one) ❑ Baxter Fund Semi-annual ❑ Fourth ❑ Special ❑ Building Fund ❑ Mid Year Semi-annual ❑ Year End ❑ Mid Year 10. Special Report Name ❑ Other: ❑ Final ❑ Special ❑ Year End ❑ Final Z D Z -L -F�, rd !�+r- . 8. Number of Fundraisers this Report ❑ Special 11. Account Information 11. Account Information . Financial Institution Full Name a. Financial Institution Full Name �rN iS JIUN CUUN [Y . Purpose r- Account Clods Z5 13 b. Purpose e. Accomat Code Nov 01 2022 - A C� a .�r `L _ ' (_ rfWT RECEIVED d. rip° Been Balance d. Period Begin Baboce S�Z�.�'4 $ 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 flasher certify that this report is complete, true and correct and that I have been trained by the NC State Board of Elections. Melissa M Merrell_ I l A r zozz_ Printed Name of Signer Si alu 61'Alrpoinied Treasurer Dare OR OFFICE USE ONLY Date Received: Employee: Delivery Method ❑ Normal Mail Date postmarked: Employee: ❑ Registered Mail Hand Delivered Is Date Scanned: Employee: Electronically Filed Date Data Entered: Employee: E3 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 the Statement of Organization (CRO -2100A -E) to snake committee changes. C'K&I NN/ NC State Board of Elections August 2008 1. Committee Full Name (and Fund if applicable)2. Me ;ssd, l`�errt(1 r : J T of Re rt 3. ID Number SSM V 2,0Z_ 3 04- Start of Election Cycle: January 1, ZO Z Z TOS this Re Period Total this Election C cl e 4) Cash on Hand at Start $ � $ 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 -1410) 10) Refunds/Reimbursements to the Committee (CRO -1240)$ 1) Other Receipt Sources 11a) Interest on Bank Accounts (CRO -1250) 1lb) Contributions from Not -For -Profit Organizations (CRO 12so) llc) Outside Sources of Income (CRO -1250) 11d) Legal Expense Fund - Other Sources (CRO -1270) 11e) Exempt Purchase Price Sales (CRO -1265) $ O $ $ l Ll 00 • O O $ o 00. D $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 12) TOTAL RECEIPTS (Add lines 5,6,7,8,9,10,1 lal lb,I Ic,I ld and I le $ « ZZ (p . �' $ EXPENDITURES 13) Disbursements 13a) Operating Expenditures (CRO -1310) 13b) Contributions to Candidates/Po[itical Committees (CRO -1310) 13c) Coordinated Party Expenditures (CRO.1310) 14) Aggregated Non -Media Expenditures (CRO -1315) 15) Loan Repayments (CRO -1420) 16) Refunds/Reimbursements from the Committee (CRO -1320) 17) In -Rind Contributions (CRO -1510) $ $ g 1)D $ 500-60 $ $ $ 2 ao ob $ $ $ $ $ $ $ $ 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ 2 JC 5$. pp $ 19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18 $ 51 1 $ ADDITIONAL INFORMATION 0) 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 (CR0.1610) 3) Debts and Obligations owed to the Commt W()N COUlt0.1620) CAMPAIGN FINANCE 4) Account Transfers Within the Committee ((CRO -1720) 5) Administrative Support NOV U 1 2VL4710) 6) Forgiven Loans R E C E I V40' 7) 48 -Haar Notice Reports Sun (CRO -2220) $ $ $ $ $ $ $ $ $ $ $ $ $ 8) Contributions to be Refunded (CRO -1215) 00 NC State Board of Elections August 2008 Contributions from Individuals Pg _ of _ ❑ Yes 19 No 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 applicable) Me I', 6so,- M erre l l um- oz rm- c.6 -6-10r\ a f- 12. ID Number_ STM 7 Y V . Contributor Information Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) h4rc. `{a((iso 1 2001 13eUe.�ores+ (',+• wo' natal NC'- 2s1-73 b. Job TitWProfesuon d. Commands ^ -- �EmployeraFidd f.e,i,a� k -S e.EllecnonSum toDole is 3 C)D . oz) F.Prier g. Accomd Code h. Fars of Paymm t L In.Yid Densipflem '. Date (owaW ftyyy) 0'7 113 7,0L t Amount $ 300, 0 c7 ❑ X513 W iR- ❑ $ ❑ $ 3. Contributor Information E3Add 0 Remove Mailing Address & Phone (include c &zip) .1 l P o e 5.1( N b. Job 7Ytle/Profesrion cEky.1, anr�Specfdc p ter' d. Comments e$Election Sam to Dote I o 00, a0 f. 1'rior El— g. Accomu Cade b. Fera of Psynot L In -Hind tion Date (a wWftyy) L Amount $ ❑ $ 3. ContriblWFInforniation ❑ Add ❑ Remove • . Full Name, Mailing Address & Phone (include city, pate, & zip) ,Ory G)(', .t1 13 3 (-1 TVCC - !l-:1( Ch . c1� d . N4,4V\6 �s1 9C 2-81Dt-{ b. Job TitleAWewdon it. Comments c- Employees filmoNSpecWK Field Gr; W— (YIuSa�r/ �' e Election Sam 99 D1t! $ 1( O®O. DO f.Prior ❑ IF Acoaanl Code h. Faesaf laysmt f. in-nK®d ;N FINANGF Date (mWddfyyyy) DS z3 soz1, i Amort $ l aOD. bb �cj �?J ❑ ' o i 7027 $ ❑ D $ 4. Total only this Page $ 1 3 00 - n D 5. Total of ALL CRO -1210 Pages (This line mart be on fine 6 of Ddailed Sum Page CRO -1100) $ fmary V ` OD ' o -O CRO -1210 NC State Board of Elections April 2007 Contributions from Individuals Pg _ of _ ❑ Yes ❑ No Use this form to report individual contributions over $50 or contributions under $50 if forth CRO 1205 is not used 1. Committee Full Name (and Fund if applicable) 2. W Number . Contributor Information ❑ Add ❑ Remove • . Full Name, Matting Address & Phone (include city, state, & zip) _ (,t.(/,.1 0 Q 1z— V Lqo► Ldk27at�es G�• Monroe-, 1q c- L 811 D b. Job Title/Profession d. Comments r� JP_ a Employees Name Specific Field `F'`�°°�toD`t` $ t Do.OD . Prior g. Account Cede d Form of Payment L lh -Xad Description J. fate (tow/dd/yyyy) K Amount $ IUa. a(7 ❑ -7S►3 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) NGE UNIONNOU GAMPAINNA lOv O 1 2022 1I b. Job Title/Profession d. Comments c. Employer's Name/Specific Field - e, Election Swas to Yate $ Pr1sr g. Account Code ayneal L la -Kind Description j. Date(mm/dd/yyyy) IL Annual: ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove . Full Name, Mating Address & Phone (include city, state, & zip) b. Job Titie/Profession d. Comments c Employer's NamdSpeu6c pidd e. Election Sane to Date $ .Prior o g. Account Code - h. Form of Payment i. In -Kind Description j. Date (mmldd/yyyy) Apart $ ❑ $ ❑ $ 4. Total only this Page $ too - 00 5. Total of ALL CRO -1210 Pages (This line most be online 6 of Detailed Summary Page CRO -1100) $ z N DO . (D CRO -1210 N(State Board of Elections April 2007 An end Contributions from Political Party Committees Pg or Yes ❑ No Use this form to report contributions from a political party u ommittee Full Narite`'(and Fund if apple 3; Contributor Information ❑ AM=;?' a. Full Name, Mailing Address & Phone b. Comments (include city, state, & zip) T6 (A V 'd-ak-N6 0c� Se,,e,�R— p.o•�c� 5kl c. Election Sum to Date 1, $ I -ao0 d. Account Code e. Form of Payment I. In -Kind Description g. Date (nm/ddlyyyy) ,01Zol ZdLz h. Amount $ t 1 o o c7 2513 $ $ 3;,Contribu orL>eonnation ❑ Add ''° ❑' Remove l a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Comments --�— — --- c. Election Sum to Date. $ d. Account Code e. Form of Payment I. In -Kind Description g. Date (mm(ddlyyyy) It. Amount $ 3. Contriti ❑;,Adi r❑;=Remove _'' a. Full N:une, 114alltng Address & Phone (include city, state, & zip) $ b. Comments - c. Election Sum to Date': $ d. Account Code e. Form of Payment C In -Kind Description It. Date (mm/dd/yyyy) It. Amount $ $ $ 4.'rotal only this Page $ 1 o O C). O C) 5. 'notal of ALL CRO -1220 Pages (This lioe nno4 be on line 7 of Detailed Summary Page CRO -1100) $ ,DOD. 0 0 CRO -1130 NC'Sijl<Bo2rd,d Iaeeiiunv April 2007 use this foul[ to report expenditures from the committee for operating expenses, Contributions to candidate/political ++ II committees and coordinated party expenditures Iz Na e Full Name (and Fond applicable) 2. ID Numher 50.1 S TM4 7 Yisbursement (Pkase use seaamte CRO -1310 forms for each trot of Disbursement) Ex nses ❑ Cuninbutions to Candidates/PoliticalCommittees ❑ Caudinated Pan Lx ndim, FNarne ormation Add Remove , Mailing Address &Phone b. Coordinated Committee Name d. Comments tets. & ap) - - n-- C Q Whp "K' I Level Registered (SP�y) rIa C\t MO A o2 C� r 1 ruderal county. ❑ Suite ❑ Municipality. a Election Sum to Date $ 5 8 c� . Acttrowd Code g. Form of payment Furpnge Cade L Dale (mmMNyyyy) Am mai L Required Rmiark, ZS05 6 1 A 0% 64 20 $ ZQ.Y 1 Ti Z S 13 1D& -A o 4 -1 ,i $ 7A. 4. Payee Information El Add 0 Remove . Full Name, Mailing Address & Phone b. Coordinated Committee Name d. Comments (include city, state, & zip) \\ \ L \\ c. Level Regi lered (Specify) QFederal County: ❑ State ❑ Municipabty e. Election Sum to Date . Account Code g. Form of payment d purpose Code i. time (nmMd/yyyy) Amountk Required Remarks is 4. Payee Information ❑ Add ❑ Remove R. Full Name, Mailing Address & Phone b. Coordinated Committee Name d. Comments (include city. state, & zip) -)UNTY GlwelRegistered (Specify) i.1NP.I�N FINANCE Nov 0 1 2022 Federal ❑ County. ❑ State ❑ Municipality e. PJxMoe s® to Date . Account Code g. Ptirm ofpayment It. Purpose Cade L Date (r®tdd/yyyy) '. Anxmnl L Required Remarks 5 5. Total only this Page $ 5 8 t 6. Total of ALL CRO -1310 Pages (This line goes in fine 13a of Detailed Summary Page CRO-1It10 if Operating Expenses) (This line goes in line 13b of IXtailed Summary Page CRO -I100 if Contrib to CandidateslPolidcal Comm) $ l d) (This line goes in line 13c of Detailed Summay Page CRO -1100 if Coordinated Party Expenditures) . Purpose Codes (List detailed expenditure code in (h.) above) * - Media B* - Printing C* - Fundraising D - To Another Candidate Salaries F* - Equipment G - Political Party He - Holding Public Office Expenses I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* Other * Codes require detailed explatisition in required remarks field it CRa - 1300 Use ttus torm to report expenditures from the comtmttee for operating expenses, contrtbuttons to candidate/political committees and coordinated partv expenditures Ig 6 1. Committee Full Name (and Fund if applicable) I�el'155OL Mexre tj jor Coat• 2. ID Number_ ISTM`7Yv- .TypeofMbumment (Pleas use separate CRO -1310 forms for each type of Disbursement) ElO Tat1nu 1]F 'nw% (_onlnbullons Ill Candrdates/Pollucal COmmlllee5 IJ Oxwdlnalcd Pam hx 'lllllnlrc� Payee Information Add ErRemoe a. Full Name, Mailing Address & Phone include city, slate. &zip) �flt�ds `' f C" I� / 1 W .v 6 ' w ���1 b. Coordinated Committee Name d. Comments - i"Nsu r6..I�r" C. Isvd Registered (Specify) Federal County 13 state C1 Municipality: e. 0ediSi m m to Date $ 5Da• aD . Account Cade g. Fw= of Payaat Fltrpoee Code Dale ( --f"yy)J.Amwunt IL Regadred Reaarb 5 13 I r- to -V ZOo- $ 5 co, DD . Payee Information ❑ Add Remove a. Full'%anw, %Iniling Address & Phone (include city, stale, &(zip) 'A n't o r V \ D tD . cloly� b. Coordinated Committee Name d. Comments e. teed Registered (Specify) Fedaw 0 State ❑ Municipality: e. FJKtlon Sum to Date $ i2, DJD, D(::) . Accounl Cade 2-513 g. Form of Payment h. Purpose Code , i. Date (m Wddtyyyy) o hiR zoaL J.Angat IL Required Realarb zr $2 ow&D 4. Payee Information Add ❑ Remove . Full Name. %railing .Address & Phom (include city, slate, & zip) FiNiON COU, vTY CAMPAIGN FINANCE NOV 0 1 2022 Pr_r^FIVED b. Coordinated Committee Name it. Comments c. Level RegWered (Specify) Q Federal ❑ County ❑ Slate ❑ Municipality: 1 e. Election Sum to Date $ . Account t'(,de g. Form or Payment h. Purpose Code L tate (mm/ddtyyyy) J. Amount $ k Required Remarks $ 5. Total only this Page $ 5 Z)O , 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Fspenses) (This line goes in One 136 of Detailed Summary Page CRO -1100 if Conlrib to Candidates/Political Comm) (This line goes in line 13r of Detailed Summary Page CRO -1100 if Coordinated Party Er nditures) $ C r I J .7 7.PUrpoSeCodes (List detailed expenditure code in (h.) above) * - Media Bs - Printing C* - Fundraising D - To Another Candidate Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* Other * Codes require detailed explanation in required remarks field k CRO -- �3( a