Merrell,Melissa_2022-3rd-qtrUse this form for general report and committee information, must be signed and submitted along wilh other detailed forms.
Do not use this form to update information.
I. Committee Information
. Full Name
c tD Number
Me -fossa Derrell 4r <✓flun� IUtKM'sstD
5 M7Y V
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
2(Pa3 Alba -rots Ln.
11 01 Lo22.
�� Cl, ` • n� s I 1-� 2- D ID 1
e. Phone Number
7a q3. 2792.
2. Report Year
3. Period Start Dates 4. Period Bad Date _(maadW,S. Treasurer Full Name
1 07 to1'Lo2,-L- ID/ZZIZO LZ I McGSSa Mer,-icl
20Z --L—
6. Type of Cottee (Check Ogee)
1jpe�of Report (check
only one type of report
from one category_)
Candidate Campaign ❑ Party
Municipal
Statelcounty
Referendum
❑ PAC ❑ Referendum
❑ Organizational
Organizational
❑ Organizational
❑ Independent Expenditure ❑ Joint Fundraiser
❑ Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pre-primary
❑ First
❑ Final
❑ Prc-election
❑ Pte -runoff
❑ Second
0 Third
❑ Supplemental Final
❑ Annual
7. Type of Fund (lfapplicable, check one)
❑ Booster 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
2 D L 7-
r a L'�+t— .
8.Number of Fundraisers this Report
❑ Special
11. Account Information
11. Account Information
. Financial Institution Full Name
a. Financial Institution Full Name
—rrw2s
jUON COUNTY
. Purpow
c. Amount Gude
b. Purpose
a Account Code
25 13
Nov o 1 2022
C r Ac -,-f ,
RECEIVED
d Pkr{ad Begin Balance
"' Per a Bt& Balance
CERTIFICATION
1 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.
WCasa M• Merrellg_ t of /W.?- 7-
Printed Name of Si er Si atu of Appointed Treasater Date
FOR OFFICE USE ONLY
Date Received: Employee: Delivery Method
❑ Normal Mail
tt7
Date postmarked: Employee: ❑ Registered Mail
Hand Delivered
Date Scanned: Employee: IN Electronically Filed
❑ Signer has not received
Date Data Entered: Employee: mandatory tramin
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-210OA-E) to make committee changes.
CA 1000 NC State Board of Elections August 2008
-
1. Committee Full Name (and Fund if app cable)
Me ;s56, Merl -4& �t ° S F D^e
- - -�
2. Type of Re rt
2� z z 3`d
--------.._..
Q+t-.
3. ID Number
SJ M V
Start of Election Cycle: January 1, ZO Z Z
ReportingTReporting
Total this
Period
Total this
Election Cycle
4) Cash on Hand at Start
$
ZfP 461$
RECEIPTS
5) Aggregated Contributions from Individuals
6) Contributions from Individuals
7) Contributions from Political Party Committees
8) Contributions from Other Political Committees
9) Loan Proceeds
10) Refunds/Reimbursements to the Committee
11) Other Receipt Sources
Ila) Interest on Bank Accounts
11 b) Contributions from Not -For -Profit Organizations
11c) Outside Sources of Income
l Id) Legal Expense Fund -Other Sources
11 e) Exempt Purchase Price Sales
(CRO -1205)
(CRO -1210)
(CRO -1210)
(CRO -1230)
(CRO -1470)
(CRO -1140)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1170)
(CRO -1265)
$ 0.-0
$
$ O
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
12)TOTAL RECEIPTS (Add lines 5, 6,7, 8,9, 10,11 a, l l b, l lc, l l d and l le
$ it
7 (o •g 1
1 $
EXPENDITURES
13) Disbursements
13a) Operating Expenditures
13b) Contributions to Candidates/Political Committees
13c) Coordinated Party Expenditures
14) Aggregated Non -Media Expenditures
15) Loan Repayments
16) Rerunds/Reimbursemeuts from the Committee
17) In -Kind Contributions
(CRO -1310)
(CRO -1310)
(CRO -1310)
(CRO -1315)
(CRO -1420)
(CRO -1320)
(CRO -1510)
$
g. ��
$
$
$
$ 2 DDO , tb
$
$
$
$
$
$
$
$
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$ 5 tj �, D p
$
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$
,� (
$
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 (CRO -1610)
3) Debts and Obligations owed to the Commltfee� "-106-1620)
4) Account Transfers Within the Committee (CRO -1720)
5) Administrative Support "V 0 1 iro•ulo)
6) Forgiven Loans �rq�ga
�+E_CE1`f D 0)
7) 48 -Hour Notice Reports Sum (CRO -2220)
8) Contributions to be Refunded (CRO -1215)
$
$
$
$
$
_7_
$
$
$
$
$
$
$
$
CRO -I mu NC State Hoard of Elections August .'um
Contributions from Individuals Pg or ❑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 FaM Name (and Fund if applicable)
Number
Me, -,sot. Ment �I an+ 0orKNt:a6tar\er--
757M`7Y\1/
3. Contributor Information Add Remove
. Full Name, Mailing Address & Phone
(include city, Yate, & zip)
b. Job TitleMWession
—
d. Comments
_-_-
hafw 11a tremor,
G Fmployer's NamelSpeeidr Field
nn C+
ZOO \ 13Q 1\�Fpf¢6�
Prt s't dent
W &KI10t o) NC 2!5173
�p 1
f�Ph.
e. Election Sam to1We
$ 30D. 00
(60�
J S
Prior
g. Aeaaat Cale
L Form et Payment
L to -Kind description
'. Date (o/d&yyyy)
t Amount
❑
$
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
b. Job THIaMwofession d. C.onooents
(include city, state, & zip)
��d Vbl`nS0'� Pro,— C- Ser0.4,?---
G Employees Nimm Sperillie FIM
P.o•Ba� sale.
M�rrb�) t -SC 2SII 1
C /
�'1fc/�t-5 . Election �an.se
( I O pU. OC7
Prior
it. Account Code
L Form of Payment
L Eo -Kind Danipliaa
J. Date (dddlyyyy)
L Amount
$
o
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
• . Full Name, Mailing Address & Phone
b. Job TitlelProfessian d. Comments
(include city, Yatq & zip)
own 1_M-1
T (�(I
I(JI�y `� Tuxc �Ct�}{,f1
c. Employees NambSpecillic Field
13 3 4 "Rock- W. Ilk Ch
Cart -W
N d+� ti�h7si C 2-81-Dq
f
G
�� 1 F4taN Sit to [lalc
ffiat 'arry M+ $ It COO. tai
. Prior
g. Account Code
L Form of Payment
I. In -Kind Desenphon
' Date (mmridlyyyy)
L Ama®t
❑
!(1V U 1 ?ui
$
❑
17°VE1_1)
$
4. Total only this Page
$ 7- D(]
5. Total of ALL CRO -1210 Pages
$ (�
Z ` D ' o_3
(Thu fine mart be on line 6 of Derailed Susemary, Page CRO -1100)
`�
CRO -1210 NC State Board of Flections April 2007
Contributions from Individuals Pg of ❑Yes ❑ Nn
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)
2. ED Number
. Contributor Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, slate, &sip)
PCLud � o Id2�
g
Zaat lra�sa,�es G+•
M on t a e l )q C Z 8 11 DfG
b. Job TiddPmtession d. Contents
(7 _ - rL -
r'r's Names
Tek,
r. Empleyer's NamdSpeci6c nw
—
(� e FJeetion Sm to Date
$ 1 Do -cc
F. Prior
g. Account Code
It. Form of Payment
i. In -Kind Description
_ - -
'. Date (mm/ddlyyyy)
- -
k Amort
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
• . Full Name, Mailing Address & Phone
I include city, .state, & zip)
UNION COUNn
CAMpAtGN FmANC C.
NOV p 1 2022
h. Job Title/Profession
d. Comments
a Employer's Name/Specific Field
e. Electloo Sam toDate
$
Prior
g. Arnot Cade
L L-Hiod Description
Daft (s/dd/yyyy)
k Anmmtt
❑
$
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
• . Full Name, Mailing Address & Phone
(include city, slate, & sip)
b. Job Title(Profession
- -
d. Comments
-
c. Employer's NamdSpeeiBc Field
& Flection Sm to Date
$
Pr1w
g.Aeeounl Code
h. Form of Payment
i. In -Kind Description
'. Date (m ohiftyyy)
IL Amount
❑
$
❑
$
❑
$
4. Total only this Page
$ 100. 00
5. Total of ALL CRO -1210 PageS
(This fine must be on line 6 ojDdaifed Summary Page CRO -1100)
$ 0c) ' D
CRO -1210 NC State Board of Elections April 2007
N7/2'L
Use this form to report expenditures from the committee for operating expenses, contributions to candidate/polltical + 1�
committees and coordinated party expenditures f3
1. Committee Full Name (and Fund if applicable)
Number
Meltss0.M'wr'e'll tVr Cofar ,....',ss;3T er
_S TM"1 `(
Type of Disbursement (Please use separate CRO -1310 forms for each type of Disbursement. )
Operating Expenses ElContributions In CandidatcJPolitical Committees E3Coordinated Party Expenditure,
Payee Information 0 Add Remove
a. Full Name, Mailing Address & Phone
It. Coordinated Committee Name
it. Comments
include city, state, &zip)
( �p
C"K, �//� r��rs ' 11171 r
c. Level Registered (Specify)
`
9;z 5 1 MA � �ZCJ.
E3 Federal E3 county:
❑ State ❑ Municipality:
e. Flection Sum to Date
$ 5 V'�c�
A000mid Code
g. Fora offaya nt L Purpose CadeL
Date (mmtdd/_yyyy) A®nnM
L Required Re®arkS
w 'i e,
2 513
bi-{
04 zp $ 211-60
4. Payee Information LIAM Ll Remove
a. Full Name, Mailing Address & Phone
It. Coordinated Committee Name
it. Comments
(include city, state, & zip)
c. Level Regielered (Spey)
Federal 0 Cmnty:
Q State Q Municipality:
e. F.lecdon S® to Date
$
. Account Code g. Form of Payment L Purpose Code L Date (®lddlyyyy) '. Amount
fT
L Required Remarks
4. Payee Information El Add ❑ Remove
. Full Name. Mailing Address & Phone
It. Coordinated Committee Name
it. Comments
(include city, state, & zip)
COUNTY
Led RegiataM(Sperify)
'�Af�1PAi;aNFINANCE
Federal County:
NOV 0 1 2022
❑ state ❑ Municipality:
e. Fin Spm to Date
$
..Account C ode
g. Form of Payment
h. Purpose Cade
L Date (mmlddlyyyy)Animal:L
Required Remarks
$
$
5. Total only this Page
$ 519-00
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Derailed Summary Page CRO -1100 if Operating Expenses)
(This line goes in line lab of if Detailed Summary Page CRO -1100 Connlb to Candidales/Polilical Comm)
$ a, 5 S g a
(This line goes in line 13c of Detailed Summary Page CRO -1100 i Coordinated Pa Ex enduures)
. PUrp(/Se Codes (List detailed expenditure code in (h.) above)
A* - Media B* - Printing Cs - Fundraising D - To Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fuel
O* Other
* Codes re uire detailed explanation in required remarks field k
CRa - (310
Use tins form to report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated oartv expenditures M �6
1. Committee Full Name ( R applicable)
2 �
I'�1el;ssQ eere�) {`or Coto. CoN..N�Ss�cr.�r—
SSM7Y V
Type of Disbursement (Pkase use seoamte CRO -1310 forms for each type of Disbursement)
rmin Expenses ® Coninbutionsto Cand Wates/Political Commee
itts ❑ Coordinated Pan Expenditures.
Payee Information Add ❑ Remove
a. Full Name, Mailing Address & Phone
b. Coordinated Committee Name d. Comments
include city, state, & zip)
Fi l e� As o� iNar k 120�o t.s�..
-- 11,^,
C.�b • �'
n
cLevel Registered (Specify)
❑ Federal County:
❑ State ❑ Municipality: P-Mactlea S®W Date
$ 5Da. a(7
. Account Code
g. Form of Paynxat
11L Purpw Cole
L Dote famfildlyyyy)
J. Amewat
!<Regired Rmria
5 13
Debt+
to za zoLv
$ Sm. Dr
4. Payee Information ❑ Add Remove
. Full Nana, '%failing Address & Phone
b. Coordinated Conuniaee Name
d. Comments
(include city, state, & zip)
G Level Registered (Specify)
Federal ❑ County:
❑ state ❑ Municipality:
e. Election Slur te Date
$
.Account Code
g. Fors. of Payment
L Purpose Code
i. Date Imm/dd/yyyy)
'. Amount
L Required Remarb
o� 1C(ALL
$7-0Db.D0
aoPC; zr
$
4. Payee Information ❑ Add 0 Remove
. Full Name, Mailing Address & Phone
h. Coordinated Committee Name
d. Comments
(include city, state, & zipi
JtJiC}N Ct7vi'8TY
?JPAIGN FINANCE
c. Level Registered (Specify)
NOV 0 1 2022
Fu.""' ❑County:
❑ State ❑ Municipality:
e. Electim Som to Date
RECEIVED
1 $
.Account ('tele
g. Form of Paymeol
L Purpose Code
L date (®idd/yyyy)
Amouml
L Regdr'el Re_rb
Is
5. Total only this Page
$ oZ 5 a0. C7
6. Total of ALL CRO -1310 Pages
('This line goes in line Ba of Detailed Summary Page CRO -1100 if Operating Expenses)$
(This line goes in line 13b of Detailed Summary Page CRO -1100 if Conlrib to CandidaleslPolilical Comm)
(e r-
:J .7
(This line goes in line 13c of Detailed .Summary Page CRO -1100 i Coordinated Parly Expenditures)
. Purpose Codes (List detailed expenditure code to (h.) above)
* - Media B* - Printing C* - Fundraising D - To Another Candidate
Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
Postage J - Penalties K* -[Mice Expenses Q* - Donation to Legal Expense Fund
O* Other
* Codes reuire detailed ex lanation in reguired remarks field k
CRO -- 13k O