Merrell,Melissa_2022-4th-qtrX IJ D
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 nncinte infnrmntinn
1. Committee Information
a. Full Name
c. ID Number
M21,ss� Herrn log Cpy4qu
S'zrM y Y
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
2,&03 A►bc,-oss LA-
z3 -
5A- 0. ku ng s g c— 2 -'?10<4
e. Phone Number
704.5Sa3 , 27g2
2. Report Year
3. Period Start Date (mm/dd/yy)
Period End Date (mm/dd/ )
5. Treasurer Full Name
ZOLZ.
1612.3 ZIDZZ.
14.
12-r 31 /7-02-2_
Mel,ssa Me_c're(l
6. Type of Committee (Check One)
9. Type of Report (check only one type of report from one category)
Candidate Campaign ❑ Party
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
❑ Third
❑ Supplemental Final
❑ Annual
%. Type of Fund (if applicable, 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
❑ Special
Z0 2-7-
Fau,.Ak, aj -M
�or-
8. Number of Fundraisers this Report
11. Account Information
11. Account Information
. Financial Institution Full Name
a. Financial Institution Full Name
b. Purpose
c. Account Code
b. Purpose
c. Account Code
213
d. Period Begin Balance
d. Period Begin Balance
V__j_
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 further certify that this
report is complete, true and correct and that I have been trained by the NC State Board of Elections.
NIL'o;sk tA- IAyyeh /1S��(M��s�.�4��p� ►t Zoz
Printed Name of Signer V� Signature of Appointed Treasurer bate
FOR OFFICE USE ONLY
Date Received: V Employe Delivery Method
❑ Normal Mail
E V❑Registered Mail
Date Postmarked:R"
" `�` Employee:
Hand Delivered
.slp ? '-°° ° Employee: ❑ Electronically Filed
Date Scanned: •- ,,
Date Data Entered: Un'On GO. BOaFd Of EIeC'jUmployee: E3 Signer has not received
mandatory training
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 changes.
UIKU-1 UUU NU Mate board of Elections August 2008
1, Committee Full Name (and Fund if applicable)
2. Type of Report
ID Number
n
'6'k5s0., to c�re \ �O.`s
ZDZZ LOU- Q_V,
13.
S _' M *N(
Start of Election Cycle: January 1, Z 0 L Z
Total this
Reporting Period
Total this
Election Cycle
4) Cash on Hand at Start
$ (PT$
,
RECEIPTS
5) Aggregated Contributions from Individuals (CRO -1205)
$ 0 -to
$
$ . DO
$
6) Contributions from Individuals (CRO -1210)
$ 0
$
7) Contributions from Political Party Committees (CRO -1220)
$ . OD
$
8) Contributions from Other Political Committees (CRO -1230)
$ /
$
9) Loan Proceeds (CRO -1410)
10) Refunds/Reimbursements to the Committee (CRO -1240)
$
$
11) Other Receipt Sources
Ila) Interest on Bank Accounts (CRO -1250)
$
$
11b) Contributions from Not -For -Profit Organizations (CRO -1250)
$
$
llc) Outside Sources of Income (CRO -1250)
$
$
11d) 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, l l b, l l c, l l d and Ile)
$ tog'
$
EXPENDITURES
13) Disbursementsx{r,�i1�c"^
13a) Operating Expenditures (CRO -1310) $ 123 �$' $
13b) Contributions to Candidates/Political Committees (CRO -1310) $ ' Z Z 5, (� $
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 -Kind Contributions (CRO -1510) $ / $
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$ 044.
$
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18',
03
$
ADDITIONAL INFORMATION
20) Non -Monetary Gifts Given to Other Committees (CRO -1330)
1) Outstanding Loans (incl. ones from other campaigns) (CRO -1430)
$ 4
$ ;
2) Debts and Obligations owed by the Committee (CRO -1610)
$
3) Debts and Obligations owed to the Committee (CRO -1620)
$
4) Account Transfers Within the Committee (CRO -1
5) Administrative Support (CRO -1710)
$ y - $
a
6) Forgiven Loans (CRO -1440)
"' " k $
) 48 -Hour Notice Reports Sum (CRO-�220�
$
r8)Contributions to be Refunded (CRO -1215)
$ $
UIEU-11 uv NU State Board of Elections August 2008
Use tilts torm to report expenditures trom the committee for operating expenses, contributions to candidate/pohttcal , I o
committees and coordinated narty exnenditures �
1. Committee Full Name (and Fund if applicable)
2. -ID -Number
Mek;5sC- MerrrU �w COW�
S-' m 7 Y Y
3. Type of Disbursement (Please use separate CR0-1310 forms for each type of Disbursement. )
Operating Expenses Contributions to Candidates/Political Committee-s------o---Coordinated Party Expenditures
4. Payee Information Add 1] Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
–
L.aa, e01 t 4rY ?4/�ers . �AA_
Q
c. Level Registered (Specify)
Federal ---]@ County:
"❑ State ❑ Municipality:
e. Election Sum to Date
$ 5g. Do
f. Account Code
g. Form of Payment
---
h. Purpose Code
-
i. Date (mm/ddlyyyy)
j. Amount
L Required Remarks
2513
'Debi-
- -
10 L5 ZoL
$ 2a.a-0
W t10fI+f-
f-25
2- 5l3
Da;k-
A
o10 ti -1-
$ Zqi.
w eb S'.-4-
4 Payee Information ❑ Add ❑ Remove
a.. Full Name, Mailing Address & Phone
(include city, state, & zip)
Tck,4 " 4a-rs CQ /�/� —
b. Coordinated Committee Name
d. Comments
c. Level Registered (Specify)
Federal County_
13 Stats 0 Municipality:.
..Election(SSum to Date
0Z)
Account Code
2513
g. Form of Payment
h. Purpose Code
i. Date (mmlddlyyyy)
ize ob(za��
j. Amount
$ 2A.00
k. Required Remarks
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
-
b. Coordinated Committee Name
-------- -------
d. Comments
c. Level Registered (Specify)
II Federal II County:
13 .State 0 Municipality:
e. Flection Sum to Date
$ 4 k43 . ZQ
Account Code
g. Form of Payment
h. Purpose Code
i. Date (mnddd/yyyy)
j. Amount
Li 13. zU
k. Required Remarks
\g, Pe" -s C, Y,
5. Total only this
Page
I$ 5045- 20
fi. Total of ALL CRO -1310 Pages »
(This Brie goes in line lin n, f -Detailed Summary Page -CR04100-if Opern�tiug, ,x�p��enses)
(This line goes in line Bb of Detailed Summary Page CRO -I d� r �£bnll ib td�Candi slPotr icaI Cain)
{Titls lure goes in lure 13c of Detailed Summary Page Cl2fl-ll#10 if Coordinated Party Expenditures)
I
$ 3 0 q 15 • 116
i
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
Use this torm to report expenditures trom the committee for operating expenses, contributions to candidate/political��
committees and coordinated narty exnenditures
. Committee Full Name (and Fund if applicable)
2. ID Number
M el;ssc� MP�rc�.l1 or Cow Cow.rw;���2r
��' M r7 Y V
Type of Disbursement (Please use separate CRO -1310 forms for each type of Disbursement.)
® OperatingExpenses ❑ ContributionstoCandidates/Political Committees❑ Coordinated Party Expenditures
1a4
. Payee Information Add ElRemove
. Full Name, Mailing Address & Phone
nclude city, state,& zip)r.
b. Coordinated Committee Name
d. Comments
RQS{�lar-f
bevel Regi54ered {Specify)
Federal County: -
0 State L3 Municipality:r$E'
ection Sum to Date
.. ......... __....___-__.__ -..
52 -?.32.
Account Code
g. Form of Payment
h. Purpose Code
i. Date (tmn/dd/yyyy)
j. Amount
k. Required Remarks
�
food
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state & zip)
b. Coordinated Committee Name
d. Comments
r'.sl-uaS
of
mor � ole LLC
Corn❑
If.
r. LevelRegistered (Specify)
Federal County.
❑ State ❑ Municipality:
e.ElectionSumto-Date
$ l0q•&(.
Account Code
2513
g. Form of Payment
D65. 4-
h. Purpose Code
i. Date (mmldd/yyyy)
j. Amount
$ 7oa.('�
k. Required Remarks
;-els r nr�.KiS
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
v ` r ( vw I C V Q
b. Coordinated Committee Name
d. Comments
--
D�Q ► G{L!-
(FoCA
c. Level Registered (Specify)
❑ Federal 0 County:
❑ -State .❑ Municipality: -
e. Flection Sum to Date
$ ';�0. 00
f. Account Code
Z 5 l ?j
g. Form of Payment
C1�61,
h. Purpose Code
i. Date (mm/dd/yyyy)
- w
j- Amount
$ . •oto
k. Required Remarks
BBQ -s ; ace +S
e
5. Total only this
Page JAN d 1 2023
$ 1 3 11
G. Total of ALL CRO -1310 Pages �n
(This line goes iulhie13anfDetadedSummary Page -CBO-1-1OL] ge��pa"40flons
(This lute goes in line 13b of Detailed Summary Page CRfl llOf1 if Coatrib io CamUdateslPoli&al Coram)
{This lute goes in -litre 13c of Detailed Summary PageR-0-1100iflCoordinated Party Expenditures)
p Q
$ 3, b � D • l 0
I
7. Purpose Codes (List detailed expenditure code in (h.) above)
A* - Media S* - 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
Use this torm to report expenclttures from tete committee for operating expenses, contributions to candiclate/political
committees and coordinated narty exnenditnres
ttee Full Name (and Fund if applicable)
2. ID Number
Disbursement (Please use separate CRO -1310 forms for each type of Disbursement.)
- --g Expenses Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
FPayve
nformation ❑ Add 0 -Remove
me, Mailing Address & Phone
, state, &zip)
b. Coordinated Committee Name
d. Comments
n dor 13 OE - Dim-ricr
1
•L•
r.Level Registered (Specify)
Federal unty:
Co
0 State ❑ Municipality:
e. Election Sum to Date
$ 2-Z-5. 00
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
2513
1. la zoz-z
$1 2-25.OD
L', l<awtvl��k �3oE
S
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
- --
c. Level Registered (Specify)
Federal County.
State ❑ Municipality: -e.;Election
Sum toDate
Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
c. Level Registered (Specify)
❑ Federal -❑ County:
1 -State ❑ Municipality:-e.Elertion.SumtoDate
$
Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/ddlyyyy)
j. Amount
L Required Remarks
5. Total only this
Page
$ 2 p
fi. Total of ALL CRO -1310 Pages Union G0. Boar"! 0:: ec!, S
(flus lire goesinliue Ba of Detailed Summary Page -CRO -1100 if Operntiug EVertses)
(This line goes in line 13b of Detailed at Page CRO -1100 if Conlrib to Candidates/Political Coram)
(This line goes inline 13c of 1letailed Summary Page =CRO -1100 if Coordinated Party Expenditures)
$ 3O LTJ Q � I d
O
. Purpose Codes (List detailed expenditure code in (h.) above)
* - Media B* - Printing C* - Fundraising D - To Another Candidate
- Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
1E1
- Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* Other
* Codes re uire detailed explanation in required remarks field k