Palandri,Gina_2022-4th-qtrAmendment
Disclosure Report Cover ❑ Yes ® No
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
1. Committee Information
a. Full Name
c. ID Number
Gina for Union County Commissioner
2JM46P
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
1023 Feather Oak Lane
Stallings, NC
1/9/2023
28104
e. Phone Number
6122965356
2. Report Year
3. Period Start Date (mm/dd/yy)
4. Period End Date
5. Treasurer Full Name
(mm/dd/yy)
2022
06/30/2022
12/31/2022
Gina Palandri
6. Type of Committee (Check One)
9. Type of Report (check only one type ofreport om one category)
® Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑ Organizational
❑ Organizational
❑ Organizational
Independent ❑ Joint Fundraiser
❑ Expenditure
❑ Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pre-primary
❑ Pre-election
❑ First
❑ Second
❑ Final
❑ Supplemental Final
7. Type of Fund (:f applicable, check one)
❑ "Booster Fund"
❑ Building Fund
❑ Pre -runoff
❑ Third
❑ Annual
Semi-annual
® Fourth
❑ Special
❑ Mid Year
Semi-annual
❑ Other:
❑ Year End
❑ Mid Year
10. Special Report Name
❑ Final
❑ Special
❑ Year End
❑ Final
❑ Special
8. Number of Fundraisers this Report
Q
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
Wells Fargo
b. Purpose
c. Account Code
b. Purpose
c. Account Code
Campaign
Acct
GPWF
d. Period Begin Balance
d. Period Begin Balance
$ 931.12
$
CERTIFICATION
I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 2213, & 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 hive been trained by the N oard of Elections.
W A
I p1l 1_1 ^ oeC,;
Printed Name of Signer ignature of Appointed Treasurer Date
FOR OFFICE USE ONLY i
1 12-02-3Employee: C Delivery Method
Date Received:
❑ Normal Mail
Date Postmarked: Employee: ❑ Registered Mail
Hand Delivered
Date Scanned: Employee: ❑ Electronically Filed
❑ Signer has not received
Date Data Entered: Employee: 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. jAi u J ZijZj
You must amend the Statement of Organization (CRO -21 00A -E) to make committee changes.
CRO -1000 NC State Board of Elections ul'lull LO, board Of A(V�W8
Detailed Summary Amendment
❑ Yes ® No
Use this form to summarize all disclosure reporting forms and to total monetnry infnrmntinn
1. Committee Full Name (and Fund if applicable)
2. Type
of Report
3. ID Number
Gina for Union County Commissioner
Fourth Quarter
2JM46P
Start of Election Cycle: January 1, 2019
Total this
Reportin2 Period
Total this
Election C cle
4) Cash on Hand at Start
$
931.12
$
6766.00
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
llb) Contributions from Not -for -Profit Organizations
Ile) Outside Sources of Income
l ld) Legal Expense Fund — Other Sources
11 e) Exempt Purchase Price Sales
(CRO -1205)
(CRO -1210)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$� 95.00
$
1660.00
$ 250.00
$
4600.00
$ 200.00
$
400.00
$
$
$
$
100.00
$
$
$
$
$
$
$
$
$
$
$
$
12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10, Ila, 11b, IIc, Ild and Ile)
$
545.00
$
6766.00
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (CRO -1310)
13b) Contributions to Candidates/Political 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 -Kind Contributions (CRO -1510)
18) TOTAL EXPENDITURES (Add lines 13a, Iib, 13c, 14, 15, 16 and 17)
$
6573.33
$ 1375.87
$
$
$
$
$
$
$ 100.00
$
$
$
$
$ 1475.87
$
$
87.00
6660.33
19) Cash on Hand at End (,4dd lines 4 and 12 together, then subtract line 18)
$
.25
$
.25
ADDITIONAL INFORMATION
20) Non -Monetary Gifts Given to Other Committees
21) Outstanding Loans (incl. ones from other campaigns)
22) Debts and Obligations owed By the Committee
23) Debts and Obligations owed To the Committee
24) Account Transfers Within the Committee
25) Administrative Support
26) Forgiven Loans
27) 48 -Hour Notice Reports Sum
28) Contributions to be Refunded
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRO -1620)
(CRO -1720)
(CRO -1710)
(CRO -1440)
(CRO -2220)
(CRO -1215) 1$
;
$
$
$
$
$
$
$JAN
�
0 2us-
$
$
f110
0.
oarfl Of MC777
a_.nv-1 I vv NU State Board of Elections August 2008
Amendment
Aggregated Contributions from Individuals Page of ' ❑ Yes ® No
Optional form used to report NC Contributions From Individuals of $50 or less
1. Committee Full Name (and Fund if applicable)
2. ID Number
Gina for Union County Commissioner
2J M46P
3. Contributor Information
a. Amend
b. Account
Code
c. Form of Payment
d. In -Kind
Description
e. Date
(mm/dd/ )
f. Amount
❑ Add
GPAB
Card
11/08/2022
$ 25.00
❑ Remove
❑ Add
GPAB
Card
11/07/2022
$ 25.00
❑ Remove
❑ Add
GPAB
Card
11/07/2022
$ 25.00
❑ Remove
❑ Ada
GPAB
Card
11/07/2022
$ 10.00
❑ Remove
❑ Add
GPAB
Card
11/06/2022
$ 10.00
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
z
�..$' I V H_ P "
❑ Remove
❑ Add
J
*� p
N 0 9 20223
El Remove
❑ Add
Union C
. Isoard of Elections
El Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
4. Total only this Page
$ 95.00
5. Total of ALL CRO -1205 Pages
(This line must be online 5 of Detailed Summary Page CRO -1100)
$ 95.00
C-RO-1605 NC State Board of Elections April 2007
Amendment
Contributions from Individuals Pg 4 of -1— ❑ Yes ® 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)
2. ID Number
Gina for Union County Commissioner
2JM46P
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
Retired
Sheri Avis Horner
1104 Tulip Tree Lane
West Des Moines, Iowa
50266
c. Employer's Name/Specific Field
Retired
e. Election Sum to Date
$ 650.00
f. Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
®
GPCK
Check
10/25/2022
$ 250.00
❑
$
❑
T
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
c. Employer's Name/Specific Field
e. Election Sum to Date
$
f. Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
❑
$
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
c. Employer's Name/Specific Field
e. Election Sum to Date
$
f. Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
❑
$
❑
2023
❑
Union
ro.sBoard of Elections
4. Total only this Page
$ 250.00
5. Total of ALL CRO -1210 Pages
(This line must be on line 6 of Detailed Summary Page CRO -1100)
$ 250.00
CRO -1210 NC State Board of Elections April 2007
Contributions from Political Party Committees Pg
Use this form to report contributions from a political party
Amendment
of ❑ Yes ® No
1. Committee Full Name (and Fund if applicable)
2. ID Number
Gina for Union County Commissioner
2JM46P
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Comments
Donation to
Campaign
Democratic Women of Union County
C/O Juliette Weiland Treasurer
7905 Tottenham Court
Waxhaw, NC 28173
c. Election Sum to Date
$ 200.00
d. Account Code
e. Form of Payment
f. In -Kind Description
g. Date
(mm/dd/ )
h. Amount
GPCK
Check
10/25/2022
$ 200.00
3. Contributor Information
❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Comments
c. Election Sum to Date
d. Account Code
e. Form of Payment
f. In -Kind Description
g. Date
(mm/dd/
h. Amount
$
3. Contributor Information
❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Comments
c. Election Sum to Date
d. Account Code
e. Form of Payment
f. In -Kind Description
g. Date
(mm/dd/ )
h. Amount
�p
,. U Z 20,23
d ion
GO$Board of Elections
4. Total only this Page $ 200.00
5. Total of ALL CRO -1220 Pages
(This line must be on line 7 of Detailed Summary Page CRO -1100)
$ 200.00
UAU_[aw NC State Board of Elections April 2007
Disbursements pg of Amendment o7 El Yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Gina for Union County Commissioner I 2JM46P
3. Type of Disbursement lease use separate CRO -1310 form for each type of Disbursement
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Online platform
for
Campaign
Donation fees
Act Blue
366 Summer Street
Somerville, MA 02144
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 81.16
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
GPCD
Card
O
11/01/2022
$12.19
Online donation
fees
GPCD
Card
O
12/01/2022
$1.44
Online Donation
fees
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
3` party
online merchant
service fees
for donations
Stripe Online Merchant
185 Berry Street
San Fran, Ca 94107
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 130.85
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
GPCD
Card
O
11/05/2022
$4.68
processing fees
online donation
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
bank fees
campaign acct
Wells Fargo
2821 Pineville Matthews Rd
Charlotte, NC
28270
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 20.00
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
GPCD
Card
O
11/30/2022
$10.00
bank fee for
camp acct
GPCD
Card O 12/30/2022 $10.00
Pae
bank fee for
camp acct
5. Total only this
$ 38.31
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses)
(This line goes in line 13b of Detailed Summary Page CRO -1100 if Contrib to Candidates/Political Comm)
(This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Parry Expenditures)
$ 1375.87
7. Pur ose Codes (List detailed expenditure code in (h.) above). _
A* - Media B* - Printing C* - Fundraising C i'j L: V 5 a Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
I - Postage J - Penalties K* - Office Expenses JAN 0 J 2023Q*- Donation to Legal Expense Fund
O* - Other
* Codes require detailed ex lanation in required remarks figjdk)�_
CRO -1310 NC State Board o ections December 2009
Amendment
Disbursements Pg of ❑ Yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Gina for Union County Commissioner 2JM46P
3. Type of Disbursement Please use separate CRO -1310 forms for each type of Disbursement.
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
per month fee
Software
for campaign
work
Pic Monkey
1505 5th Avenue
Seattle, WA
98103
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 103.92
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
GPCD
Card
K
11/01/2022
$12.99
per month fee
campaign work
GPCD
Card
K
12/01/2022
$12.99
per month fee
campaign work
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
office supplies
for campaign
Target
12830 Walker Branch Dr.
Charlotte, NC 28273
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 95.87
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
GPCD
Card
K
11/03/2022
$31.47
office supplies
for campaign
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
office supplies
for campaign
Amazon.com
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 385.25
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy) j. Amount
k. Required Remarks
GPCD
Card
K
11/02/2022 $11.69
office supplies
for campaign
Pae
5. Total onIV this
$ 69.14
6. Total of ALL CRO -1310 Pages N 0 9 2023
(This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating' xpenses)
(This line goes in line 13b of Detailed Summary Page CRO -1100 if Cont ib to n a l't' a tm)
( g f y g f ��1104 �,"i jfftj f_f6���Yf�
This line goes in line 13c o Detailed Summar Page CRO -1100 i Coor rna a arty xpenditures)
$ 1375.87
7. Pur ose 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)
c.lcv-1.5 f u NC State Board of Elections December 2009
Disbursements pg of 7
Amendment
❑ Yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party exnenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Gina for Union County Commissioner 2JM46P
3. Type of Disbursement Please use separate CRO -1310 fornu for each type of Disbursement)
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Campaign Staff
Assistant
Payment
Racquel McNeil Washington
4413 Northaven Drive
Charlotte, NC
28206
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 1200.00
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
GPCD
Card
E
11/09/2022
$1200.00
Campaign Staff
Salary
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Postage
for campaign
mailings
USPS.com
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ .203.54
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
GPCD
Card
I
12/14/2022
$37.55
Postage for
Campaign
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Water for
Pollgreeters
Harris Teeter
10616 Providence Rd
Charlotte, NC
28104
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 30.87
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
GPCD
Card
O
11/05/2022
$30.87
Water for
Pollgreeters
Pae ®
5. Total onlythis
$ 1268.42
6. Total of ALL CRO -1310 Pages a�� Q ��2�
(This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses)
(This line goes in line 13b of Detailed Summary Page CRO -1100 if Contri���� toII Cadid����es/PQ 1n11 �'�q1 Cggm
(This line goes in line 13e of Detailed Summary Page CRO -1100 if Coordinated Pa�ty�xpendit r� s) 11 O
$ 1375.87
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)
UIKU-131 V NC State Board of Elections December 2009
Loan Repayments
Use this form to report payments on an existing loan.
Amendment
Pg ) of —L— ❑ 1'es ® No
1. Committee Full Name (and Fund if applicable) 2. ID Number
Gina for Union County Commissioner 2JM46P
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Comments
Loan Payback
Gina Palandri
1023 Feather Oak Lane
Stallings, NC 28104
c. Original Loan Date
03/02/2022
d. Original Loan Amount
$ 100.00
e. Remaining Loan Balance
f. Account Code
g. Form of Payment
h. Date (mm/dd/yyyy)
i. Repayment Amount
$ 100.00
GPCD
Card
12/20/2022
$ 100.00
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Comments
c. Original Loan Date
d. Original Loan Amount
$
e. Remaining Loan Balance
f. Account Code
g. Form of Payment
h. Date (mm/dd/yyyy)
i. Repayment Amount
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Comments
c. Original Loan Date
d. Original Loan Amount
$
e. Remaining Loan Balance
f. Account Code
g. Form of Payment
h. Date (mm/dd/yyyy)
i. Repayment Amount
$
$
4. Total only this Page JAN 0 9 2023
$ i 00.00
5. Total. of ALL CRO -1420 Pages
Union Co. Board of Elections
(This line must be on line IS ojDetailed Summary Page CRO -1100)
I—Pri 1.411n
$ 100.00
iNU 3iaie noara of r.iecnons December 2007