Ross,Taylor_2023-Pre-electionDisclosure Report Cover 171 AmeYes °`Q 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 undate information.
1. Committee Information
u. Full Name
4dl-
c. IID Number
b. Mailing Address (include City, State and Vp Code)
d. Date Filed
721 1,v (Z,-X.,t.W -17V4 5+(
/hV,, rdti �� 1 rh v
e. Phone Number
2. Report Year
3. Period Start Date (mm/dd yy) 4. Period End_Date (m n thilyy)
5. Treasurer Full Name
)o);
C4/`)7//1,,)'; in/1J 2d13
//- .r t- o' ,-
6. pe of Committee_LCheck One) _
9 Type of Report (check only one type of report from one category) ,
CCandicate Campaign ❑ Puny
❑ PAC Referendum
independent Expenditure ❑ Joint Fundraiser
❑ legal Expense Fund
Municipal
[:] Organizational
❑ Thirty-five day
❑ Pre-primary
State/County
❑ On anizational
(jumerly
O First
Referendum
❑ organizationai
❑ Pre -referendum
❑ Frna1
[ r election
O Pr runoff
Semi-annual
[3 Second
O Third
❑ Fourth
❑ Supplemental Final
❑ Annual
❑ Special
7. Type of Fund (if applicable, check one)
B,�,.icr Fund
❑ Building Fund
Mid Year
Semi-annual
❑ oilier.
Ym End
Final
Special
❑ Mid Year
❑ Year End
❑ Final
❑ speriul
10. Special_ Report Niimffl
8. Number of Fundraisers this Report
- 0
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Fnll Name
h. Purpose
c. Account Code
b. Pur
:;F:4PR Z A! NCE
c Account Code
-
Nld.
OCT 2 4 2023
Period Begin Balance
d. Period Begin Balance _
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, we and correct and that I have been trained by the NC State Board of Elections.
1 LC31griature
Pri ted Name of Signer of Appointed Treasurer Date
FOR OFFICE USE ONLY
Date Received: Employee: Delivery Method
❑ Normal Mail
Date Postmarked: Employee: ❑ Registered Mail
Hand Delivered
Date Scanned: 5 a 3 Employee: Electronically Filed
Date Data Entered: Employee: ❑ Signer has not received
mandatory training
Please Note: This form cannot be used to amend committee informau n 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.
CRU -1000 NC State Board of Elutions August 2008
Detailed Summary Am
nYa�mtanl ❑ No
Use this form to summarize all disclosure renortine forms and to total mnnetary infroton inn
1. Committee Full Name (and Fund if applicable)
2. Type of Report
3. ID Number
Start of Election Cycle: January 1, 2JIL--
Total this
Reporting Period
Total this
Election Cycle
4) Cash on Hand at Start
$
$
RECEIPTS
5) Aggregated Contributions from Individuals
6) Contributions from Individuals
(CRO -120.5)
CR0.1210)
$
$ S
$
$
7) Contributions from Political Party Committees
(CRO -1220)
$
$
8) Contributions from Other Political Committees
(CRO -1230)
$
$
9) Loan Proceeds
(CRO -tato)
$
$
10) Refunds/Reimbursements to the Committee
(CRO.1240,1
$
$
1) Other Receipt Sources
11a) Interest on Bank Accounts
(CRO -1250)
$
$
11b) Contributions from Not -For -Profit Organizations
(CRO -1250)
$
$
l lc) Outside Sources of Income
I Id) Legal Expense Fund -Other Sources
Ile) Exempt Purchase Price Sales
(CR0.1250)
(CRO -1270)
(CRO -1265)
$
$
$
$
$
$
S
12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10,11 a, I l b, l l c, l l d and IIed
3
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 -Melia Expenditures
(CRO -1315)
$
$
5) Loan Repayments
(CRO -1420)
$
$
6) Refunds/Reimbursements from the Committee
(CRO -1320)
$
$
7) In -Kind Contributions
(CRO -1510)
$ 7Y-
$ 7
S 1
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
19) Cash on Hand at End (Add lines S and 12 together, then subtract line 181
$0.00
S
ADDITIONAL INFORMATION
0) Nun -Monetary Gifts Given to Other Committees
1) Outstanding Loans (incl. ones from other campaigns)
(CRO -1330)
(CRO -1430)
S
$
2) Debts and Obligations owed by the Committee
(CR04610)
$
23) Debts and Obligations owed to the
FiNpNQ€R0.1620)
$
24) Account Transfers Within the Committee
(CRO -1720)
$
25) Administrative Support
(CRO -1710)
$
$
26) Forgiven Loans CQ r ! �
$
$
7) 48 -Hour Notice Reports Sum
Contributions to be Refunded
(CRO -2220)
(CRO -1215)
$
$
$
$
CRO -1100 NC State Board of Elmtions August 2008
Amendment
Contributions from Individuals Pg _ of ❑ Yea ❑ No
Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used
I. - Committee Full Name (and Fund if applicable)
ss Fes- �,s "
2. ID Number
3. Contributor Information ❑ Add Remove
. Full Name. Mailing Address & Phone
(include city, state, & zip)
-7 '&— RA );y
T-7
�1d1 br �laXf/L�i 61V4 �,rt A
&U, rdt N(_ 1�I J,)
b. Joh Thle/Profession
d. Cununent,
c. Employer's Nanu/Spectfic Field
C&-, /^f �j-f"idti.l
5`rt/,`(Af L.(,C.
e. Election Sum to Date
$ .362-GZ
r. Prior
_ ❑
g. Account Code
h. Form of Payment
- - -
i. In -Kind DDescription
j. Date (mtm'lddlyyyy)
k Amount
�
J J /�ir� nl
LI 3
$ a,' 3- P
❑
lJ stlt
/11)WO
$ 3l • 3V
❑
C-=�
i0/ °la 3
5 1st
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Professinn
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)
UNION C�,jyANCE
�,AMPPIGN
b. ,fob Title/Profession
d. Comments
c. Employer's Name/Specific Field
e. Election Sam to Date
$
f. Prior
g. Accomt Code
h. Form of Pa
Description
J. Date (mmlddlyyyy)
k Amount
13—
—
-- p
$
❑
$
t. Total only this Page $ I% DJ
5. Total of ALL CRO -1210 Pages
fThi., lure mast be ori line 6 of heladed Suarmary Page. CRO -1100) Q
CRO -1210 NC State Ro, rd of Elections April 2007
In -Kind Contributions Pg —of _ p Amendment
❑ No
Use this form to report non -monetary contributions, donations, goods or services provided to the committee or fund.
Use CRO -1215 if fit -Kind Contributions were or will be refunded within 7 dovS.
.,Committee Full Name{and Fund if applicable]_
3. Contributor Information ❑ Add ❑ Remove
. Full Name,Mailing Address & Phone
(include city, stale, & zip)
-
17) Tf
alUl W IwJfL ti.I+f SIJA. S�C
I / ^
f�Y-d
b. Tt c of C'omributor
India idiri I
:o�
❑tJ:uc
11 Pa
PAC
❑ Referendum
❑ Other Receipt Source
C. Comments
d. Election Sam to Date
$
c. Description
f. Date (mm/ddlyyyy)
g. Fair Market Amount
Lug✓ �
/�/9 �
$ , �//
3. Contributor Information ❑ Add ❑ Remove -
a. Full Name, Mailing Address & Phone
(include city, slate, & zip)
b. Type of Contributor
Individual
❑ Candidate
❑ Party
❑ PAC
❑ Referendum
❑ Other Receipt Source
C. Comments
d. Election Stun to Date
$
e. Description
f. Date (nudddlyyyy)
g. Fair Market Amount
5
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name. Mailing Address & Phone
(include city, state, & zip)
UN10N�UNp(❑
r,A ppdicGN FINANCE
f 2 4 2023
OC 1
ED
b. Type of Contributor _c.
Q Individual
Candidate
❑ Party
❑ PAC
❑ Referendum
❑ Other Receipt Source
Commentr
d. Election Sum to Date
$
on
e. Description
P
f. Date (mm/dd/YYYY)
it. Fair Market Amount
$
4. Total only this Page
$ Q�
5. Total of ALL CRO -1510 Pages
(This line must been line 17gfDe1ai1ed Surmnwy,Pege CRO -1100)
s71'r
CRO -1510 NC Since Ai,ard of Elections December 2007