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Schallenkamp,Dan_2023-35-DayDisclosure Report Cover Amendment Yes p 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 e ID Number !! II An SC�0.+t�CQV1kA It. Mating Address (Made City, State and Zip Code) d. Date Fled yob pai^jvee- fir, a -vc,+- 26A3 e. Pbone Number ►�'la�lbtews, �/ C d 9 ( 76y—Os-061 2. R*rt rt ear 3l. Period Start Date immid ) 14. Period End Date (mwa ) 15. Treawnr Fa Nam Ro 23 1 �o—jA-aoa3 0Z-5*-0-a0a3 anS�lnAP�c�l�awl 6. T pe -of m _Comittee (Check One) -❑ 9. ckonlyoneypelreport from one category) Candidate Campaign Party Municipal State/Comity __ Referendum PAC ❑ Referendum ❑ Organizational ❑ Organizational ❑ Organizational ❑ Independent Expenditure ❑ Joint Fundraiser Thirty-five day Quarterly ❑ Pre -referendum ❑ legal Expense Fund H Pre-primary ❑ First ❑ Final ❑ Pre-election [3Pre-runoff Semi-annual ❑ Second 13 Third ❑ Fourth ❑ Supplemental Final 13 Annual ❑ Special 7. T of Fmd (if applicable, check oneJ Booster Fund ❑ Building Fund ❑ Mid Year Semi-annual ❑ Year End ❑ Mid Year 10. Special Report Name Other: ❑ Final ❑ special ❑ Year End ❑ Final ❑ Special 8. Number of Fundraisers this Re rt 11. Account Information 11. Account w a. Financial Institution Full Name a. Financial i tiN on Van.Nartie S+oje- i. _ r b. Purpose a Account Code It. Purpose Account Code CCLIAl pi �o i Q} 1 C'^Ion Co. Board Of EI ,r _ 11 fl lyttitarx T0.;x d. Period Begin Balance d, Period Begin Balance $ mo or $ 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 b n trained by the NC to B and of u � a -0(-+--2W3 h &GVw K QC At 4itre` Printed Name of Si nee Signature of Appointed Treasurej Date FOR OFFICE USE ONLY Date Received: Employee: Delivery Method ❑ Normal Mail Date Postmarked: Employee: �aglStered Mail ['Hand Delivered Date Scanned: A& Employee: ❑ Electronically Filed // r' ❑ 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 -2100A -E) to make committee changes. CRO -1000 NC State Board of Elections August 2008 Detailed Summa Amendment �' ❑Yes ❑ No Use this form to summarize all disclosure reDorLinR forms and to total monetary information 1. CommitteeFullame an NOW e 12. Type o eportID a� S .en 35-d0. Start of Election Cycle: January 1, 0Z0 Total this Re orting Period Total this Election Cycle 4) Cash on Hand at Start $ 3 000, $ 3 000. 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 11b) Contributions from Not -For -Profit Organizations Ile) Outside Sources of Income 1Id) Legal Expense Fund -Other Sources Ile) Exempt Purchase Price Sales (CRO -1205) (CRO -1210) (CRO -1220) (CRO -l (CRO -1410) UniO (cao 1250) (CRO-1240)t$0 (CRO -1250) (CRO-1250)� (CRO -1270) (CRO -1265) $ $ $ 100' G0 $ 3 $ $ $ _ $ 7t7 $ $ $ $ 12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10,11 a.1Ib,I1c,1 I and l le) $ 100- EXPENDITURES 13) Disbursements 13a) Operating Expenditures foto 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 (CR04510) $ I 15$3.1/6 $ $ $ $ S $ $ $ $ $ $ $ $ 5 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ j$3.#7,6 S % S g, 19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18 $ 1 , N/ S 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 7) 48 -Hour Notice Reports Sum - (CRO -1330) (CRO -1430) (CRO -1610) (CRO -1626) (CRO -1720) (CRO -1710) (CRO -1440) (CRO -2220) $ $ $ $ $ $ $ $ $ $ $ 8) Contributions to be Refunded (CRO -1215) $ $ CRO -1100 NC State Board of Elections August 2009 Amendment Contributions from Individuals Pg / of I ❑ 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 ifpable) �-DqVk 5r-ko-vl?LL 2. ID Number 3. Contributor Information ❑ Add ❑ Remove . Full Name, Mailing Address & Phone (include city, state, & zip) // �Q fry Inc+"fowelr 02 30 -Rain+re e 12 / tM,?-/heG)s,W(, ag(c)y b. Job Title/Profession / rp ,/1 d. Comments c. Employer's Name/Specific Field Re+edVIV07'ej ttof ewe a Election sum to Date $ /00.0— r Prior g. Aceomtt Code h. Form of Payment 1. In -Kind Description . Date (mmlddlyyyy) k Amount ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove . Full Name, !hailing Address & Phone (include city, atate, & zip) . b. Job Title/Profession R t lEC d. Comments IVED e. Employer's Neme/S Md c. ElicI an Sum to Date $ r. frier ❑ g. Account Code h. Form of Payment 1. In -Kind Description j. Date (imddd/yyyy) k Amount $ ❑ $ ❑ S 3. Contributor Information ❑ Add ❑ Remove . Full Name, Mailing .Address & Phone (include city, state, & zip) b. Job Title/Profession it. Comments c. Employer's Name/Specinc Field e. Election Sum to Date $ .Prior ❑ g. Account Code h. Form of Payment I. In -Kind Description J. Date (mm/dd/yyyy) Is. Amount $ ❑ S ❑ S 4. Total only this Page S o, 5. Total of ALL CRO -1210 Pages (This line must bean line 6 of Detailed Summary Page CRO -7100) S V , CRO -/2/0 NC Siete Board of Elections April 2007 I Other Receipt Sources Pg of Amendmentp Y--- ❑ Na Use this form to report income not reported on another form. i.e. interest income, not for profit contributions etc. 1. Committee Full Name and Fund if applicable)2. �Q>r\ SC �. QV\V0'0� ID Number 3. Type of Receipt Source (Please use separate CRO -1250 forms for each type of Receipt Source.) hnerest ❑ Contribution, from Nnr-for-Profit Organizations ❑ Outside Sources of Income 4. Contributor Information Add ❑ Remove . Full Name, Mailing Address & Phone (include city, state, & zip) S icae E MCb�e e sr Cre dl 4 LAWN' 4? a ?6 l b. Not -for -Profit Federal ID # d. Comments c. Outside Source Explanation e. Election Sam to Date $ 0, I -r F. Account Code a. Form of Payment h. In -Kind Description - — - i. Date (mo✓dd/yyyy) J. Amount eQill1e ror;� a6-TVJ400 $ 0,01 /�� Fi �1 QXP��roni`C to-AV6-0a3 $ 4. Contributor Information Add Remove . Full Name, Mailing Address & Phone (include city, state, & zip) S`^�r nn LA.h y,�"S/ C�e(Jt 1UY1I,O� l t�A YrallU21j✓ (a 57.279 j,,, , )c a1761� b. Not-for-ProfitFederal ID # d. Comments "`D c. Outside Sourcejilaoation c. Election Sum to Date E. Account Code g. FormofPayment IL In -Kind Description 1. Date (mm/dd/yyyy) 1j. Amount $ Q,O% 1 QC C�fOJt1IL ��^ -o�� S 4. Contributor Information ❑ Add 0 Remove . Full Name, Mailing Address & Phone (include city, state, & zip) b. Not -for -Profit Federal ID # d. Comments c. Outside Source Explanation e. Election Sum to Date $ . Account Code g. Form of Payment h In -Kind Description 1. Date (mm/dd/yyyy) J. Amount $ $ 5. Total only this Page $ 0, r 6. Total of ALL CRO -1250 Pages (This line goes in line Ila of Detailed Summary Page CRO -1100 if Interest) (This line goes in line 11 b of Detailed Summary Page CRO -1100 if Not -for -Profit Contribution) This line mues in line I le of Detailed Sum mary Pare CRO -1100 if Oulside Sources of Income $ / D / CRO -1250 NC Slate Board of Elections December 2007 Disbursements Amendment Pg I of ❑ 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 (an a ca a um r p �av1 Sc(A 2 f Oka ) 3. Type of Disbursement (Please use separate CRO -1310 forms for each tune of Disbursement. ) O areiin Ex apses Contributions to Candidates/Politic:] Coininiuces Ll Coordinated Panv Expenditures 4. Payee Information E3 Add E3Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Coordinated Committee Name d. Comments S-�`�'^)Gr4t�.Qoyee CtfG t� rpV��� "7Federal f^�) a 7� I c. Level Registered (Specify) County: [3 State Municipality e.$'Iecam on to Date Su 3,00 . Account Code g. Form of Paym emt h. Purpose Code L Date (m mlddlyyyy) J. Amount 1k. Required Remarb 1 d fq d o ao at,a3 $ 1, °i vrrF e -e �p ✓a 4 D OS 10 11023 S1.'% ✓ti1oP6�{Q dee 4. Payee Information 0 Add ORemove . Full Name, Mailing Address & Phone (include city, state,& zip) b. Coordinated Commit>reee Name d. Comments U " t)� Slafc FmP'Qo m Cfc'"fUIli on / a �a /// RLZ+C-QI�- /V C c. Level Registered (s Federal Court y: 13 state ! ut�cipality: 8R-t,-p.�021 e. Election Sum to Date Cd;L3. oi� . Account Code g. Form of Payment h. Purpose Code i. Date (mmldd/yyyy) J. Amount L Required Remarks m 1 re,f-1--+ 0 09 i X23 $ MOO fes` —$ 4. Payee Information Add Remove a. Fug Name, Mailing Address & Phone (include city, state, & zip) j� V Xe Che le C k b. Coordinated Comn]ttee Name d. Conn lent, e. Level Registered (specify) Federal Ll County: ET State ❑ Municipality: isElection Sam to Date $ 50, V— . Account Code g. Form of Payment 1h. Purpose Code if. Dau own dly yy h. Amount IL Required Remarb 1 eb; C 5x023 $ 50- 0, S w r- GA"k5; 5 S. Total only this Page $ Jr , e9--- 6.Total of ALL CRO -1310 Pages ("Phis line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses) (This line goes in line 13h 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 Party Expenditures) $ 7. Purpose Codes (List detailed expenditure code in (h.) above) A* - Media II* - 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 ex lanation in required remarks field W CRO -1310 NC State Board of Elections December 2009 Amendment Disbursements Pg of ❑ Yes ❑ No Use this form to report expenditures from the committee for operating expenses, contributions to candidate/pohdcal committees and coordinated Darty expenditures Conmilittee Fuff Num (and Fund if applicable) 12. QA S CtAo,-L e w In Number 3. Type of Disbursement P e use se CRO -1310 forms for each e of Disbursem a O ,rano ; Expenses U Contributions to Candidates/Political Cumminces Q Coordinutui Parts Es tnditure+ Payee Information Add 0 Remove a. Ful l Nante. Mailing Address & Phone (include city, state, & zip) 1 f t Net (te ir' S4d vis I p O Q t_ I_U_ r J Bq ker �) f 1 "ti -4ane W Sr AIC � $ 1 O b. Coordinated Committee Name d. Comments c. Level Registered (Specify) CIFderal CYC..nty: ❑ State ❑ Municipality: e. Election Sum m 17 t It 766. G_Acmtmt Code I&FormotPaymest JILPurpnCode it. Date (mntfddt"yy) . Amount 116 Required Remarks 0�2 a o8 os aoaj $ 883.'6 ��„ ; H st' vls 11 De hit 1 0 o s A a Oa3 $ 583. -YS -IV 4. Payee Information 0 Add 0 Remove . Full Name, Mailing Address & Phone (Include cit), state, && zip) b. Coordinated Committee Name ..Comment. - -- / t. o ✓1 '31l 1Yt�1ah �i�'/p2� kU w� li r � c Level Registered(Specify)/ Federal U County: ❑ Smte ❑Municipality: e.$ lection Sum to Date 057 6 Y f. Account Code g. Form of Payment JIL Purpose Code IL Date (mmld&yyyy) U. Amount IL Required Remarks ®® Debit 1 0 O 02,; $ 6 .°f— F)5"vie55 COA s I'd $ 4. Payee information Add Remove a. Full Name, MniBng Address & Phone (include city, state, & zip) b. Coordinated Committee Name d. Comments - - c. Level Registered (Specib) Federal 13 County: ❑ State ❑ Municipality: e. Election Sum to Date $ . Account Code g. Form of Payment 111. Purpose Code L Date (mmlddlyyyy) Amount L Required Remarks $ 5 5. Total only this Page S 53Q, 7 6. Total of ALL CRO -1310 Pages (This fine goes in line 13a of Derailed Summary Page CRO -1100 if Operating Expenses) (This line goes in line 13b of Detailed Summary Page CRO -1100 if Contfib to Candidates/Political Comm) (This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures) S 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 Postuge J - Penalties K* - Office Expenses Q* . Donation to Legal Expense Fund O* Other * Codes re vire detailed ex lanation in required remarks field W CRO -1310 NC State Board of Elections December 2009