Simpson,Anne_2023-35-Day-Amended-pgsAmendment
Disclosure Report Cover I N 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
Anne M. Simpson for Commisioner
LJMJOX
b. Mailing Address (include City, State and Zip Code)
it. Date Filed
2517 Trading Ford Dr
Warshaw NC 28173
9/29/2023
e. Phone Number
704-256-4976
2. Report Year
3. Period Start Date (mm/dd/yy)
. Period End Date
5. Treasurer Full Name
2023
07/07/2023
09/26/2023
Anne Marie Simpson
6. Type of Committee (Check One)
9. Type of Report
check only one tvpe of report on; one category)
N Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ Organizational
❑ Organizational
[j Organizational
❑ PAC ❑ Referendum
Independent Joint Fundraiser
El Expenditure
Thirty-five day y
Quarterly❑
Pre -referendum
Legal Expense Fund
❑ Pre-primary
❑ Pre-election
❑ First
❑ Second
❑ Final
❑ Supplemental Final
7. Type of Fund (if applicable, check oma)
❑ "Booster Fund"
❑ Building Fund
❑ Pre -runoff
❑ Third
❑ Annual
Semi-annual
❑ Fourth
❑ Special
❑ Mid Year
Semi-annual
❑ Other.
❑ Yew End
❑ Mid Year
10. Special Report Name
❑ Final
❑ Special
❑ Yew End
❑ Final
❑ Special
8. Number of Fundraisers this Report
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
Wells Fargo
N COU
b. Purpose
c.Account Code
b.Purpose MPAFGN
e. Account Code
Campaign
Finance
4 WX W
OCT 11 2023
d. Period Begin Balance
d. Period Begin Balance
Activities
S 2000.00
RECEIVED
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
Anne Marie Simpson
B ard of Elections. /Q /
<9/24fZ02
Printed Name of Signer Signature
of AppojItted Treasurer Date
FOR OFFICE USE ONLY
Date Received: Employee:
Delivery Method
❑ Normal Mail
Date Postmarked: Employee:
Date Scanned: Employee:
Registered Mail
Hand Delivered
E] 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.
You must amend the Statement of Organization
CRO -2I OOA-E to make committee changes.
CRO -1000 NC State Bound of Elections August 2008