Simpson,Anne_2023-Pre-election' "v `' v `Lj Amendment
Disclosure Report Cover �� ail i I ❑ Yea ® No
Use this form for general report and committee information, must b e Itted 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)
d. Date Filed
2517 Trading Ford Dr
Waxhaw NC 28173
10/25/2023
e. Phone Number
704-2564976
2. Report Year
3. Period Start Date (mm/dd/yy)
4. Period End Date
5. Treasurer Full Name
(mm/dd/yy)
Anne Marie Simpson
2023
09/27/2023
10/23/2023
6. Type of Committee (Check One)
9. Type
of Re rt check only
one type of report om one tate o
® Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑
Organizational
❑ Organizational
❑ Organizational
Independent Joint FundraiserThi
El Expenditure ❑
❑
five
ny- day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑
®
Pre-primary,
Pre<lection
❑ First
❑ Second
❑ Final
❑ Supplemental Final
7. Type of Fund (iJnpplicable, check ow)
❑ "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
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
4 WX W
Finance
d. Period Begin Balance
d. Period Begin Balance
Activities
$ 140.80
$
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 1 have been trained by the NC S e B and of Elections.
Anne Marie Simpson
10/25/2023
Printed Name of Signer
Si re of Appointed Treasurer
Date
FOR OFFICE USE ONLY
Date Received: Ifr013
Employee: C /YIQ(jYL
Delivery Method
❑ Normal Mail
Registered Mail
Date Postmarked:
Employee:
Hand Delivered
Electronically Filed
Date Scanned:
Employee:
❑ Signer has not received
mandatory training
Date Data Entered:
Employee:
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
Amendment
Detailed Summary OCT 2 5 M3 ❑ Yes ® No
Use this form to summarize all disclosure reoortinp forms and to total monetary information.
L Committee Full Name (and Fund if applicable) 2. Type
oANW"-
b0afa
Ot LIM onS
3. H) Number
Anne M. Simpson for Commissioner Pre election
LJMJOX
Start of Election Cycle: January 1, 2023
Total this
Reporting Period
Total his
cle
Election Cycle
Cy
4) Cash on Hand at Start
111RIPTS
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
lld) Legal Expense Fund — Other Sources
11 e) Exempt Purchase Price Sales
(CRO -1205)
(CRO.1110)
(CR&1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1165)
$
140.80
$
2000.00
$ $
$ $
5.00
$ $
$ $
$ $
2000.00
$ $
$ $
$ $
$ $
$ $
$ $
12)
13)
14)
15)
16)
17)
TOTAL RECEIPTS (Add lines 5, 6, 7.8, 9, 10, Ila, rlb. tic, IIdand Ile)
Disbursements
13a) Operating Expenditures (CRO -1310)
13b) Contributions to Candidates/Political Committees (CRO -1310)
13c) Coordinated Party Expenditures (CRO -1310)
Aggregated Non -Media Expenditures (CRO -1315)
Loan Repayments (CRO -1420)
Refunds/Reimbursements From the Committee (CRO -1320)
In -Kind Contributions (CRO -1510)
$
$
2005.00
$ 54.99 $
1914.19
$ $
$ $
$ $
$ $
$ $
$ $
5.00
18)
TOTAL EXPENDITURES (Add lines 13n, rib, 13c, 14,15, 16 and 17)
$
54.99
$
1919.19
19) Cash onHandatEndl:Idd11m,,4 and 12together, then mleractllnel8)
AD AERAL INFOO
$
85.81
$
85.81
20)
21)
22)
23)
24)
25)
26)
27)
28)
Non -Monetary Gifts Given to Other Committees
Outstanding Loans (incl. ones from other campaigns)
Debts and Obligations owed By the Committee
Debts and Obligations owed To the Committee
Account Transfers Within the Committee
Administrative Support
Forgiven Loans
48 -Hour Notice Reports Sum
Contributions to be Refunded
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRO -1620)
(CRP -1720)
(CRO -1710)
(CRO -1440)
(CRO -2120)
(CRO -1215)
$
$
$
$
$
$
2000.00
$
$ $
$ $
$ $
CRO -1100 NC State Board of Elections August 2008
•�va�r V `L—,,
Amendment
Disbursements OCT 2 5 2W Pg 1 of i ❑ Yes
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) 72—ID Number
Anne M. Simpson for Commissioner I LJMJOX
3. Type of Disbursement Please use separate CRO -1310 forms for each type of Dlsbarsemm
_
® Operating Ispenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information Z Add Ej Remove
a. Full Name, Mailing Address & Phone
Include city, smtc, & zip)
It. Coordinated Committee Name
d. Comments
e. Election Sum to Date
$ 94.99
Meta Ads
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ state ® Municipality:
L Account Code
g. Form of Payment
Is. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
4WXW
Debit
A
09/30/2023
$19.99
Post Boost
4WXW
Debit
A
10/14/2023
$25.00
Post Boost
4. Payee Information Add IJ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
it. Comments
Wells Fargo
5926 Weddington Monroe Rd
Wesley Chapel N 28104
e. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 10.00
L Account Code
g. Form of Payment
h. Purpose Code
L Date (mm/ddlyyyy)
j. Amount
K Required Remarks
4WXW
Draft
H
09/29/2023
$10.00
Service Fee
$
4. Payee Information Add Remove
a. Full Name, Mailing Address & Phone
include city, state, & ri
b. Coordinated Committee Name
d. Comments
c. Level Registered (Specify)
❑ Federal ❑ County
❑ State ❑ Municipality:
e. Election Sum to Date
L Account Code
g. Form of Payment
Is. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k Required Remarks
5. Total only this Pae
$ 54.99
6. Total of ALL CRO -1310 Pages
(This fine goes in line 13a of Detailed Summ a" Page CRO -1100 if Operating Erpenses)54.99
(This fine goes in fine 136 of Demiled Summary Page CRO -1100 if Conrrib to CandidatdPofitica/ Comm#
(This fine goes in Gee 13e of DetalledSummuny Page CRO -1100 if Coordinated Party Ecpendimra)
$
7. Purpose Codes(List detailed expenditure code in above
A* - Media B* - Printing C* - Fundraising D - To Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
1 - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field k
CRO -1310 NC State Board of Elections December 2009
n LZ l-,, C I V C l_ Amendment
Outstanding Loans OCT 2 5 2023 It I of ' ❑ ves ® No
Use this form to report any outstanding loans received during a previous reporting period and until the loan is paid in full.
1. Committee Full Name and Fund if applicable) ull'u" UO. 130ard of Election.2. ID Number
Anne M. Simpson for Commissioner LJMJOX
3. Lender Information ® Add ❑ Remove
e. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
Registered Nurse
Anne M. Simpson
2517 Trading Ford Dr.
Waxhaw NC 28173
e. Start Bate (mm/dd/yyyy)
e. Employer's NamelSpecific Field
07/05/2023
Novant Health
E End Date (mm/dd/yyyy)
g. Rate
Is. Security Pledged
i. Original Loan Amount
J. Remaining Loan Balance
0 %
$ 2000.00
$ 2000.00
L Fail Name of Lending Institution
I. Lona Number
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include City, smtq & Yip)
b. Job Title/Profession
d. Comments
e. Start Date (mm/dd/yyyy)
c. Employer's Name/Specific Field
E End Date (mm/ddlyyyy)
g. Rate
lo Security Pledged
i. Original Loan Amount
j. Remaining Loan Balance
$
$
L Fall Name of lending Institution
L Loan Number
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job litie/Profession
d. Comments
e Start Date (mm/ddlyyyy)
e. Employer's Name/Specific Field
E End Date (mm/dd/yyyy)
g. Rate
Is. Security Pledged
i. Original Loan Amount
J. Remaining Loan Balance
$
$
L Full Name of lending Institution
I. Loco Number
4. Total only this Pae S 2000.00
5. Total of ALL CRO -1430 Pages $ 2000.00
(This fine must be on fine 21 of Detailed Summary Page CRO -1100)
CRO -1430 NC State Board of Elections December 2007