Simpson,Anne_2023-Year-endC�j�O `/ LSU Amendment
Disclosure Report Cover I ❑ Yes ® No
Use this form for general report and committee informs on, m,"cliona4d su itted along with other detailed forms.
Do not use this form to update information
1. Committee Information
union Co.
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
e. Phone Number
704-296-8052
2. Report Year
3. Period Start Date (mm/dd/yy)
4. Period End Date
mm/ddt
5. Treasurer Full Name
202;
10,'24.202;
12/31/2023
Anne Marie Simpson
6. Type of Committee Check One
9. Type
of Report check only
one type of report
om one category)
® Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑
Organizations]
❑ Orgam7urtional
❑ Organizational
Independent Joint Fundraiser
El Expenditure E]❑
Thirty-five da
m'- Y
Quarterly
E] Pre -referendum
❑ Legal Expense Fund
❑
❑
Pre-primmy
Preclection
❑ First
❑ Second
❑ Final
❑ Supplemental Final
7. Type of Fund (of applicable, check one)
❑ "Booster fund"
❑ Building Fund
❑
Pre -runoff
❑ Third
❑ Am"
Semi-annual
❑ Fourth
❑ Special
❑
Mid Year
Semi -mutual
❑ 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
e. Account Code
b. Purpose
a Account Code
Campaign
Finance
4 WX W
d. Period Begin Balance
d. Period Begin Balance
Activities
$ 85.81
$
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 prohibi or other non -disclosed funds. 1
t
fu er certify that this report is
complete, true and correct and that 1 have been trained by the NC State bard f lecfpanS.
Anne Marie Simpson ((((////���� (,
Printed Name of Signer
Signature of Appointed Treasurer
Date
FOR OFFICE USE ONLY
Date Received: - ��
Employee: Delivery Method
❑ Normal Mail
Date Postmarked:
Date Scanned:
Employee: ❑ ,Registered Mail
E Hand Delivered
Employee: F] 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 Board of Elections August 2008
Amendment
Detailed Summary ❑ Yes- - ®__ No
Use this form to summarize all disclosure reporting forms and to total monetary information.
1. Committee Full Name and'Fund if a licable 2. T
e of Re ort
3. ED Number
Anne M. Simpson for Commissioner Year End
LJMJOX
Start of Election Cycle: January 1, 2023
Total this
Re ortin Period
Total this
Election Cycle
4) Cash on Hand at Start
$
85.81
$
2192.00
_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
llc) Outside Sources of Income
lld) Legal Expense Fund — Other Sources
11 e) Exempt Purchase Price Sales
(CR04205)
(CRO -1210)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CR0.1250)
(CRO -1270)
(CRO -1265)
$
$
$ 100.00
$
100.00
$
$
$
$
$
$
2000.00
$
$
$
$
$
$
$
$
$
$
$
$
12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10, Ila, lib, llc, lldand Ile)
$
100.00
$
2100.00
EXPENDITURES
13) Disbursements
13a) Operating Expenditures
,13b) Contributions to Candidates/Political Committees
13c) Coordinated Party Expenditures
14) Aggregated Non -Media Expenditures
15) Loan Repayments
16) Refunds/Reimbursements From the Committee
17) In -Kind Contributions
(CRO -1310)
(CRO -1310)
(CRO -1310)
(CRO -1315)
(CRO -1420)
(CRO -1320)
(CRO -1510)
$ 184.99
$
2099.18
$
$
$
$
$
$
$
$
$
$
$ 87.00
$
92.00
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14,15,16 and 17)
$
271.99
$
2191.18
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18)
$
0.82
$
0.82
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)
$
$ 2000.00
$
$
$
$
$
$
$
$
$
$
$
CRO -1100 NC State Board of Elections August 2008
I Amendment
Disbursements Pg 1 of 2 L❑ Yes ® No
Use this form to report expenditures from the committee for; operating: expenses, contributions to candidate/political
committees and coordinated nartv ex enditures.
I. Committee Full Name and Fund if applicable) 2. ID Number
Anne M. Simpson for Commissioner LJMJOX
3. Type of Disbursement Please use separate CRO -1310 orna for each type of Disbursement
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Pa eeInformation 0 Add ❑ Remove
a. Full Name, Mailing Address'& Phone _` `_
include city, state & zi
b: Coordinated,Committee Name _'.>
d. Comments `
Meta Ads
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
' e. Election Sum to11ate
$ 249.98
`-h.
f. Account Code
g: FarmofPaymeut
Purpose Code,.
P .
i. Date'
(mm/dd/yyyy)
j.Amount',_kRequired
Remarks;'
4WXW
Debit
A
10/25/2023
$35.00
Post Boost
4WXW
Debit
A
10/31/2023
$32.63
Post Boost
4. Payee Information Add El Remove
"a. Full Name, Mailing,Addr7s & Phone -
include'ci , state, & zi
b. Coordinated, Committee Name ' ?` "
'd. Comments
Meta Ads
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ Stam ® Municipality:
a Election Sam to Date
$ 249.98
'f. Account Code
g. Form ofPayment,
h: Purpose.Code
1, Date (mm/ddtyyyy)
J. Amount ` , "
• k Required Remarks'
4WXW
Debit
A
11/03/2023
$35.00
Post Boost
4WXW
Debit
A
11/07/2023
$50.00
Post Boost
4. Payee Information Add ❑ Remove
a. Full Name, Mailing Address'& Phone " -
include city, state, -& zip)'
' b.Coordinated Committee Name `-^'
-d. Comments - ^
Meta Ads
e. Level Registered (Specify): _
❑ Federal ❑ County:
❑ State ® Municipality:
' e; Election Sum to Date
$ 249.98
f. Account Code -
g. Form of Payment
'h. Purpose. Code'
i. Dole,(mm/dd/yyyy)' _
j. Amouk t..
k Required Remarks •'
4WXW
Debit
A
11/31/2023
$2.36
Post Boost
$
5. Total only this
Pae �'
$ 154.99
6. Total' of ALL CRO-1310�Pages
$ 184.99
(This line goer in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses)
(This Rnegoes in line 13b of Detailed Summary Page CRO -1100 ifContrib to CandidatevPolitical Contra)
(This lingoes in tine 13c ofDelailed Summary Page CRO -1100 ifCoordinatedPany Fapendimrev)
7. Purpose Codes(List detailed expenditure code in h. above
A* -Media _'_N_-, B* -Printing _ _;�C*„Fundraising °., .` ,,._.,_ D- To Another Candidate
E Salaries_ . F_# ;Equipment ' ` G - Pohucal Party _ H* -Holding Public Office Expenses .- -
I - Postage enalties 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 December2009
' Amendment
Disbursements Pg 2 of 2 L❑ 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
Anne M. Simpson for Commissioner LJMJOX
3. Type of Disbursement lease use separate CRO -1310 forim for each type,of Disbursement.
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information Z Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, &'zi
b. Coordinated Committee Name '-
d. Comments
Wells Fargo
5926 Weddington Monroe Rd
Wesley Chapel N 28104
c. Level Registered (Specify) ...
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 40.00
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date.(mmldd/yyyy)
j. Amount
k. Required Remarks
$
4WXW
Draft
H
10/31/2023
$10.00
Service Fee
4. Payee Information ® Add ❑ Remove
a. Full Name, Mailing Address & Phone''
include city, stat & A
b. Coordinated Committee Name
it. Comments •. '
Wells Fargo
5926 Weddington Monroe Rd
Wesley Chapel N 28104
c Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 40.00
f. Account Code
g. Form of Payment
It. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount ,
k. Required Remarks
4WXW
Draft
H
11/30/2023
$10.00
Service Fee
4WXW
Draft
H
12/31/2023
$10.00
Service Fee
4. Payee Information El Add .❑ Remove
a. Full Name, Mailing Address & Phone
include city, stat & zip) `
b. Coordinated Committee Name -
d. Comments
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 30.00
C Account Code
g. Form of Payment
h. Purpose. Code
i. Date (mm/dd/yyyy)
j. Amount
it. Required Remarks
$
5. Total only this Pae
$ 30.00
6. Total of ALL CRO -1310 Pages
$ 184.99
(This line goer in line Hir of Detailed Summary Page CRO -1100 if Operating Expenses)
(This line goes inline Iib ofDetafledSummary Page CRO -1100 if Contrib to Candidate&Tolidcal Comm)
(This ffnegoes in line 13e of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures)
7. Purpose Codes(List detailed expenditure code in h. above
A* - Media____ G _ _ B* - Printing '_ C* - Fundraising - _ _ D - To Another Candidate
E - _ Sas _ _ F* - Equipment - Political Party _ R* -:Holding Public Office Expenses
larie.
I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
- Other
_O*
* Codes require detailed explanation in required remarks field (k)
CRO -1310 NC State Board of Elections December 2009
Outstanding Loans pg , of > Amendment
❑ Yes ® Na
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) 2. fl) Number
Anne M. Simpson for Commissioner LJMJOX
3..Lender Information ® Add ❑ Remove
,a. Full Name, Mailing Address & Phone.. '. " ,
(include city, state &zip)= . "': - _ ::
b. Jab Title/Profession �; `- „"
d. Comments
Registered Nurse
Anne M. Simpson
2517 Trading Ford Dr.
Waxhaw NC 28173
e. Start Date (mm/ddiyyyy)
c. Employer's Name/SpecnicField
07/05/2023
Novant Health
L Sud Date (mm/dd/yyyy)°^
g. Rate,-
- h. Security Pledged
1. Original Loan Amount
bj. Rcmaining Loan Balance
0 %
$ 2000.00
$ 2000.00
IL Full Name ofLending jnstitudon"-' - _`- r, " *` ' .. . `..
I. Loan Number
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address &:Phone - .,.
(include city, state, & zip)
b. Job Title/Professiou .,
`&comments
.'. e.. Start Date(mm/dd/yyyy) `
c. Employer's Name/Specific Field "
v f End Date (mmldd/yyyy)
g' --Rate, ,, .,,. ',
h. Security Pledged
'i. Original EoanAmount :, -
1j. Remaining Loan"_Balance-_
%
$
$
k. Full Name of Lending Institution " " _ ' , < .
I: Loan Number
3. Lender Information ^ ` ❑ Add ❑ Remove
a. -Full Name, Mailing Address & Phone' ,r
,(include city,: state, & zip)',-r,d
b_. Job Title/Professiom ".
= d. Comments
{e. Start Date (mmldd/yyyy)
e. Employer's Name/Specific Field "7
;f f.. End Date.(mm/dd/yyyy)• .'
g. Rate h. Seen try
i. Original Loan Amount
, j.=Remaining Loan Balance %
%
$
$
k. Full Name ofUnding Institution,' <:. .' - - _`
I.Loan Ntmber
'.4. Totat only this Pae
$ 2000.00
5. Total of ALL CRO -1430 Pages
_ (This line rust be on Line 21 ofDetaffedSunmmry Page CRO -1100)
$ 2000.00
CRO -1430 NC State Board of Elections December 2007
Ameodme a
Contributions from Individuals Pg I of 1 Yes ® Na
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
Anne M. Simpson for Commissioner
LJMJOX
-
1 Contributor Information ® Add ❑' Remove
a. Fuli Name, Mailing Address & Phone . - ;
(include city; state; &.zip)' _ - ' •`
b. Job Title/Profession <' , '"
' d: Comments , ' ° ' • '
RN
Filing Fee
Anne M. Simpson
2517 Trading Ford Dr
Waxhaw NC 28173
c. -Employees Name/Specitie Field
Novant Health
`e. Election Sum to Date
$ 192.00
G Prior.g.
Account Code;,-
k. Form of Payment„ �,
i. In lend Description 1, V, `
j. Date (mm/dd/yyyy)
k. Amount,,-' ` - -'
❑
4WXW
Draft
Operating Esp
11/02/2023
$ 100.00
❑
Cash
Filing Fee
12/14/2023
$ 87.00
❑
$
3. Contributor Information ❑ Add ❑ Remove
'a. Full Name,Mailing Address&Phone ;'. -
(include city, state, & zip)'-,
'b. Job. Title/Profession ..,'e"".°
d. Comments
' c.Employei's Name/SpecifieField'
e. Election Sum to Date
$
'.E'Prior ".
'g. Account Code `
-h. Form ofPayment ,
i. In=Kind Description" , -
j. Date (mm/dd/yyyy) .„ -
k. Amount _
❑
$
0
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing'Address & Phone. c ' ` r', ,' -�.
(include city, state,&zip)
b. Job Title/Profession
8. Comments
c. Employer's Name/Specific Field
_.. ...
e..Election Sum to Date,"',
K Prion
g. Account Code <
= h. Form of Payment'.
L In -Kind Description
j. Date (mm/dd/yyyy),
k. Amount
❑
$
❑
$
❑
$
4. Total
only this Page
$ 187.00
5. Total of ALL CRO -1210 Pages.
„ (Tbis line most be online 6 of Detailed Sum rimy. PageCRO-1100) '
$ - 187.00
CRO -1210 NC State Board of Elections April 2007
Amendment
In -Kind Contributions Pg t of t _❑ Yes E___No
Use this form to report non -monetary contributions, donations, goods or services provided to the committee or fund.
Use CRO -1215 if In -Kind Contributions were or will be refunded within 7 days.
1. Committee F61INaini grid-Fuud"if a' lica'ble - "..- -" "--"
Anne M. Simpson for Commissioner LJMJOX
3. Contributor Information Add - Remove
a. Full Name, Mailing Address & Phone
(include city, state, &zip)
b. Type of Contributor
c. Comments
❑ Individual
® Candidate
❑ Parry
❑ PAC
❑ Referendum
❑ Other Receipt Source
Operating Exp
UC Filing Fee
Anne M. Simpson
2517 Trading Ford Dr
Waxhaw NC 28173
d. Election Sum to Date
$ 92.00
e Description
I. Date(mm/dd/yyyy)
g. Fair Market Amount
$
Filing Fee Union County BOC
12/14/2023
$ 87.00
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, &zip)
b. Type of Contributor
c. Comments
❑ Individual
❑ Candidate
❑ Party
❑ PAC
❑ Referendum
❑ Other Receipt Source
d. Election Sum to Date
$
e. Description
f. Date (mm/dd/yyyy)
g. Fair Market Amount
$
$
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Type of Contributor
c. Comments
❑ Individual
❑ Candidate
❑ Ply
❑ PAC
❑ Referendum
❑ Other Receipt Source
d. Election Sum to Date
$
e. Description
f. Date (mm/ddlyyyy)
g. Fair Market Amount
$
$
4. Total only this Pae $ 87.00
5. Total of ALL CRO -1510 Pages
(This fine must be on fine 17 ojDetaitedSummary Page CRO -1100) $ 87.00
CRO -1510 NC State Board of Elections December 2007
Amendment
Contributions from Individuals Pg t of I ❑ ves ® 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 ifapplicable)
2. ID Number
Anne M. Simpson for Commissioner
LIMJOX
3. Contributor Information ® Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, stats & rip)
b. Job Thle/Profession
d. Comments
RN
Filing Fee
Anne M. Simpson
2517 Trading Ford Dr
Waxhaw NC 28173
c. Employer's Name/Specific Field
Novant Health
e. Election Sam to Date
$ 100.00
E Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/ddlyyyy)
k Amount
❑
4WXW
Draft
Operating Esp
11/02/2023
$ 100.00
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Namq Mailing Addrm & Phone
(include city, state. & rip)
b. Job Tide/Profession
d. Comments
c. Employer's Name/Specific Field
e. Election Sam to Date
E Prior
g. Account Code
it. Form of Payment
i. la -Mad Description
j. Date (mm/dd/yyyy)
Y. Amount
❑
$
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & rip)
b. Job Title/Profession
d.Comments
c. Employer's Name/Specific Field
e. Election Som to Date
E Prior
g. Account Cade
It. Form of Payment
i. la -Mad Description
J. Date (mm/ddlyyyy)
L Amount
❑
$
❑
$
❑
$
4. Total only this Page $ 100.00
5. Total of ALL CRO -1210 Pages
$ 100.00
(This line now be on fine 6 of DefaUed Summary Page CRO -1100)
CRO -1210 NC State Board of Elections April 2007