Simpson,Anne_2024-1st-QtrAmendment
Disclosure Report Cover ❑ ves ® 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
LIMJOX
b. Malang Address (include City, State and 21p 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 Datey> mm/
5. Treasurer Full Name
2024
01/01/2024
02/17/2024
Anne Marie Simpson
6. Type of Committee (Check One
9. Type
of Report check only one type o re ort om one cote o
® Candidate Campaign ❑ Party
Municipal
Statelcounty
Referendum
❑ PAC ❑ Referendum
❑
Organizational
❑ Organizational
❑ Organizational
Independent
❑ Expenditure E]Joint Fundraiser
E]
Thirty-five day
Quarterly
E]Pre-referendum
❑ Legal Expense Fund
❑
❑
Pre-primary
Pre-election
® First
❑ Second
❑ Final
❑ Supplemental Final
7. Type of Fund (if applicable, check ora)
❑ '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
& Number of Fundraisers this Report
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
Wells Fargo
uNi
b. Purpose
c. Account Code
CAMEFljiifdrjid✓<p'"
-''
c. Account Code
Campaign
Finance
4 W X W
F1
g 2 6 2024
d. Period Begin Balance
d. Period Begin Balance
Activities
ESV Ea
S 0.82 R
$
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 NCS a oard ofElections.
11 ,
Anne Marie Simpson
212 G y`
Printed Name of Signer
Sigliature of Appointed Treasurer
Date
FOR OFFICE USE ONLY /
Date Received: i0 ci`I
Employee:
14
Delivery Method
❑ Normal Mail
Date Postmarked:
Employee:
Registered Mail
Hand Delivered
Date Scanned: 3 02
Employee:
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 -2 100A -E) to make committee changes.
CRO -1000 NC State Board of Elections August 2008
Amendment
Detailed Summary ® Yes p No
I Ise this form to summarize all disclosure renortina forms and to total monetary information.
1. Committee Full Name and Fund ita licable
2. Type
of Report
3. ID Number
Anne M. Simpson for Commissioner
I" Quarter
LJMJOX
Start of Election Cycle: January 1, 2024
Total this
Reporting Period
Total this
Election Cycle
4) Cash on Hand at Start
$
$
0.82
S
$
2000
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
I la) Interest on Bank Accounts
I1b) 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 -1170)
(CRO -1110)
(CRO -1130)
(CRO -1410)
(CRO -1240)
(CRO -1150)
(CRO -1250)
(CRO -1150)
(CRO -1270)
(CRO -1165)
$
326.59
$
518.59
$ $
$ $
$ $
2000.00
S $
$ $
S $
$ $
$ $
$ $
12) TOTAL RECEIPTS (Add lines 5, 6, 7.8.9, lo, lla, Ilb. Ile. lldandIle)
S
326.59
$
2518.59
T;XP'
13) Disbursements
l3a) 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 -1370)
(CRO -1310)
(CRO -1315)
(CRO -7410)
(CRO -1320)
(CRO1510)
$
53.55
$
2152.73
S $
$ S
$ $
$ $
$ $
$ 46.00 S
138.00
18) TOTAL EXPENDITURES (Add Imes 13a, 13b, 13c, 14, 15, 16 and 17)
S
99.55
S
2290.73
19) Cash on Hand at End (4ddlims 4mtd 11 together, thensubiract line 18)
$
227.86
$
227.86
`°
ADDITIONAL INFO''
.. 1.
20) Non -Monetary Gifts Given to Other Committees
21) Outstanding Loans (incl. ones from other campaigns)
22) Debts and Obligations owed By the C�mfale'' "' '
orAIC; N FINANC,c
23) Debts and Obligations owed To the't olmmittee
24) Account Transfers Within the Commft6� 2 6 2 24
25) Administrative Support RECEIVED
26) Forgiven Loans
27) 48 -Hour Notice Reports Sum
28) Contributions to be Refunded
(CRO -1330)
(CRO -1430)
(CRO -1670)
(CRO -1620)
(CRO -1710)
(CRO.171o)
(CRO -7440)
(CRO -2220)
(CRO -1215)
S
$
$
$
S
2000.00
1
$ $
$ $
$ $
$ $
CRO -1100 NC State Board of Elections Auger 2008
Amendment
Contributions from Individuals Pg I 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 if applicable)
2. ID Number
Anne M. Simpson for Conunissioner
LJMJOX
3. Contributor Information ® Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, stale, & zip)
b. Job Title/Profession
d. Comments
RN
Website hosting
e. Election Sum to Date
Anne M. Simpson
2517 Trading Ford Dr
Waxhaw NC 28173
704-296-8052
c. Employer's Name/Specific Field
Novant Health
$ 238.00
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
L Amount
Debit
Website
01/07/2024
$ 23.00
Lftiw
Debit
Website
02/07/2024
$ 23.00
ibutor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Tine/Profession
d. Comments
e. Election Som to Date
$ 20.00
Brand Field Person
Gina Palandri
1023 Feather Oak Lane
Stallings NC 28104
612-296-5356
c. Employer's Name/Specific Field
Primal Pet Foods
f. Prior
g. Account Cale
IT. Form of Payment
i. be -Kind Description
j. Date (mm/dd/yyyy)
L Amount
❑
4WXW
Credit
donation
01/07/2024
$ 7o oo
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, stat&zip) UNION COUNTY
4
b. Job Title/Prafession
d. Comments
Civil Engineer
James Kelly IT
3039 Hornell Place FEB 2 6 M`i
Charlotte NC 28270
980-365-0425 RECEIVED
c. Employer's Name/Specific Field
Town of Waxhaw
e. Election Sum to Date
$ 260.59
f. Prior
g. Account Code
It. Form of Payment
L In -Kind Deaeription
j. Date (mm/dd/yyyy)
le. Amount
❑
4WXW
Credit
donation
1/24/2024
$ 260.59
❑
$
❑
$
4. Total only this Page $ 326.59
5. Total of ALL CRO -1210 Pages
$ 326.59
(This fine new be on fine 6 of Detailed Summary Poste CRD -1100)
CRO -1210 Vl State Board otL lecbnn, April 2007
Amendment
Disbursements Pg 1 of 1 ❑ 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 I LJMJOX
3. Type of Disbursement Please use se arale CRO -1310 fortits for each type o Disbursement
® (operating I xpenses ❑ Coninbulions to( anddate0lobtical Committees ❑ Coordinated Part, Expenditures
4. Payee Information Add 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
C. Level Registered (Specify)
❑ Federal ® County:
❑ state ❑ Municipality:
e. Election Sum to Date
$ 50.00
E Account Code I
g. Form of Payment
h. Purpose Code
L Date (mmtddlyyyy)
j. Amount
K Required Remarks
4WXW
Draft
H
1/31/2024
$10.00
Service Fee
$
4. Payee Information Add Remove
a. Full Name, Mailing Address & Phone
include city, state & ti
b. Coordinated Committee Name
it. Comments
Stripes
354 Oyster Pint Blvd
South San Fransico CA 94080
a Level Registered (Specify)
❑ Federal ® County.
❑ State ❑ Municipality:
e. Election Som to Date
$ 13.65
L Account Cook
g. Form of Payment
Is. Purpose Code
i. Date (mmlddlyyyy)
j. Amount
k. Required Remarks
4WXW
Draft
H
01/08/2024
$1,23
Service Fee
4WXW
Draft
H
01/25/2024
$12.42
Service Fee
4. Payee Information Add Remove
a. Full Name, flailing Address & Phone
include city, state,&a 0UN11
b. Coordinated Committee Name
d. Comments
Meta Ads Hh,IpgIGNFI
FEB Z U 2024
C
RECEIVE
a t.evd Registered (Specify)
❑ Federal ® County:
ElState ElMunicipality:
e. Elation Sum to Date _
$ 279.88
E Account Code
g. Form of Payment
k. PurPoae Code
i. Date (mm/ddlyyyy)
j. Amount
k. Required Remarks
4WXW
Debit
A
02/01/2024
$29.90
Post Boost
5. Total only this Pae
$ 53.55
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Summa" Page CRO -1100 if Operating Expenses)
(This line goes in line 136 of Detailed Sumnmy Page CRO -1100 if Contrib to Candidates/Polifieal Conn
(This line goes in line Be of Detailed Sumnnq• Page CRO -1100 if Coordinated Party Expenditures)
$ 53.55
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
I - 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
Amendment
In -Kind Contributions Pg 1 of 1 ❑ Yes ® No
Use this form to report non -monetary contributions, donations, goods or services provided to the committee or fund.
Use CRU -121 _� It In -r ma COntriDutic
1. Committee Full Name (and Fund
Anne M. Simpson for Commissioner
3. Contributor Information
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
Anne M. Simpson
2517 Trading Ford Dr
Waxhaw NC 28173
704-296-8052
c. Description
Square Space website
Square Space website
a. Full Name, Mailing Address & Phone
(include city, stale, & zip)
I e.
a. Full Name, Mailing Address & Phone
(include city, state, & zip) , u.ttflN C
FEB 2 6 2024
RECEIVED
I e.
4. Total only this Page
5. Total of ALL CRO -1510 Pages
(This line must he on hne 17ofDelailed
wimm r
b. Type of Contributor
❑
Individual
®
Candidate
❑
Party
❑
PAC
❑
Referendum
❑
Other Receipt Source
E Date (mm/d,
01/07/2024
02/07/2024
b. Type of Contributor
❑
Individual
❑
Candidate
❑
Ply
❑
PAC
❑
Referendum
❑
Other Receipt Source
L Disk (mm/dt
b. Type of Contributor
❑
Individual
❑
Candidate
❑
Party
❑
PAC
❑
Referendum
❑
Other Receipt Source
L Date tmm/dr
LJMJOX
c. Comments
Operating Exp
Website hosting
d. Election Sum to Date
$ 138.00
q g. Fair Market Amount
$ 23.00
$ 23.00
c. Comments
d. Election Sum to tate
$
Fav Market Amount
$
$
c. Comments
d. Election Sum to Date
g. Fair Market Amount
$
$ 46.00
$ 46.00
(SRO -1510 NC State Board of Elections uecemner zuu
Outstanding Loans
Amendment
Pg I of t ❑ 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)
2. ID Number
Anne M. Simpson for Commissioner
LJMJOX
3. Lender Information ® Add ❑ Remove
a. Full Name, Wiling Address & Phone
(include city, state, & zip)
It. Job Title/Profession
d. Comments
Registered Nurse
Anne M. Simpson
2517 Trading Ford Dr.
Waxhaw NC 28173
e. Start Date (mm/ddlyyyy)
c. Employer's Name/Specific Field
07/05/2023
Novant Health
L End Due (mmld&)M)
g. Rate
It. Security Pledged
L Original loan Amount
j. Remaining Loan Balance
0 %
$ 2000.00
$ 2000.00
It. Full Name of Leading Institution
I. loan Number
3. Lender Information ❑ Add ❑ Remove
a. Full Name, :Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
e. Start Date (mm/dd/y)))
c. Employer's Name/Specific Field
L End Date (mm/ddlyyyy)
g. Rate
It. Security Pledged
I. Original Loan Amount
j. Remaining Loan Balance
$
$
k. Full Name of Lending Institution
1. Loan Number
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phnne
(include Wfttil
FEB 2 6 2024
RECEIVED
b. Job Title/Profession
d. Comments
e. Start Date (mm/dd/My)
c. Employer's Name/Specific Field
f. End Date (mm/dd/yyyy)
g. Rate
It. Security PledgedL
Original Loan Amount
J. Remaining Loan Balance
%
$
$
L Full Name of Lending Institution
L Loan Number
4. Total only this Pae $ 2000.00
5. Total of ALL CRO -1430 Pages $ 2000.00
(This Rne must be on Hate 11 ojDemUed Summu)y Page CRO -1100)
CRO -1430 NC State Board of Elections December 2007