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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