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Simpson,Anne_2024-2nd-qtrAmendment Disclosure Report Cover I ❑ Yea ® 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. 11) 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 RECEIVED JUL 0 5 2024 07/05/2024 e. Phone Number UNION COUNTY 704-296-8052 2. Report Year 3. Period Start Date (mm/dd/yy) 4. Period End Date 5. Treasurer Full Name mm/dd 2024 02/18/2024 06/30/2024 Anne Marie Simpson 6. Type of Committee (Check One) 9. Type of eport check only one e o re ort rota one cafe o ® Candidate Campaign ❑ Party Municipal State/County Referendum ❑ Organizational ❑ Organizational ❑ Organizational ❑ PAC ❑ Referendum Independent ❑ Joint Fundruser ❑ Expenditure ❑ Thirty-five day Quarterly ❑ Pre -referendum ❑ Legal Expense Fund ❑ ❑ Pre-primary Pre-election ❑ First ® Second ❑ Final ❑ Supplemental Final 7. Type of Fund (fappllcable, check ore) ❑ 'Booster Fond" ❑ Building Food ❑ Pre -runoff ❑ Third ❑ Annuai Semi-annual ❑ Fourth ❑ Speciai ❑ Mid Year Semi-annual ❑ Other: ❑ Yew 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 It. Purpose c. Account Code Campaign Finance 4 WX W d. Period Regiu Balance Activities d. Period Begin Balance $ S 227.86 CERTIFICATION 1 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'Boqrd of Elbetions. Anne Marie Simpson Lk 07/05/2024 Printed Name of Signer Signature of Appointed Treasurer Date FOR OFFICE USE ONLY Date Received: Employee: Delivery Method ❑ Normal Mail Date Postmarked: Date Scanned: a 1 Employee: Registered Mail Hand Delivered 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 -2I OOA-E to make committee changes. CRO -1000 NC State Board of Elections August 2008 Amendment Detailed Summary ® Yes r-1 No Use this form to summarize all disclosure remortinB forms and to total monetary information. 1. Committee Full Name and Fund if applicable) 2. T of Report 3. JD Number Anne M. Simpson for Commissioner 2nd Quarter LJMJOX Start of Election Cycle: Januar 1, 2024 Total this Reporting Period Total this Election Cycle 4) Cash on Hand at Start $ 227.86 $ 0 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 I lb) Contributions from Not -for -Profit Organizations Ile) Outside Sources of Income 11d) Legal Expense Fund — Other Sources 11 e) Exempt Purchase Price Sales (CRO -1205) (CR04210) (CRO -1220) (CRO -1230) (CRO -1410) (CRO -1240) (CRO -1250) (CRO -1250) (CRO -1250) (CRO -1270) (CRP -1265) S $ S $ 18.59 S $ S S $ $ 2000.00 $ S $ $ $ $ $ "UNION COL NJY .nARD OF EL ONS $ $ 12) TOTAL RECEIPTS (Add lines 5.6, 7, 8.9. 10. Ila, Iib, Ile, Ildand lie) $ 0 S 2518.59 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) $ 178.00 $ -- 2330.73 $ $ $ $ S $ $ 49.86 $ 49.86 $ $ $ $ 138.00 18) TOTAL EXPENDITURES (Add lines 13a, 136, 13e, 14, 15,16 and 17) $ 227.86 $ 2518.59 19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18) $ 0 S 49.86 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 -/330) (CRO -1430) (CRO -1610) (CRO -1620) (CRO -1710) (CRO -1710) (CRO -1440) (CRO -2220) (CRO -1215) $ $ 2000.00 $ S $ $ S $ 1950.14 $ $ $ S $ CRO -1100 NC State Board of Elections August 2008 Amendment Disbursements Pg 1 of 2 ❑ Yea ® 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) —21D Number Anne M. Simpson for Commissioner LJMJOX 3. Type of Disbursement Please use separate CRO -1310 formy for each type of Disbursement Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures 4. Payee Information ® Add D Remove a. Full Name, Mailing Address & Phone include city, state, & a b. Coordinated Committee Name d. Comments Wells Fargo 5926 Weddington Monroe Rd Wesley Chapel N 28104 e. Level Registered (Specify) ❑ Federal ® Conway: ❑ State ❑ Municipality: e. Election Sam to Date $ 90.00 L Account Code I g. Form of Payment h. Purpose Code L Date (mm/ddlyyyy) j. Amount L Required Remarks 4WXW Draft H 02/29/2024 $10.00 Service Fee 4WXW Draft H 03/29/2024 $10.00 Service Fee 4. Payee Information 0 Add Remove a. Full Name, Mailing Address & Phone include eity, state, & zip) 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 $ 90.00 E Account Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) j. Amount L Required Remarks 4WXW Draft H 04/30/2024 $10.00 Service Fee 4WXW Draft H 05/31/2024 $10.00 Service Fee 4. Payee Information ❑ Add Remove a. Full Name, Mailing Address & Phone include city, state, & A Meta Ads RECEIVED JUL 0 5 2024 UNION COUNTY BOARD OF ELECTIONS b. Coordinated Committee Name d. Comments c. level Registered (Specify) ❑ Federal ® County: ❑ State ❑ Municipality: e. Election Som to Date $ 394.88 f. Account Code g. Form of Payment h. Purpose Code i. Date (mm/ddlyyyy) j. Amount k. Required Remarks 4WXW Debit A 02/01/2024 $65.00 Post Boost 4WXW Debit A 04/01/2024 $50.00 Post Boost 5. Total only this Pae $ 155.00 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of DetaUedSu,nmiuy Page CRO -1100 if Operating Frpenses) (This lingoes in line 136 of Deraled Stun"" Page CRO -1100 iiConrrlb to Candidares/Poliriral Comm) (This lingoes in line Fie ojDelaled Summouy Page CRO -1100 if Coordinated Parpv Eapendirures) _ $ 178.00 7. Purpose Codes List detailed expenditure code in h. 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 Disbursements Pg 2 of 2 ❑ Yes 0 Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political commmees ano coorummea parLy ex enunures. 1. Committee Full Name (and Fund if applicable) 2. ID Number Anne M. Simpson for Commissioner I LJMJOX 3. Type of Disbursement Please use separate CRO -1310 forms for each type ofDishursenwm) ® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures 4. Payee Information 0 Add Ll Remove a. Full Name, Mailing Address & Phone include city, state, & a b. Coordinated Committee Name d. Comments j. Amount Square Space Inc 225 Varick St 12i1 Floor New York, NY 10014 c. Level Registered (Specify) ❑ Federal ® county: ❑ state ❑ Municipality: e. Election Sum to Date $ 23.00 E Account Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) j. Amount k. Required Remarks 4WXW Draft H 03/08/2024 $23.00 Website Hosting _ it. Comments RECEIVED JUL 0 5 2024 UNION COUNTY BOARD OF ELECTIONS c. Level Registered (Specify) 4. Payee Information Z Add Remove a. Full Name, Mailing Address & Phone b. Coordinated Committee Name it. Comments c. Level Registered (Specify) RO-1310 NC State Board of Elections December 201 ❑ Federal ❑ ❑ State ❑ County: Municipality: e. Election Sum to Date $ E Account Code & Form of Payment h. Purpm Code 1. Date (mm/dd/yyyy) j. Amount k. Required Remarks $ 4. Payee Information Add El Remove a. Full Name, Mailing Address & Phone include city, state & a It. Coordinated Committee Name _ it. Comments RECEIVED JUL 0 5 2024 UNION COUNTY BOARD OF ELECTIONS c. Level Registered (Specify) E] Federal [-]County: ❑ State ❑ Municipality: e. Election Sum to Date $ f. Account Code g. Form of Payment h. Purpose Code (. Date (mm/dd/yyyy) j. Amount k. Required Remarks $ 5. Total only thu Page $ 23.00 6. Total of ALL CRO -1310 Pages (This fine goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses) (This fine goes in fine 136 of Detailed Summary Page CRO -1100 if Conttib to Candidates/Political ConatO (This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Parry Expenditures) $ 178.00 7. Purpose Codes (List detailed expenditure code in (h.) above) A* - Media B* - Printing C* - Fundraising E - Salaries F* - Equipment G - Political Party I - Postage J - Penalties K* - Office Expenses O* - Other * Codes require detailed explanation in required remarks field (k) D - To Another Candidate H* - Holding Public Office Expenses Q* - Donation to Legal Expense Fund RO-1310 NC State Board of Elections December 201 Kim Westbrook Strach Executive Director North Carolina State Board of Elections 441 N Harrington Suca Raleigh, NC 27603 Forgiven Loan Statement Mailing Address PO Box 27255 Raleigh, NC 27611-7255 (919) 733-7173 This form is used to report a loan that has beenr forgiven by the lender. The lender's signature is required on this form and it must accompany the next filed report. Name of Lender: Anne Marie Simpson Committee receiving loan: Anne M. Simpson for Comm Date of loan: 07/05/2023 Amount of original loan: 2000 *Amount of loan to be forgive n: 1950.14 1, Anne Mare Simpson do not wish to be reimbursed for the amount of the loan indicated above' and will consider the amount loaned a contribution to the committee. I understand and confirm no other parties are responsible for payment of this loan. I may not forgive a loan for which there is an outstanding balance owed to any source.' Signature 11 Signature Treasurer RECEIVED 5 2024 . ?'UNION COUNTY BOARD OF ELECTIONS Note: This Statcment is to be filed with the Election Board where the committee's reports are filed. CRO -6200 Forgiven Loan Statement July 2014 Loan Repayments Use this form to report payments on an existing loan. Amendment Pg 1 of I ❑ yes ® No 1. Committee Full Name and Fund if applicable) 72-11D Number Anne M. Simpson for Commissioner LJMJOX 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Comments Self Anne Marie Simpson 2517 Trading Ford Dr. Waxhaw, NC 28173 704-296-8052 c. Original Loan Date 07/05/2023 d. Original Loan Amount $ 2000 e. Remaining Loan Balance E Account Code g. Form of Payment h. Date (mm/ddlyyyy) L Repayment Amount $ 1950.14 4WXW Draft 07/05/2024 $ 49.86 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Comments RECEIVED JUL 0 5 2024 UNION COUNTY BOARD OF ELECTIONS c. Original Loan Due d. Original Loan Amount $ e. Remaining Loan Balance E Account Code g. Form of Payment Is. Date (mm/dd/yyyy) I. Repayment Amount $ $ 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Comments c. Original Loan Date d. Original two Amount $ e. Remaining Loan Balance L Account Code g. Form of Payment h. Date (mmldd/yyyy) i. Repayment Amount 4. Total oDly this Page $ 49.86 5. Total of ALL CRO -1420 Pages $ 49.86 (This Une muss 6e on 6ne IS ojDe/aOedSammary Page CR0.1/001 CRO -1420 NC Slate Board of Elections December 2007 Amendment Forgiven Loans Pg of i ❑ ves ® No Use this form to report any loan which has been forgiven by the lender. A Forgiven loan statement (CRO -6200) must accomnanv each forgiven loan. 1. Committee Fall Name and Fund if applicable) 2. ID Number Anne M. Simpson for Commissioner LJMJOX 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) It. Comments Self Anne Marie Simpson 2517 Trading Ford Dr Waxhaw NC 28173 704-256-4976 c. Original Lona Date (mm/dd/yyyy) E Election sum to Date 07/05/2023 $ 2000 d. Original Loan Amount g. Date (mm/ddlyyyy) $ 2000 06/30/2024 e. Remaining Loan Balance It. Forgiven Amount $ 1950.14 $ 1950.14 3. Lender information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & rip) Jr. Comments RECEIVED JUL 0 5 2024 UNION COUNTY BOARD OF FLECTIONS c. Original Loan Date (mm/dal/yyyy) E Election Sum to Date $ d. Original loan Amount g. Date(mm/dd/yyyy) $ e. Remaining Loan Balance Is. Forgiven Amount 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) It. Comments c. Original Loan Date (mm/dd/yyyy) E Election Sum to Date $ d. Original Loan Amount g. Date (mm/dd/yyyy) e. Remaining Loan Balance It. Forgiven Amount 4. Total only this Page $ 1950.14 5. Total of ALL CRO -1440 Pages $ 1950.14 (This fine must be on line 26 of Detailed Summary Page CRO- 1100) The lender Mfornunion should contain the some information as supplied under the original lawn proceed CRO -1440 NC State Board of Elections December 2007 Outstanding Loans Amendment Pg i of 1 ❑ Yes ® 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, Mailing Address & Phone (include city, state, & zip) b. Job Title/Protession d. Comments Registered Nurse Anne M. Simpson 2517 Trading Ford Dr. Waxhaw NC 2$173 e. Sart nate (mm/ddyyyy) c. Employers Name/Specific Field 07/05/2023 Novant Health L End Date(mm/dd/yyyy) g. Rate h. Security Pledged I. Original Loan Amount j. Remaining Loan Balance 0 % $ 2000.00 $ 2000.00 L Full Name or Leading Institution 1. Lean Number 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments RECEIVED JUL 0 5 1014 UNION COUNTY BOARD OF ELECTIONS e. Start Date (mm/dd/yyyy) c. Employer's Namc/Specific Field E End Date (mm/dd/yyyy) g. Rate It. Security Pledged i. Original Loan Amount J. Remaining Loan Balance % $ $ k. Full Name of Lending 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/yyyy) c. Employer's Name/Specific Field E End Date (mm/dd/yyyy) g. Rate L Security Pledged i. Original loan Amount j. Remaining Loan Balance $ $ k. Full Name of Lending Institution 1. Loan Number 4. Total only this Pae $ 2000.00 5. Total of ALL CRO -1430 Pages (This fine must be on One 21 of DemUed Suuwmry Page CRO -1100) $ 2000.00 CRO -1430 NC State Board of Elections December 2007