Smith,Thomas_2023-35-DayAmendment ,
Disclosure Report Cover o Yes WKr No
Use this form for general report and committee information, must be signed and submitted along with other detailed fori
rms.
Do not use this form to update inlormation.
1. Committee Information
a. Full Name
swl +� yw� 0 2 �, wi
c. ID Number
C 7W P4
b. Mailing Address (include City, State and Zip Code)
d. Date Piled
1a7
e. Phone Number
7o`/ V? ,s
2. Report Year
3. Period Start Date (mmlddyy) 4. Period End Date (mmladyy)
5. Treasurer Full Name
((tcr�t�:sS.jlc:s
t..Upe of Committee (Check �_
9. Type of Report
(check
only one type of reportJrom
one category)
Lj Candidate Campaign ❑ Party
Municipal
State/Counly
Referendum
❑ PAC ❑ Referendum
❑ organizauonal
organizational
❑ organirational
❑ Independent Expenditure ❑ Joint Fundraiser
Th ry-five day
Quarterly
❑ Pre -referendum
❑ legal Expense Fund
❑ Pre-primary
❑ First
❑ Final
❑ Preetection
❑ Pre -runoff
❑ Second
❑ Third
Q Suppiementai Final
Annual
7. Type of Fund (if applicable, check one)
❑ Booster Fund
Semi-annual
❑ Fourth
Special
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year End
❑ Mid Year
10. Special Report Name
❑ Other:
❑ Final
❑ Special
❑ fear End
❑
8. Number of Fundraisers this Report
❑ 1�`u IJI
11. Account Information
11. Account Information
a. Financial Institution rull Name
7lil.t S _
a. Financial Institution Full Name
-
b. Purpose
�� vt.ri Pre./ •t..
c. Account Code
/ d
I h
Ir. Purpose
— --
OCT 02 AL
Union Co. Ele
t Code
d. Period Begin Balance
g j U D
d. Period Begin Balance
ons
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, we and correct and that 1 have been trained by the
NC State Board of Elections.
--/ 'n -- /
Z2u25)
Printed Name of Signer Signature of Appointed Treasurer t Dale
FOR OFFICE USE ONLY
Date Received: EmployDe
' 1
'ver Method
Normal Mail
Date Postmarked: Employee:
Registered Mail
0 Hand Delivered
/ r^�
Date Scanned: / d Employee:
[3 Electronically Filed
Date Data Entered: Employee:
[3 Signer has not receivedmandatory 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-2100A-E)to make committee changes.
CRO -1000 NC State Board of Elections August 2008
Amendment .�
Detailed Summary ❑ ,.es fr`,tj No
Use this form to summarize all disclosure renortine forms and to total monetary information
1. Committee Full Name (and Fund if applicable)
2. Type of Report
13. ID Number
S[n2, LjG 0 12, PW wI
3, AV
I czs-m P9 r
Start of Election Cycle: January 1, 2 u Z3
Total this
Reporting Period
Total this
Election Cycle
4) Cash on Hand at Start
$
RECEIPTS
5) Aggregated Contributions from Individuals (CRO -1205)
6) Contributions from Individuals (ca0•1210)
$ 3 D S, G
$ Q, U J
7) Contributions from Political Party Committees (CRO -1220)
$
$
8) Contributions from Other Political Committees (CRO -1230)
$
$
9) Loan Proceeds (CRO -1410)
$
'$
10) Refunds/Reimbursements to the Committee (CRO -1240)
$
$
11) Other Receipt Sources
Ila) Interest on Bank Accounts (CRO -1250)
$
$
11b) Contributions from Not -For -Profit Organizations (CRO -1250)
$
$
.Ile) Outside Sources of Income (CRO -1250)
$
$
11d) Legal Expense Fund - Other Sources (CRO -1270)
$
$
Ile) Exempt Purchase Price Sales (CRO -1265)
$
$
12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9,10,lla,1lb,l lc,l Id and l le)
$ 0.00
$ s t U
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (CRO -1310)
$ 7061.7 .
$
13b) Contributions to Candidates/Political Committees (CRO -1310)
$
$
13c) Coordinated Party Expenditures (CRO -1310)
$
$
14) Aggregated Non -Media Expenditures (CRO -1315)
$
$
15) Loan Repayments (CRO -1420)
$
$
16) Refunds/Reimbursements from the Committee (CRO -1320)
$
$
17) In -Kind Contributions (CRO -1510)
$ 12 676
$ Y % (,7
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$ 0.00
$ 4
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$ 0.00
$ L i
ADDITIONAL INFORMATION
0) Non -Monetary Gifts Given to Other Committees (CRO -1330)
$
21) Outstanding Loans (incl. ones from other campaigns) (CRO -1430)
$
22) Debts and Obligations owed by the Committee (CRO -1610)
$
3) Debts and Obligations owed to the Committee (CRO -1620)
$
4) Account Transfers Within the Committee (CRO -1720)
$
25) Administrative Support (CRO -1710)
$
$
6) Forgiven Loans (CRO -1440)
$
$
7) 48 -Hour Notice Reports Sum (CRO -2220)
$
$
8) Contributions to be Refunded (CRO -1215)
$
$
C11U-1100 NC State Board of Elections August 2008
Reset Form
Amendment
Disbursements pg L of _ ❑ Yes VP No
Use this form to report expenditures from the committee for operating expenses. contributions to candidate/political
committees and coordinated arta ea ienditures
1. omm_ itte_e ane =_ und_if applicab e) _ _
urn r
3. Type of Disbursement (Please use separate CRO -1310 forms for each type of Disbursement.)
12rQ ..ruin , E.penses ❑ ( onlnbutiuns to Cnndidme>/PnfilinJ CCunun'itlees ❑ Coo,dhnawd PumExpenditure,
4. Payee Information 'AddRemove
a. Full Name, Mailing Address & Phone
Include city, —e, & zlP)
O e(rn.X-e, 60 pal(A��
a
�
1��o 1 J • 1• tvA� -c,,rG i
I Y ` ( i1 tq 4tA O v l (,S M N; t' 0
5o o-% 030 i
It. Coordinated Committee Name
d. Comments
..Level Registered (Specify)
ja Federal County:
❑ Scare Municipality:
e. Election Sum to Date
$ .
. Account Code
g. Form of Payment
It. Purpose Code
1. Date ( d yyyy)
.Amount
k Requi Rem
yyrIL
Is
4. Payee Information ❑ Add ❑ Remore
a. Von Name, Mailing Address & Phone
i include city. state, & zip)
5
Z 7 r{ M� �105 ]101 �/
)e 1 n q I.vs/ A r ii, t%L ` ,
g66-Zo7-�l ysS
h. Coordinated Committee Name
d. Comments
c. Level Registered (Specify)
❑ Federal ❑ County:
❑Stun — 0 Municipality:
-
e. Election Sum to Date
$ 60. Q2
. Account Code
g. Form of
k ParposeCode
v -O
L Date (tnmldd/yyyy)
/5 2023$
1j. Amoaot
k Requited Remarlm
-
60-�Z
16c -s1
Is
4. Payee Information Ll Add L3 Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
s �(Ze v-IUvva PIS t e
POV (v �) L
t{.y ���
IG ..[] ssza— az s Q❑State
�,—o . 6 8 r — 210 "1
b. Coordinated Committee Name
it. Comments
c. Level Registered (Specify)
eral
FedCounty:
Or Municipality:
—
e. Election Sum to Date
Is 2 02-6. U d
. Accoum Code
114
g.FormolPsymat
C6
litpurposeCode
I
1. Date (ma Utyyyyy) B. Amount
o!gl5 lot $ Zou"0
IL Required Remarla
GJ. ' e aSl It
$
5. Total only this Page
$ 2 V O
6. Total of ALL CRO -1310 Pages
(76is line goes in line 1Ja of Detailed .Summary Page CRO -1100 if Operating Expenses)
(This line goes in line 13b of Detailed .Summon, Page CRO -1100 if Cantrib to CandidauslPolitical Comm)
(This linegoes in line 13c of Detailed Summa Page CRO -1100 if Coordinated Party Expenditures)
%
$
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 - Penal ies K* - Office Expenses Q* - Donation to Legal Expense Fund
O* Other
* Codes re uire detailed explanation in reunited remarks field k
CR(1.1.i10 NC Suue M,ard of Elections December 2009
Amendment - - - -
Disbursements Pit 2. or _ ❑ yes y7}No
�)('
Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated party expenditures
[Ixonsmittee Nams and
141:ci 2-
P
.3.'Fype of Disbursement (Please use .separate CRO -1.310 forms for each type of Disbursement.)
1!`J [" "ung E,p,,,,, ❑ Conti bunon, to Ca nJld.nc.R'O tical Commiuce, ❑ (uorJ'maled I-� xndiiurr
4. Payee Information Add 0 Remove
a. Full Name, Mailing Address & Phone
b. Coordinated Committee Name
d. Conmtenls
include, sla &zip)
u s - lc" �I Ilti� � �b
A "Ll
• , (/ b
V h i / G 2 l
state
70'-1- /4(1/r
c Level Registered (Specify)
Federal 13C„unty:
a[,y�
[3 [XMunicipality:
e. Flection Sum to Date
$ r l2t o(�
. Account Code
g. Fo m P yment
cpv 6-
Ir. Purpose Code
-O
1. Date (mtddd/yyyy)
J. Amount
$ //),6
k Required emarjts
Prt-X n
�g 2�?V7
$
4. Payee Information Ll Add Ll Remove
. Full Name, Mailing Address & Phone
b. Coordinated Committee Name
d. Comments
(include city, state, & zip) -
r o w CV
i �/
n /�7. S 0 hN ' 1 /
(1'e ` Ic- '-� yl G 2� (3 J
c. Level Registered (Spxify)
❑ Federal ❑ County:
❑ State Municipality:
e. Election Sum to Date
. Account Code
g. Forsit of Payer
111. Purpose Cork
It. Date (mmlddhyyy)_
l9 loi-7
. Amount JIL Required Remarks
$ Z, c> �6A St
L c I<��
$
4. Payee Information .odd Remove
. Fill Name, Mailing Address & Phone
It. Coordinated Committee Name
d. Comments
I include city, state, & sip) -/�
(Vu ssom MAY 1. 111
6Cy / ��,/�
rf/(-.6 `�-lfl!)--Q� ' UUUc 7VVV �
V 4v 6i 2 0 L�
LevelRegisteredered(Specify)
Federal ❑ Counry:
❑ State Municipality:
— -
e. Election Sum to Date
$ 3Z0. 6 d
. Account Code
g. Form or Payr_ nt
�Gc k-
It. Purpose Code
O
1. Dole(mndddlyyyy)..
vy US Zug
J• Amount
L Required Remarks
6,7c - t 1
5
5. Total only this Page
6. Total of ALL CRO -1310 Pages
(Tlris line goes it, line 13a aflklailed Summary Page CRO-1100RO-1100 if Operating Expenses)
(T'Iris line goes in line 136 of Detailed Summary Page CRO -1100 if Contrib to C'andidateslPolilical Comm)
$ Y/ !�q q, S(�
1
(This line goes in line 13r of Detailed Summary Page CRO -1 100 if Coordinated Party Expenditures)
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 ret uired remarks field k
CRO -1310 c tii,ac Board of Election, Dmember 201 9
Disbursements Pg —3—of _ ❑e Yes eat Ur No
Use this formto report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated party expenditures
1. Committee. Full Name (and Fund if a . licable)
2. ID Number
S l �„�G� zlvGt�✓t�t ��
�-� V�� �
3. Type of Disbursement (Please use separate CRO -1310 fornts for each type ofDisburseineut.
13 Operating Expenses U Contributions to Candidates/Political Committees U Coordinated Party Ex enditures
4. Payee Information t❑ Add I❑ Remove
a. Full Name, Mailing Address & Phone • : ..-
(include ci'tyy, state,,$r '
b.. Coordinated Committee Name %
d. Comments -
7D
� C1UJ
JR 511+15e
cilevel Registered (Specify)
Federal County: a'
State Municip:
e. Election Srn to Date '
$S-,36
f: AccouaCCade
g. Form of Payment ='
h. Purpose'Code. `
is Date (mm/dd/yyyy);'
j. Amount =
kT Required Rem rks •
v o6 1j$
Is
I
4: Pa ee Information I
,
y n ❑ Add j❑ Remove
.Fu1PName,Mailing Address & Phone
• (include city, & zip) - " , , - ;
b. Coordinated Committee Name _ •.
d. Comments
^state
I ✓11 Ve iC4 Up to L-\
V U
/L(/ CG4 0 LtiI(
0 exw.VKf itUG. C
C* Level Registered (Specify)
Federal county:
❑ State EgMunicipality:
e. Election Sumio Date= ,
Is (-17, () 6
f. Account Code
g. Form of Payment,
h. PurposesCode .:
t. Date (mmd&yyyy) :.
ji Amount -
k. Required Remarks
1� I
(_)_0W4)3/207,5$
0
Poe (p h. C"q Ve
4. Payee Information l❑ Add j❑ Remove
. Full Name, Mailing Address & Phone , :. _... „ ; ` ' -
..(include city, state,&zip)`.
b. -Coordinated Committee Name ,`, ,
d. Comments- -
.
GVj�� j
t!� o.$4-2;(93,
c. Level Registered (Specify)- ''`---
Federal County:
❑ State Municipality:
e. Election Sum to Date
f. Account Code
g. Forip of Pa Yment
1h. Purpose Code _
i. Date (mm/dd/yyyy)''
j. Amount -
k) RequiredRemarks '
Ghox V
1
1 0!3hrK_67.6 o
YAG lu s
$
5. Totalonly this Page ., _
$ e 3 0
6. Total of ALL CRO -1310 Pages
/
(This Hue goes in line Ma of Detailed Summary Page CRO -1100 if Operating Expenses)
(This line goes in line lab of Detailed Summary Page CRO -1100 if Coutrib to CandidateslPolitical Comm)
(This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures)
7, Purpose Codes (List detailed expenditure code in (h.) above)
A* - Media _ B* - Printing 1C*- Fundraising,. ': D - To Another Candidate
E Salaries Fx - Egmpmentc.° , GPolitical Patty II* Holding Public OMee Expenses
_.
I Postage : J Penalties K* Office Expenses' - Q* -Donation to Legal Expense Fund
O* Other
* fades require detailed ex lanation in required remarks field' k
CRO -1310 NC State Board of Elections December2009
Amendment
Contributions from Individuals Pg _ of _ .❑ Yea Al No
We thio form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used-
1.abinittee Full_..ams (aFund--U4" ea e
y�-
3. Contributor Information 0 Add Remove
. Full Name, Mailing Address & Phone
(tnelade city, stele, & alp) _
�
4 S J�m t
r'Ait ews /vv��r0y
b. Job Title/Profession
eL
k� 1
d. Comments
c. Employer's NameMpecifie Field
N V �.OrJyQ�e.Elx7>�SumtoDde
U
<a 0s.oc�
I.Prior
❑
& Accom d Code
lt.Formofftyment
L Jn-Sind Description
-
Date (tmdddfyyyy)
J7 2� �7i
IL Ammmt
$ 000e 0�
G C C
❑
$ Z D (-)0, U
❑
vF 1 Zo
$ ( b00, v
3. Contributor Information Add Remove
. Full Name, Mailing Address & Phone
(include city, state, & sip)
2� 1 ts�JAkt 6
jM P G I Gl 0 �
b. Job TidelProfesstan
LJ <
d. Comments
eetion sum to Date
r p�rplo er's Name/1 Field
! T
S,a
$ Zov, a U
.Prior
g. Account Code
b. Form of Payment
1. In -Sind Dttxrlptieo
J.Date (mmldd(yyyy)
t Amaatn
❑
/A
'$ 2 0 0, 0
3. Contributor Information ❑ Add Remove
. Fell Name, Mailing Address & Phone
(Include city, state, & sip)
b. Job Titieftofessinn
d. Comments
L Employer's Namdspedtic Field
e. Election Sum to Date
S
It Prior
❑
S. Account Code
L Form of Payment
1. bn Wnd Dpeztptkm
1. Date (mmlddfyyyy)
k Amount
$
❑
S
❑
$
Total only this Page
$ S U u u
5. Total of ALL CRO -1210 Pages
(This line mwr be online 6 of Detailed Summary Pa a CRO-II00)
CRO -1210 NC Stall Rnard of Elections Apri12(107
Amendment
In -Kind Contributions Pg of ❑Yes xa
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. Cornmittee Fup Name (and Fund if applicable) _ -
2. ED Number
3. Contributor Information 1❑ Add -J❑ Remove
. Full Name, Mailing Address & Phone ';
'=,(iudude c(ty; state, &,zip) ..
b.:Type of Contributor
c.Comments `,.
Individual
❑ Candidate
❑ Party
❑PAC
❑ Referendum
❑ Other Receipt Source
( �/Vl Pa ( G i
U
3 v fs /L41tY (1�
—7
•tel „) ��( � G 2 �/ / 3
v
d. Election Sum'to Date . -
$ `/
e: Descripd_ ou ..;- '.r = .`- , ..' .: �. rr:.�. ,.., ::
f. Date (mm/ddlyyyy)
g. Fair MarhetAmount
14S e- -Eos f
�� 202
$c,/,z 67,6
5b 3 Ca r �,t-�cf-� i s
$
3. Contributor Liformation Add., ❑' Remove
a. Fail Name, Mailing Addres's & Phone ,' , + . '
:(include city, state, &'zip) ... _ . �. , `. .. "• , .
b, Type of Contributor `^`; .. ' -
c. Comments - . • '
- Individual
❑ Candidate
❑ Party
❑ PAC
❑ Referendum
❑ Other Receipt Source
d Election Sum to Data -. -
$
e: Description
f. Date (nm� ddlyyyy) ,
g. Fair Mar4e440ouat " -
$
$
$
3. Contributor Information M Add, , 1❑:Remove
. Full,Name, Mallin g Address &'Phone ' ,
�,(indudecity, state&;Lj
b. Type of Contributor ?
c. Comments
individual
❑ Candidate
❑ Ply
❑ PAC
❑ Referendum
❑ Other Receipt Source
d. Election Srmi to Date.
$
e. Description - ,.,�. ,. ''•'.,,t ',.-'4.,.� `..�
f. Date.(mm/dd/yyyy)..
g. Fair Market` Amount
$
$
$
4Aotal only this Page, =: - -3
$ L ,
5. Total of ALL CRO -1510 Pages
(This fine must beanline.l7 of Detailed Summary Page CRO -1100)
2 s /
CRO -1510 NC State Hoard of Elections December 2007