Wilson,Travis_2022-4th-FinalAmendment
Disclosure Report Cover Lo ,,., _VrN_o
Use this form for general report and committee information, must be signed and submitted along with other detailed form,
Do not use this form to update information.
1. Committee Information e
. Fun Name
ID Nund"
I One C
lJ(oo� C�
. Mailing Address (include City, Stale and Zip Code)
d. Date Fred
e. Phone Number
W QV( rl� "J/
2. .Report Year 33. Period Start _(mrday) 9. a/y�'
DatePeriod End Date (mm/dd/yy)
5. Treasurer Full Name
� I
Q
-
9. Type of Report (check
only one rape of rei('rP
front one category)
Candidate Campaign Party
Municipal
State/Counly
Referendum
PAC ❑ Referendum
❑ Organizational
❑ Organizational
❑ Organizational
❑ Independent Expenditure ❑ Joint Fundraiser
❑ Thirty-five da}
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pre-primary
❑ First
❑ Final
❑ Pre-election
❑ Pre -runoff
❑ Second
❑ Third
❑ Supplemental Final
❑ Annual
7. Type of Fund(ifrtpptiwbte, check"
Boo ler Fund
Semi-annual
❑ Fourth
❑ Special
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year End
❑ Mid Year
10. Special Report Name
❑ Uihcr.
❑ Final
❑ Special
❑ Year End
❑ Final
- -
S. Number of Fundraisers this Report
❑ Special
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
. Purpose
—C
c. Account Code
b. Purpose
c. Account Code
f�yJl ��i j (�
(`� I
d. Period Begin Balance
d. Period Begin Balance
{/��}
/ 1 CG0 U,1�
$ `
$
CERTIFICATION
1 cenify 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 1 have been trained by the NC State Board of Elections.
Printed Name of Signer Signature of Appointed Treasurer Date'
FOR OFFICE USE ONLY
A (
Date Received: Delivery Method Employee: ❑ Normal Mail
Date Postmarked: Employee: Registered Mail
Hand Delivered
Date Scanned: Employee: Electronically Filed
Date Data Entered: Employee: ❑ manSigner has nowtnineived
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 El Yes a
Usc this form to summarize all disclosure reporting forms and to total monetary information
1. Committee Full Name (and Ftmd if applicable) ___T
Type Type of Report
3. ID Number
Start of Election Cycle: January 1, �,C2,��
Total this
Re ng Period
Total this
Election Cycle
4) Cash on Hand at Start
$ , `
$
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
1Ic) Outside Sources of Income
(CRO -1205)
(CRO -1210)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -125o)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
l Id) Legal Expense Fund - Other Sources
lle) Exempt Purchase Price Sales
(CRO -1270)
(CRO -1265)
$
$
$
$
12) TOTAL RECEIPTS (Add lines 5. 6, 7. 8, 9,10,1 la,l Ib,l Ie,l Id and I le)
$
$
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (CRO -1310)
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)
$
$
$ a.36
$
a
$
$
$
$
$
$
$
$
$
$
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$
$
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$ 40
$
ADDITIONAL INFORMATION
20) Non -Monetary Gifts Given to Other Committees
21) Outstanding Loans (incl. ones from other campaigns)
22) Debts and Obligations out ed by the Committee
3) Debts and Obligations owed to the Committee
24) Account Transfers Within the Committee
K.RO. 13.10)
(CRO -1430)
(CRO -1610)
(CRO -1620)
(CRO -1720)
$
$
$
$
$
In
5) Administrative Support
(CRO -1710)
$
$
26) Forgiven Loans
7) 48 -Hour Notice Reports Sum
8) Contributions to be Refunded
(CRO -1440)
(CRO -2220)
(CRO -1215)
$
$
$ $
$ $
CRO -1100 NC State Board of Elections August 2008
Amcadment
Disbursements Pg ef1S ❑ Yea the
Use this forth to report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated party expenditures
1£ oumtitteeFttB Natuc: and Ftmd if a licable)
t`C^n 6(CrmM jo e
21111111111Pate CRO -1310 forins for each • e o Disliursentent '
❑ Clpvrating Expenec> 0Contributions to Lind W.rrcJ4':J ni.al C,nnin i:trc, ❑ Co':rdinated Para Es Pendiuocs
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
It. Coordinated Committee Name
d. Comments
Include city, state & zip)
Co60 - rnr Y
IZ��/ Vef
c. Lesel Registered (Specify)
5315
El Federal County:
� t'r�
11 l0(1Coei, �Vl� o—
® Smte ❑ Municipality:
e. Election Stan to Date
. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mmldd/yyyy)
J. Amount
km
. Required Rearks
t�
$ :3 C-
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & I'hone
b. Coordinated Committee Name
d. Comments
(include city, state, & zip)
c. Level Registered (Specify)
El Federal 0 County:
❑ State ❑ Municipality:
e. Election Sum to Date
L Account Code
g. Form of Payment
h. Purpose Code
i. Date (mmlddlyyyy)
D. Amount
k. Required Remarks
Is
1
4. Payee Information ❑ Add ❑ Remove
. bull Name, Mailing Address & Phone
b. Coordinated Committee N:une
d. (onunents
(include city, state, & zip)
c. Level Registered (Specify)
Federal 0 County:
❑ State ❑ Municipality:
e. Election Sum to Date
L Account Code
g. Form of Payment
h. Purpose Code I. Date (mndddlyyyy) J. Amount
k. Required Remarks
g
5. Total only this Page $
6. Total of ALL CRO -1310 Pages
..,
`�)l
rThis lineguec in line 13a of Detailed SummaryPa a CRO-1100if Operating Expenses) •^J!
$
("This line goes in line 13b of Detailed Summary Page CRO -1100 if Contrib to Candidates/Political Como,)
(This line goes in line 13c of Detailed Samoan, Page C110-1100 if Courdinaled Parti, 1, vpendouresl
7. Purpose Codes (List detailed expenditure cone in (h.) above)
A* - Metria B* - Printing C* - Fundraising 1) - "fo Another Cimdidzlo
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 re uire detailed exillanation in refluired. remarks field (it); « ...... _-
CRO -1310 NC State Board of Elections December 2009