Atkinson,Jeff_2022-YearEndAmendment
Disclosure Report Cover I ❑ Yes ® 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 inforntation
1. Committee Information
a. Fun Name
c. ID Number
The Vote Jeff Atkinson Committee
ATK118
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
8509 Whitehawk Hill Rd
01/27/2023
Waxhaw, NC 28173
e. Phone Number
(704)641-4491
2. Report Year
3. Period Start Date {mm/ad yy>
4. Period End Date
5. Treasurer Full Name
mm/ddl )
Baxter Ware Starnes
2022
07/01/22
123L/22
6. Type of Committee (Check One)
9. Type
of Report cheek only one ivrie o -re ort rom one category))
® Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑
Organintional
❑ Organizational
❑ Organizational
Independent ❑ Joint Fundraiser
❑ Expenditure
❑
Thirty-five day
Quarterly
❑ Pre -referendum
Legal Expense Fund
' d /i/appLcobWii
❑
Pre-primary
❑ First
❑ Final
❑ "Booster Fund"
❑
Preclection
❑ Second
❑ Supplemental Final
❑ Building Fund
❑
Pre -runoff
❑ Third
❑ Annual
Semi-annual
❑ Fourth
❑ Special
❑
Mid Year
Semi-annual
❑ Other:
❑
Year End
❑ Mid Yew ..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 Faro Bank
b. Purpose
c. Account Code
b. Purpose
a Account Code
Checking
1
Account for
Committee
it. Period Begin Balance
-
d. Period Begin Balance
$
$ 52.52
CERTIFICATION
certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B, Bc 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 thetatgg Board Qf Electiolif
Baxter Ware Starnes
Printed Name of Signer
S gnature of Ap int d Treasurer
Date
FOR OFFICE USE ONLY
Date Received:
Employee: Delivery Method
❑
Normal Mail
Date Postmarked:
Employee: El Registered Mail
VHand Delivered
Date Scanned:
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 -2100A -E to make committee changes.
('HO-lll00 NC State Board of Elections August 2008
Detailed Summary ❑
Use this form to summarize all disclosure reaortin2 forms and to total monetary information.
1. Committee Full Name and Fund if applicable)
2. Type
of Report
3. ID Number_
The Vote Jeff Atkinson Committee
Year End
ATK118
Start of Election Cycle: January 1, 2022
Total
riod
Reporting Period
Total this
Election Cycle
4)
5)
6)
7)
8)
9)
III)
11)
Cash on Hand at Start
Aggregated Contributions from Individuals
Contributions from Individuals
Contributions from Political Party Committees
Contributions from Other Political Committees
Loan Proceeds
Refunds/Reimbursements To the Committee
Other Receipt Sources
]La) a) Interest on Bank Accounts
11 b) Contributions from Not -for -Profit Organizations
Ile) Outside Sources of Income
lid) Legal Expense Fund — Other Sources
11 e) Exempt Purchase Price Sales
(CRO -1105)
(CRO -1110)
(CRO -1120)
(CRO -1230)
(CRO -1410)
(CRO -1140)
(CRO -1150)
(CRO -1250)
(CRO -1150)
(CRO -1270)
(CRO -1165)
$
$
52.52
$
$
52.52
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
12)
13)
14)
15)
16)
17)
TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10, Ila, llb, llc, Ild and Ile)
Disbursements
13a) Operating Expenditures (CRO4310)
13b) Contributions to Candidates/Political Committees (CRO -1310)
13c) Coordinated Party Expenditures (CRO -1310)
Aggregated Non -Media Expenditures (CRO -1315)
Loan Repayments (CRO -1410)
Refunds/Reimbursements From the Committee ((RO-1310)
In -Kind Contributions (CRO -1510)
$
$
$
$
$
$
$
$
$ H — r,_
$
$
$
$
$
$ f IC(
$
18)
TOTAL EXPENDITURES (Addlinesl3a. 13b, 13c, 14.15.16and 17)
$
$
19)
Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18)
$
52.52
$
52.52
20)
21)
22)
23)
24)
25)
26)
27)
28)
Non -Monetary Gifts Given to Other Committees
Outstanding Loans (incl. ones from other campaigns)
Debts and Obligations owed By the Committee
Debts and Obligations owed To the Committee
Account Transfers Within the Committee
Administrative Support
Forgiven Loans
48 -Hour Notice Reports Sum
Contributions to be Refunded
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRO -1610)
(CRO -1710)
(CRO -1710)
(CRO -1440)
(CRO -1110)
(CRO -1215)
$
$
$
$
$
$
$
$
$
$
$
$
$
CRO -1100 NC State Board of Elections August 2008