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Change For Monroe_2024-Org-amendndment Disclosure Report Cover Nyes ED No Use this form for general report and committee information, nest be signed and submitted along with other detailed forms. Do not use this form to update information. 1. Committee Information a. Full Name c. to Number CHANGE FOR MONROE It. Mailing Address (include City, State and Zip Code) d. Date Fled P.O. BOX 395 05/15/2024 MONROE, NC 28111 e. Phone Number 2. Report Year 13. Period Start Date (mm/dd/yy) 4. Period Find Date (mm/ddtyy) 15. Treasurer Fall Name 2024 05/03/2024 05/10/2024 KEVIN DANIELS 6. Type of Committee (Check One) 9. of Re check only one type ore ort om one category) ❑ Candidate Campaign ❑ Party Municipal State/County Referendum ❑ Joint Fundraiser ® PAC ❑ Organizational organizational 0 Organizational ❑ Referendum Legal Expense Fond ❑ ❑ ❑ Thirty-five day Pre-primary Pre-election Quarterly ❑ First ❑ Second ❑ Pre -referendum ❑ Final ❑ Supplemental Final 7. Type of FLnd 0faPPl+cable, check one) ❑ "Booster Fund" ❑ Building Fwd ❑ Pre -runoff ❑ Third ❑ Annual ❑ Presidential Election Year Candidates Fwd Semi-annual ❑ Fourth ❑ Special ❑ NC Pudic Campaign Financing Fwd ❑ Mid Year Semi-annual ❑ Year End ❑ Mid Year 10. Special Report Nsme ❑ Other: ❑ ❑ Final Special ❑ Year End ❑ Final ❑ Special 8. Number ofFlandraisers this Re 0 3. Account Information 3. Account Information a. Financial Institution Full Name a. Financial Institution FLIT Name CHANGE FOR MONROE b. Purpose c. Account Code e. Account Code TO COLLECT AND C4M DISTRIBUTE FUNDS d. Period Begin Balance MAY 17 2024 a. Period Begin Balance $ $ o.00union Co. Elections CERTIFICATION I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B & 2213-22M of Chapter 163 of the NC General Statutes and that no funds are commingled with prohibited or othernondisclosed funds. I further certify that this report is complete, true and correct and that I have been trained by the NC State Board N`� I re_\ —� \ 05/15/2024 Printed Name of Signer Signature of Appointed Treasurer Date FOR OFFICE LISEONLY y Delivery Method Date Received: Employee: ❑ Normal Mail ❑ Registered Mail Date Postmarked: Employee: ❑ Hand Delivered ❑ Electronically Filed Date Scanned: Employee: ❑ 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, oraccount information. You must amend the Statement of Organization CRO.2100A-E to make committee changes. CRO -1000 NC State Board of Elections December 2007 ndment 4�t Detailed Summary r3 Yes ® No Use this formto sumrterize all disclosure reporting forts and to total monetary information 1. Committee Full Name and Flood if applicable) 2. Type of Report 13. ID Number CHANGE FOR MONROE 2024 Organizational Start of Election Cycle: January 1, 2024 Total this Total this Re rtin Period Flection Cycle 41 Cash on Hand at Start I $ 0.00 1 $ 0.00 5) Aggregated Contributions from Individuals 6) Contributions from Individuals 7) Contributions from Political Party Committees 8) Contributions from Other Political Committees 9) Loan Proceeds 0) Refunds/Reimbursements to the Committee 1) Other Receipt Sources I la) Intereston Bank Accounts I1b) Contributions from Not -For -Profit Organizations I lc) Outside Sources of Income IId) Legal Expense Fund- Other Sources I le) Exempt Purchase Price Sales (CRO -1205) (CRO -1210) (CRO -1210) (CRO -1230) (CRO -1410) (CRO -1240) (CRO -1250) (CRO -1150) (CRO -11.50) (CRO -1170) (CRO -1165) $ 0.00 $ 0.00 $ 366.90 $ 366.90 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ $ 0.00 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 2) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9,10,1 I a I 1 b, l I c.11 d and I le) $ 366.90 $ 366.9 3) Disbursements 13a) Operating Expenditures 13b) Contributions to Candidates/Political Committees 13c) Coordinated Party Expenditures 4) Aggregated Non -Media Expenditures 5) Loan Repayments 6) Refunds/Reimbursements from the Committee 7) In-I(IndContributions (CR0.1310) (CRO -1310) (CR0.1310) (CR0.1315) (CRP -1410) (0R0-1320) (CRO -1510) $ 0.00 $ $ 0.00 $ A00, $ 0.00 $ $ 0.00 $ $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 366.90 $ 366.90 8) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ 366.90 $ 366.90 9) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18) $ 0.00 $ 0.00 0) Non-Moaetary Gifts Gisen to Other Committees (CRO -/330) $ 0.00 1) Outstanding Loans (incl. ones from other campaigns) (CRO -1430) $ 0.00 2) Debts and Obligations owed by the Committee (CR0.1610) $ 0.00 3) Debts and Obligations o%ed to the Committee (CRO -1620) $ 0.00 4) Account Transfers Within the Committee (CRO -1720) $ 0.00 5) Administrative Support (CRO -1710) $ 0.00 $ 0.00 $ 0.00 $ 0.00 6) Forgiven Loans (CRO -1440) $ 0.00 $ 0.00 7) 48 -Hoar Notice Reports Sum (CRO -1110) 81 Contributions to be Refunded (CRO -1215)1 $ 0.00 $ 0.00 w 0 0 U Q) _ W 0 L) r- 0 0 'c A ndment Contributions from Individuals Pg ! of I Yes IN No Use this fonnto report individual contributions over $50 or contributions under$50 iffonnCRO 1205 is not used 1. Committee Fall Name and Fuad if applicable) 2. In Number CHANGE FOR MONROE 3. Contributor Information ❑ Add ❑ Remove a. FLIT Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments KEVIN DANIELS NC c. Employer's Name/Specific Field e. Election Sum to Date $ 366.90 f. Prior g. Account Code b. Form of Payment i. In -Kind Description J. Date (mm/ddlyyyy) k. Amount ❑ C4M In -Kind PAYMENT FOR WEBSITE 05/03/2024 $ 366.90 ❑ $ ❑ $ 4. Total only this Page $ 366.90 5. Total of ALL CRO -1210 Pages (Tbic line must be on line 6 ojDaaLed Summary Page CR0.1100) $ 366.90 CRO -1110 NC State Board of Elections MAY 17 ZGZ4 Co, Elections April 2007 A,.m/ee dment In -Kind Contributions Pg of 1 IIa Yee ® No Use this form to report non-rrwnetary, 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. Committee Full Name and Fund if applicable) 2. ID Nvn ber CHANGE FOR MONROE 3. Contributor Information ❑ Add ❑ Remove e. Full Name, Mailing Address & Phone (include city, state, & zip) b. Type of Contributor C. Comments IM Individual ❑ candidate ❑ Party ❑ PAC ❑ Referendan ❑ Other Receipt Source KEVIN DANIELS NC d. Election Sam to Date $ 366.90 e. Description f. Date (mm/ddlyyyy) g. Fair Market Amount PAYMENT FOR WEBSITE 05/03/2024 $ 366.90 4. Total only this Page $ 366.90 5. Total of ALL CRO -1510 Pages (This Rne muss be on Rae 17 ojDeralled Summary Page CRO -1100) $ 366.90 CRO -1510 NC Slate Board of Elections December 2007 MCC, AD MAY 17 2024 Union Co. Elections