Amburgey,Michael Thomas_2025-OrgDisclosureAmendment
Disclosure Report Cover ❑ 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 fnrm to undate information
1. Committee Information
. Full Name
c. ID Number
7il04-wws Amb!r
. Mailing Address (include City, State and Zip Codei
d. Date Filed
�olZ-Cown�et"l
f l� t Ant Tm' I k Q 7 _i
e. Phorte Number
1 d`O
v
D
��-a��-y yo
2. Report Year
3. Period Start Date (mm/dd/yy) 4. Period End Date urouldmyy)
15. Treasurer Full Name
a 0
1 07ll� l 2S 071 affIAO ;-s
1 rYlkch.4 —Xie-t~s Amb
6. Type of Committee (Check One)
9. Type of Report (check
only one type of report
from one category)
Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
Organizational
❑ Organizational
❑ Organizational
❑ Independent Expenditure ❑ Joint Fundraiser
Thiny-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Prc-primary
❑ First
❑ Final
❑ Pre-election
❑ Pre-mnoff
❑ Second
❑ Third
❑ Supplemental Final
[3 Annual
. Type of Fund (if applicable. check one)
❑ Boosnr Fund
Semi-annual
❑ Fourth
❑ Special
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year End
❑ Mid Year
10. Special Report Name
❑ lli her
❑ Final
❑ special
❑ Year End
❑ Final
8. Number of Fundraisers this Report
❑ Special
11. Account Information
11. Account Information
. Financial Institution Full Name
a. Financial Institution Full Name
f -^+c P.� b Cr4d,7- btwtoo
b. Purpose
c. Account Code
b: urposP ''
c. Account Code
i4fw%00 ;g,✓
`1Dw
JUL 2 4 2025
d. Period Begin Balance
0-DRECEIVED
d. Period Begin Balance
$ pr
$
CERTIFICATION
1 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 other non -disclosed Ponds. 1 further certify that this
reELo4reTplete, we a►nydr correct and tl t I have been trained by the NC Ate Board of Elections.
�dl+Ca
yr
Printed Name o i ncr Sin rc of Appointed TrAsureh
FOR OFFICE USE ONL
Date Received: Employee: Delivery Method
E] Normal Mail
t)r
Date Postmarked: Employee: ❑ Registered Mail
Hand Delivered
8
Date Scanned: Employee: Electronically Filed
Date Data Entered: Employee: ❑ Signer has not receivedmandatory training
Please Note: This form cannot he 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-210oA-E) to make committee changes.
CR •1000 NC State Board of Elections August 2008
Detailed Summar Andment
Summary me
❑ Yes _ -0 No
Use this form to summarize all disclosure reoortimt forms and to total monetary information
1. Committee Full Name (and Fund if applicable)
12, Type of Report
13. ID Number
Jcvf <'o>"i b
I' t Nanrce
/�SY✓l �'Q
Start of Election Cycle: January 1,
Total 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
(CRO -1210)
$
11&9,,13
$
7) Contributions from Political Party Committees
(CRO -1220)
$
$
8) Contributions from Other Political Committees
(CRO -1230)
$
$
9) Loan Proceeds
(CRO -1410)
$
$
10) Refunds/Rehnbursements to the Committee
(CRO -1240)
$
I $
11) Other Receipt Sources
Ila) Interest on Bank Accounts
(CRO -1250)
$
�7
O (
$
11b) Contributions from Not -For -Profit Organizations
(CRO -1250)
$
$
11c) Outside Sources of Income
(CRO -1230)
$
$
I ld) Legal Expense Fund -Other Sources
(CRO -1220)
$
$
$
$
Ile) Exempt Purchase Price Sales (CRO -1265)
12) TOTAL RECEIPTS (Add lines 5, 6, 7.8.9,10.1 la.I Ib.I Ic,l Id and I Ie)
$
//65,10
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (cx0.1310)
13b) Contributions to Candidates/Political Committees (CRO -1310)
$
$
41a.33 $
$
13c) Coordinated Party Expenditures
(CRO -1310)
$
$
14) Aggregated Non -Media Expenditures
(CRO -1315)
$
$
5) Loan Repayments
(CRO -1420)
$
$
16) Refunds/Rehnbursements from the Committee
(CRO -1320)
$
$
17) In -Kind Contributions
(CRO -1510)
$
&to3
$
8) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15. 16 and 17)
$
i f 1. 3 to
$
19) Cash on Hand at End (Add lines 4 and 12 together. then subtract line 18
$
5-7, ]
$
ADDPITONAL INFORMATION
0) Non -Monetary Gifts Given to Other Committees
1) Outstanding Loans (incl. ones from other campaigns)
2) Debts and Obligations owed by the Committee
(CRO -1330)
(CRO -1430)
(CRO-161U
$
$
,40N
CCIUN i
3) Debts and Obligations owed to the Committee
(CRO -MR),
$
24) Account Transfers Within the Committee
(CRO -1720)
5) Administrative Support
(CRO -17
$
6) Forgiven Loans
(CRO -141)
$
7) 48 -Hour Notice Reports Sam
(CRO -2220)
$
$
8) Contributions to be Refunded
(CRO -1215)
$
$
CRO -1100 NC State Board of Elections August 2008
Amendment
Contributions from Individuals Pg of, _ (3 Yea ❑ No
Use this form to report individual contributions over $50 or contributions tinder $ 0 if form CRO 1205 is not used
1. Committee Fall Name (and Fund if applicable)
/ bu -
2. ID Number
1/�nt� 13m
3. Contributor Information ❑ Add ❑ Ramoe'e
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
h. Joh'I'ide/Prute,u n d. Comments
of,✓NG1-
c. Employer's Name/Specific Field
C" 'J' is, Y vC k e. Election Sum to Date
$ /Ooa �o
L,`evdn CIW�y
1 y) 1
!(00 /V.:Ma(,Z' J %Pw, )cCC
Tr.N I N �-
d N l 9907k
F. Prior
g. Account Code
h. Form of Payment
i. I. -Kind Description
J. Date (mm/ddtyyyy)
k Amount
❑
7oYYl
G)hec
os/13/
$ /voO.c)"
❑
$
3; Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, &zip)
b. Job Title/Profession
�e�✓�vw. /i
c. Employer's Name/Speciftc Met
d. Comments
yy1/Z,,b � 1 % b4rr��r�
/
, 60 AJC- ' Ctv'CIG
4 11 lV-4" r1C 0407J
e. Election Sum to Date
$
r. Prior
g. Account Code
h. Form of Payment
1. In -Kind Description
J. Date (nvnlddlyyyy)
It. Amount
❑
-Te,
$ o 0 00
❑
B�s,�csS
7 /4/,25
$ i1'V,03
❑
F;7l,U
7/,yeas
3. Contributor Information ❑ Add ❑ Remove
a. Full :Name, Mailing Address & Phone
(include city, state, Si(RiION
llp T�
2 4 1�2J
JUL J
RECEIVEo
b. Joh Tifle/Proression
d, C'unnnente
c. Employer's Name/Specific Field
c.Election Sum to Dale
f. Prior
g. Account Code
h. Form of Payment
1. In -Kind Description
J. Date (mmldd/yyyy)
k Amount
❑
$
❑
$
❑
$
4. Total only this Page 7777s
7
5. Total of ALL CRO -1210 Pages
(This line must he on line 6 of Detaifed Summary Page CRO -1100)
$
(.RO.1210 NC Stale Uuard ut Election, April 2007
Other Receipt Sources
:\nu•ndment
Pg _ of _ ❑ Yes Q No
Use this form to report income not reported on another form. i.e. interest income, not for profit contributions etc.
�71. Committee Full Name (and Fund if applicable)
2. ID Number
3. Type of Receipt Source (Please use separate CRO -12,50 forms for each hype of Receipt Source.)
Eg-Inmrem ❑ G.mribwionx limn N,,t-(m1 mtu Org.mizatione ❑ Ouulde Sources of htcomc
4. Contributor Information ❑ Add ElRemove
it. Full Name, Moiling Address & Phone
(include city, state, & zip)
Ste ! e Emp l o y s Cy t
(J.N t Ow)
b. Not -for -Profit Federal ID 0
d. Comments
c. Outside Source Explanation
e. Election Sum to Date
$ r 67
I. Account Code
70tEY17
g. Form of Payment
Cr-ecG't
It. In -Kind Description
- - -
I. Dale (nun/ddtyyyy)
7/IIQ�a S
J. Amount
0-7
s
4. Contributor Information ❑ Add ❑ Remove
a. Full Name, \lailing Address & Phone
(include city, state, & zip)
b. Not -fur -Profit Federal to g
d. Comments
c. Outside Source Explanation
e. Election Sum to Date
1. .Account Code
g. Form of Payment
It. In -Kind Description
t. Date (tmJddlyyyy)
. Amount
$
C
4. Contributor Information ❑ Add Remove
a. Full Name, Mulling Address & Phone
(include city, state, & zip)
,'vid G-6 gNC.E
C;Ai'.lpA1GN FIN
JUL 2 4 2025
EIvED
b. Not -Cor -Profit Federal ID 0
d. Comments
c. Outside Source Explanation
e. Election Sum to Date
$
f. Account Code
g. Form o Payment
It. In -Kind Description
I. Date (mndddlyyyy)
J. Amount
S
S
5. Total only this Page
6. Total of ALL CRO -1250 Pages
(This linegoes in line Ila of Derailed Summary Page CRO -1100 if Interest)
(This line goes in l(ne llb of Detailed summary Page CRO -1100 if Nal-for-Profrr Contribution)
(This line nes in lice !Ica Uemiled Smm�ra Pn a CHb-f100 i Darside Suurces o Income)
$ 007
CRO -1250 NC State Board of Elections December 2007
(
Disbursements pg _ of Amendment _ ❑ Yes ❑ No
Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated party expenditures
1. Committee Nam_ a (andd if aPplcs leJ
2. ID Number
USivlli/ 3 Q
3, Type of Disbursement (Please use sepin le CRO -I 0 forms far each type ofDisbursemenfJ
m. I : - __ ___-❑ Qn(Inbm anima ( Cindld.iavl 11icW GmnGua. ❑ C'xmGnamd Pam Ga xndimras
4. Payee Information E3 Add -❑ Remove
a. Full Name, Mailing Address & Phone
(_include city, state, & zip)
It. Coordinated Committee Name
d. Conmients
C
!%4 ✓ aC S/� r.1f
/
J"Z, G,k- yc"O-d' 1 y NS
(jt�lkNtLo,Fl 3a807
c. Level Registered (Specify)
Lj Federal County:
❑ State ❑ Municipality:
a Election Sum to Date
$ 9y)L,33
I'. Account Code Ig. Form of Payment
h. Purpose Codei. Dute (mmlddlyyyy)
J. Amouut k. RegWred Remarks
04VI 71 At ,r,)-
7 3 as
$ '441.2,331 5l �s
d. Payee Information ❑ Add Remove
o. Pull N:uur. \tailing .lddress S Thune
(include city, state, & zip)
h. Coordinated Committee Name
d. Comments
a Level Registered (Specify)
Federal CYC.u.ty:
❑ State ❑ Municipality:
e. Election Sum to Date
$
. Account Code
g. Form of Payment
h. Purpose Code
i, Date (mmfdd/vyyy) J. Amount
Is Required Remarks
$
4. Payee Informatio Add Remove
a. Full Nome, Mailing Addre9a&� ieCUN
(include city,state,& 4PZlna0.1GN FINANC
b. Coordinated Committee Name
d. Comments
--
JUL 2 4 2025
RECEIVED❑
c. Level Registered (Specify)
Federal 11 County'.
State ❑ Municipality:
e.Elecdoo Sumto Date
$
f. Account Code
g. Form of Payment
It. Purpose Code
1. Date (mm/dd/yyyy)
J. Amount
Required Remarks,
Ik.
$
$
5. Total only this Page
5
6. Total of ALL CRO -1310 Pages
1'his line goes in line lin of Derailed Summarr Page CRO -1100 if Operating )iapemee.el
(This line goes in line 136 of Demiled Summary Page CRO -1100 if C'ontrib to C'andidatestTolifical Comm)
(This line goes in line 13c o Detailed Summary Page CRO -1100 i Coordinated Party F.x endimres)
n
(may (�� 33
7. Purpose Codes (List detailed expenditure code in (hJ above)
A* - Media 13* - 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 W.
CRO -1.110 NC Slate Board of Elections December 2009
In -Kind Contributions Pg or Amendment
❑Yes �y �Na
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. Committee Full Name (and Fund if applicable)
2. ID Number
3. Contributor Information Add 0 Remove
a. Full Name. Mailing Address & Phone
(include city. state. &zip)
L ; r
Ol.
IV. 'j`ra
(-"
� ri
:J;Jd►�w -rw-hl , ,2 8a? 9
b.'fype of Contributor
® Indie-idudl -
W C:mdidate
❑ Pasty
❑ PAC
Referenda
r Receipt Source
c. Comments
-
d. Election Sum to Date
$ 10()0'60 `()U eQ 0
L. Description
f. Date 63 1
g. Fair Market Amount
0N4lt iJnl ti4
5
S
S
3. Contributor Information 0 Add ❑ Remove
I . F all Name. Mailing Address & Phone
(include city. state, & zip)
b"4-zl /tom
V U
re- C; r
�4967
b. Type of Contributor
❑ Indieidual
%Candidate
❑ Party
❑ PAC
❑ Referendum
❑ Other Receipt Source
c. Comments
d. Election Sum to Date
$ /& qPg°3
e. Description
f. Date (mmlddlyyyy)
g. Fair Market Amount
T i
7/3/;Z5-
S /001"'
71151 �s
$ (� y o 3
F7l I
?//
S `,r-
3. Contributor Information ❑ Add ❑ Remove
. Full Name. Mailing Addrf A9MOUNT ;,
(include city, state. & V r 1PAIGN FINAN(,I-
b. Type of Contributor
❑ Individual
c. Comments
❑ Candidate
JUL 2 4 2025
❑ Party
❑ PAC
RECEIVED
13Referendum
❑ Other Receipt Source
d. Election Sum to Date
$
.Description
f. Date munIdd)yryr(
g. Fair !Market .Amount
$
S
4. Total only this Page $ e O
5. Total of ALL CRO -1510 Pages $
(This fine mutt be on line 17 of Detailed Summary Page CRO -1100)
(:K0-1511) VC .S:a(c Roans of Elections December 2007