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Anthony,Surluta_2026-2nd Qtr AmendedAmendment Disclosure Report Cover I N 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 information 1. Committee Information 1 a. Full Name - c,to Number COMMITTEE TO ELECT SURLUTA B ANTHONY 46-3149470 b. Mailing Address (include City, State and Zip Code) d. Date Filed 1307 VIRGINIA AVENUE MONROE NC 28112 e Phone Number 704-6184116 Year 3. Period Start:Date (mmtddryy) 4.$.'Report ' mm/dd(mm/dd/ yy End'Date '5. Treasurer,Full Name % 1 2026 9/8/25 6/30/26 KATHLEEN M DOMANSKI b. T e ofCommittee' CheckfOne 9.Type ofiReport (check'onl .one type ore orf'rom one category)I N Candidate Campaign ❑ Party Municipal _ . State/County Referendum ❑ PAC ❑ Referendum ❑ Organizational ❑ Organizational ❑ Organizational Independent ❑ Joint Fundmiser ❑ Expenditure ❑ Thirty-five day Quarterly ❑ Pre -referendum ❑ Legal Expense Fund ❑ ❑ Pre-primary Pre-election R First N Second ❑ Final ❑ Supplemental Final 1.T e(ofFund (ifappticab/e, check one) } ❑ "BoosterFund" ❑ Building Food ❑ Pre-rwoff ❑ Thud ❑ Annual Semi -amoral ❑ Fourth ❑ Special ❑ Mid Year Semi-ammal ❑ Other. ❑ YearEnd ❑ Mid Year .10. S eeiaFRe ort Name ' } ❑ ❑ Final Special ❑ Year End ❑ Final ❑ Special SECOND QUARTER 18. Number of Fundraisers this Report ( I 11. Account Information 11. Account Information 1 a. Financial Institution Full Name a. Financial'Iostitotion.Full Name " FIFTH THIRD BANK b. Purpose c. Account Code b. Por - INV a Account Code FUNDRAISING" D2026 AMPAIGN FINANCE JUL 2 y 2026 U. Period Begin Balance it. Period Begin Balance $ °BECFIVED $ 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, true and correct and that I have been trained KATHLEEN M DOMANSKI by the NC Staty Board of Elections. Printed Name of Signer - 'r5i o �AppoinIe Wr r Date FOR OFFICE USE ONLY r� Date Received: —//()—q /IL Employee: �f - Delivery Method ❑ Normal Mail Date Postmarked: Employee: ❑ Registered Mail N Hand 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. I Amendment Detailed Summary L®_ Yes ❑ xo Use this form to summarize all disclosure reporting forms and to total monetary information. l.='Committee,Full Namer(and IFund,if a 7icable) 11. TyperdfiReport 11 .3.1ID Number ' { COMMITTEE TO ELECT SURLUTA B ANTHONY 21m QUARTER AMENDED 46-3149470 Start of Election Cycle: January 1,Total 2024 this Reporting Period Total this Election Cycle 4) Cash on Hand at Start $ 0 $ DE IP�1iS 5) Aggregated Contributions from Individuals (CRO -1205) $ 496.72 $ 6) 7) 8) Contributions from Individuals Contributions from Political Party Committees Contributions from Other Political Committees (CRO -1210) (CRO -1220) (CRO -1230) $ 4119.59 $ $ $ $ $ $ 2000 $ $ $ 9) Loan Proceeds (CRO -1410) 10) 11 Refunds/Reimbursements To the Committee Other Receipt Sources Ila) Interest on Bank Accounts (CRO -1240) (CRO -1150) $ $ $ $ llb) Contributions from Nat -for -Profit Organizations (CRO -1150) Ile) Outside Sources of Income (CRO -1150) $ $ $ $ lid) Legal Expense Fund — Other Sources 11 e) Exempt Purchase Price Sales (CRO -1170) (CRO -1265) $ $ 12) TOTAL RECEIPTS (Add fines5,6,7,8,9,10,Ila, Ilb,Ila IldandIle) $ 6616.31 $ NHEND 1i S 13) Disbursements 13a) Operating Expenditures 13b) Contributions to Candidates/Political Committees _ (CRO -1310) (CRO -1310) $ $ 3048.62 $ $ 13c) Coordinated Party Expenditures (CRO -7310) $ $ 14) 15) 16) Aggregated Non -Media Expenditures Loan Repayments Refunds/Reimbursements From the Committee (CRO -1315) (CRO -1420) (CRO -1310) $ 50.67 $ $ $ $ $ 1932.16 $ $ 17) In -Kind Contributions (CRO-IslO) 18) TOTAL EXPENDITURES (Add lines 13a, 13b,13c, 14, 15, 16 and 17) $ 5031.45 $ 19) Cash on Hand at End (Add lines 4 mrd 12 together, then subtract It,, 18) $ 1584.86 $ 20) DIiP 0O N O 1#IOO N 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) $ 23) Debts and Obligations owed To the Committee (CRO4620) $ $ $ 24) Account Transfers Within the Co,-"jjN1Y (CRO -1720) 25) Administrative Support CAMNpAIGN FINANCE_- - (CRO -1710) $ $ 26) 27) 28) Forgiven Loans JUL 2 4 2M 48 -Hour Notice Reports Sum RECENED Contributions to be Refunded (CRO -1440 (CRO -1120) (CRO -1115) 1 $ $ $ $ RIM7111t An.,d EMIR Amendment Aggregated Contributions from Individuals Page 1 of z LK Yes ❑ No Optional form used to report NC Contributions From Individuals of $50 or less 1. Committee Full Name, and iFundif applicable) 2. ID Number COMMITTEE TO ELECT SURLUTA B ANTHONY 46-3149470 3.'Contributor in formation a. Amend b.Account Code ,c, Form of Payment d. In-IGnd Description e, Date mm)d E Amount ❑ Add D2026 CASH 6126/26 $ 20 ❑ Remove Ada D2026 PERSONAL CARD BOTTLED WATER 6/25/26 $ 32.03 ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ Remove ❑ Add $ ❑ Remove ❑ Add $ F1 Remove ❑ Add $ ❑ Remove ❑ Add $ F1 Remove ❑ Add ! $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ E] Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ E] Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add .' $ ❑ Remove ❑ Add UNUIN CAMPAIGN FINANCE _ $ ❑ Remove ❑ Add JUL 2 4 2026 $ F1 Remove ❑ Add RECEIVED $ ❑ Remove ❑ Add $ ❑ Remove 4. Total only this Page $ 52.03 S. Total of ALL CRO -1205 Pages (This fine most Leon Ane 5 ofDadleaSummmy Page CR0.1106) $ 496.72 pan tont WI Q.-R.-Ytn-.r:....e A-AIOMC Amendment In -Kind Contributions Pg 3 of 3 ® Yes ❑ No 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 applicabi e) 2.'ID Number { COMMITTEE TO ELECT SURLUTA B ANTHONY 46-3149470 3.'Contributor1nformation El Add ;❑ 'Remove { a. Full Name, Mailing Address & Phone (include city, state, &.zip) b. Type of Contributor ' c. Comments - ❑ Individual ® Candidate ❑ Party ❑ PAC ❑ Referendum ❑ Other Receipt Source 1 ' SURLUTA B ANTHONY 1307 VIRGINIA AVE MONROE NC 28112 704-860-8512 d. Election Sum to Date $ 1832.60 e. Description E Date(mm/dd/yyyy) g. Fair Market Amount FOOD FOREVENT—PUBLIC 6/23/26 $ 63.24 DISHES UTENSILS—DOLLAR TREE 6/23/26 $ 20.05 CHAFING FUEL, TRAYS—DOLLAR TREE 6/25/26 $ 7.47 3. ContributorlIoformatioo Add !❑ .Remove i a. Full Name, Mailing Address & Phone (include city, state, &zip) b. Type of Contributor c.Comments ❑ Individual ® Candidate ❑ Party ❑ PAC ❑ Referendum ❑ OlherReceiptSource SURLUTA B ANTHONY 1307 VIRGINIA AVE MONROE NC 28112 704-860-8512 d. Mectian Sum to Date $ 1864.63 e. Description _ r ., f. Date (mealdd/yyyy) g. Fair Market Amount CASE OF WATER FOR EVENT—TREEHOUSE 6/25/26 $ 32.03 3.' Contributoclnformation Add ;❑ Remove ; a. Full Name, Marling Address & Phone (include city, state, &zip) b. Type of Contributor c. Comments ' ❑ Individual ❑ Candidate ❑ party, ❑ PAC ❑ Referendum ❑ Other Receipt Source UNION COUNT CAMPAIGN FINANCE JUL 2 4 2026 RECENED d. Election Sum to Date $ e. Description - - E Date(mm/dd/yyyy) g. Fair Market Amount $ $ $ 4. Total onl this Tae $ 122.79 5. Total of ALL CRO -1510 'Pages �(Tbis,' ine must be on'line47 of Delailed'Summary'PageCR&1?00) $ 1932.16 CRO -1510 NC State Board of Elections December 2007