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Cabuno,Brittany_2026-3rd-QtrAmendment Disclosure Report Cover p Yes p 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. 10 1. Committee Information a. Full Name c. ID Number 15-M L b. Mailing Address (include City, State and Zip Code) d. Date Filed /v f/ / �U eo`l ermp`n 1r� �� 1e � �' I �d j7Tq f ►� N Com- e. Phone Number .512, — (Q3 sem 16 / 2. Report Year 3. Period Start Date (mm/dd/ ) 4. Period End Date (mm/dd/ 5. Treasurer Full Name Z(p I 10° ZvzU r i Go �0-toU(IL) 6. Type of Committee (Check One) Candidate Campaign ❑ Party ❑ PAC [] Referendum ❑ independent Expenditure 17 Joint Fundraiser Legal Expense Fund 9. Type of Report (check Nlunicipal only one type of reportfiRom State/County one category) Referendum ] Organizational 0 Thirty-five day 0 Pre-primary Pre-election Pre -runoff Semi-annual El Mid Year ❑ Organizational Quarterly ❑ First ❑ Second PI Third Fourth Semi-annual Organizational Pre -referendum ❑ Final [D Supplemental Final E] Annual 0 Special 7. Type of Fund (if applicable, check one) ❑ Booster Fund ❑ Building Fund ❑ Other: Ej Year End 0 Final F7 Special 0 Mid Year 0 Year End ❑ Final 10. Special Report Name 8. Number of Fundraisers this Report ID Special 11. Account Information 11. Account Information a. Financial Institution Full Name 4J a. Financial Institution Full Name - b. Purpose --------.-----M-1pAIGN c. Account Code b. P c. Account Code OCMPOL't k1 & Zo OCT d. Period Begin Balance d. Period Begin Balance _ 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 by the NC State Board of Elections. Printed Name of Signer Signature -of Appoi ted Trea rer Date FOR OFFICE USE ONLY Date Received: � Employee: DeliverMethod Q y ❑ Normal Mail ❑ Registered Mail Date Postmarked: Employee: and Delivered Wectronically Date Scanned: Employee: Filed Date Data Entered: Employee: ❑ Signer has not received 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. CKU-1000 NC State Board of Elections August 2008 Amendment Detailed Summary [:]Yes ❑ No Use this forrn to summarize all discln,nre. rennrtina form, and to tnt it mnnetnry infnrmntion 1. Committee Full Name (and Fund if applicable) 2. Type of Report 3. ID Number aA Start Of Election Cycle: January 1, (�) �` Total this Reporting 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 1lb) Contributions from Not -For -Profit Organizations llc) Outside Sources of Income lld) Legal Expense Fund - Other Sources lle) Exempt Purchase Price Sales (CRO -1205) (CRO -1210) (CRO -1220) (CRO -1230) (CRO -1410) (CRO -1240) (CRO -1250) (CRO -1250) (CRO -1250) (CRO -1270) (CRO -126.5) $ /00 $ $ y $ $ $ $ $ $ $ $ $ • t• $ $ $ $ $ $ $ $ $ $ 12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9,10,11 a, l l b, l 1 c, l l d and l l e) $ //pj) — $ EXPENDITURES 13) Disbursements 13a) Operating Expenditures 13b) Contributions to Candidates/Political Conunittees 13c) Coordinated Party Expenditures 14) Aggregated Non -Media Expenditures 15) Loan Repayments 16) Refunds/Reimbursements from the Committee 17) In -Kind Contributions (CRO -1310) (CRO -1310) (CRO -1.310) (CRO -1315) (CRO -1420) (CRO -1320) (CRO -1510) $ 5 .5 2— PEW $ $ $ $ $ $ $ $ $ $ $ $ 1-4 C $ 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ Ig tj $ 19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18 $qqq, Vg$ ADDITIONAL INFORMATION 20) 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,. �pAI0-1620) _�tR 24) Account Transfers Within the Committee C, (CRO -1720) 25) Administrative Support (CRO -1710) 26) Forgiven Loans (CRO -1440) 27) 48 -Hour Notice Reports Sum (CRO -2220) 28) Contributions to be Refunded (CRO -1215) $ P- $ $ $ t ry` $ $ $ $ $ $ $ $ $ CCU -11 UU NC State hoard of Elections August 2008 Contributions from Individuals Pg of A❑meYdment N� Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used ommittee Full Name (and Fund if applicable) 2. EDNumber F ontributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) '3 h/ 111 '� ' b. Job Title/Profession d. Comments c. Employer's Name/Specific Field j C(66S §�AjIZd ( h C, e. Election Sum to Date f. Prior g. Account Code h. Form of Payment i. In -Kind Description j. Date (mm/dd/yyyy) k. Amount ❑ c��1��-�� �� i� za��- $ 90 = ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments c. Employer's Name/Specific Field e. Election Sum to Date f. Prior g. Account Code h. Form of Payment i. In -Kind Description j. Date (mm/dd/yyyy) k. Amount $ ❑ ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone r\;.i 1, (include city, state, & zip) U-N1ON Gr,MPAlu�-� I.N F1 L� L I REcENED b. Job Title/Profession -- - -- --------- d. Comments c. Employer's Name/Specific Field e, Election Sum to Date f. Prior g. Account Code h. Form of Payment i. In -Kind Description j. Date (mm/dd/yyyy) k. Amount ❑ $ ❑ $ ❑ $ 4. Total only this Page $�y 5. Total of ALL CRO -1210 Pages (This line must be on line 6 of Detailed Summary Page CRO -1100) $ C �' r UIev-ILIU NC State Board of Elections April 2007 ment Aggregated Contributions from Individuals Page of [:]Amendnd ❑ No Optional form used to report NC Contributions From Individuals of $50 or less 1. Committee Full Name (and Fund if applicable) 2. 1D Number 1.5MI-AS 3. Contributor Information a. Amend b. Account Code c. Form of Payment d. Li -Kind Description e. Date (mnt/dd/yyyy) f. Amount 1:1 Remove V! %, �iU" /� �' qo Acid ❑ Remove tl �� �� $ Acid ❑ Remove C Q 7j to $ Add ❑ Remove Add ❑ Remove $ Lj Add ❑ Remove $ Add ❑ Remove $ Acid ❑ Remove Add ❑ Remove $ Acid ❑ Remove $ Acid $ ❑ Remove Acid ❑ Remove $ Add I❑ Remove $ LJ Add ❑ Remove $ Acid ❑ Remove $ Acid ❑ Remove C(]U�� iY ,,onN � Acid n 1G�1 - Chi k�a ❑ Remove r Add �1�� f E• ❑ Remove $ Add ❑ Remove $ Add ❑ Remove $ Add ❑ Remove $ Add ❑ Remove $ Acid ❑ Remove $ 4. Total only this Page $ 5. Total of ALL CRO -1205 Pages (This line be line 5 Detailed $ /00 j.� U' must on of Summary Page CRO -1100) CKV-16U.) NC State Board of Elections April 2007 Amendment Contributions from Political Party Committees Pg _L of ❑ Yes ❑ No Use this form to report contributions from a political party I. Committee Full Name (and Fund if applicable) -- C&bvno Xh4� 2. ID Number /15 IMAKS 3. Contributor Information Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) 3� rW 3ah y �' Way -haw, ay—howl IV, 9-tkI, b. Comments — c. Election Sum to — -- --- -- d. Account Code e. Form of Payment f. In -Kind Description g. Date (mm/dd/yyyy) erte z3 � h. Amount $ 5 c — 2v $ $ 3. Contributor Information Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) Un ivn Po x Mon rope, N'�, 9k1rr b. Comments - c. Election Sum to Date $ d. Account Code e. Form of Payment f. Iii-Kinr�iHcFipljyfXjV� g. Date (mm/dd/yyyy) io /6 ze h. Amount $ iso _ , 7 A9 9 y $ $ 3. Contributor Information Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) % �,� _c �L V�+' 4 11671 ifl Awl - 1 ?"© x gLt e 4�A• 9 T_�i') n ' /.91- �e 7q b. Comments c. Election Sum to Date $ d. Account Code e. Form of Payment f. In -Kind Description g. Date (mm/dd/yyyy) 0 z� '?$ h. Amount �� 0— �LIz Owe, $ $ 4. Total only this Page $ (YO 5. Total of ALL CRO -1220 Pages (This line mast be an line 7 of Detailed Summary Page CRO -1100) lrin� $ _ quo uew-i/,w NC Mate board of Elections April 2007 In -Kind ContributionsAmendment Pg of ❑ Yes ❑ No Use this form to report non -monetary contributions, donations, goods or services provided to the corrunittee or fund. Use CRO -1215 if In -Kind Contributions were nr will he refnnrlerl within 7 rlavc 1. Committee Full Name (and Fund if applicable) 2. ID Number 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) I ��I� -- — — �WWl ( ZrrGa ��11n c1�^ LL b. Type of Contributor c. Comments Individual Candidate Party ❑ PAC ❑ Referendum ❑ Other Receipt Source d. Election Sum to Date $ CIO e. Description t o f. Date (mm/dd/yyyy) g. Fair Market Amount $ 4, PC 1S 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Type of Contributor ❑ Individual ❑ Candidate ❑ Party ❑ PAC ❑ Referendum ❑ Other Receipt Source c. Comments d. Election Sum to Date $ e. Description C�^I �'iui`! j y - '�ly}C-,Iv HNN f. Date (mm/dd/yyyy) g. Fair Market Amount $ jWj 2 f z N61 $ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Type of Contributor c. Comments ❑ hidividua] ❑ Candidate ❑ Party ❑ PAC ❑ Referendum ❑ Other Receipt Source d. Election Sum to Date $ e. Description f. Date (mm/dd/yyyy) g. Fair Market Amount $ $ $ 4. Total only this Page $ 61 D- 5. Total of ALL CRO -1510 Pages (This line must be on lime 17 of Detailed Summary Page CRD -1100) $/ 1 UKU-1.)IV NC State Board of Elections December 2007 Disbursements Amendment Pg of ❑ Yes 21 No Use this form to report expenditures from the corin-iittee for operating expenses, contributions to candidate/political conuruttees and coordinated Marty expenditures 1. Committee hull Name (and Fund if applicable) 2. ID Number ea641/7 0 15M G AB 3. Type of Disbursement (Please use separate CRO -1310 forms for each type of Disbursement.) Operatinz Expenses Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures 4. Payee Information Add ❑ Remove a. Full Name, Mailing Address & Phone b. Coordinated Committee Name d. Comments (include city, state, & zip) 4 SOPC- - I"' c. Level Registered (Specify) El Federal 11 County: I �tf/f � g7ex- � l` e. Election Sum to Date ����=�. 3 ❑ State E] Municipality: 512-.933 vv if. �/L/D Account Code g. Form of Payment h. Purpose Code i. Date (mrn/dd/yyyy) J. Amount k. Required Remarics Al u 0 %c,7q $ 01 ,� ' 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing ,Address & Phone b. Coordinated Committee Name d. Comments (include city, state, & zip) �ef c. Level Registered (Specify) Federal ❑ County: 1 q0 ('�•y J y ❑ State ❑ Municipality: e. Election Sum to Date ] f. Account Code �� 2U 7,U, g. Form of Payment h. Purpose Code i. Date (mm/dd/y}yy) (1 cl c( Utz j. Amount - --- k Required Remarks SYS 4. Payee Information ❑ Add ❑ Remove a. Frill Name, Mailing Address & Phone Chi'='' b. Coordinated Committee Name d. Comments (include city, state, & zip)yiUi'.FlI��1V� P�d��j Level Registered (Specify) -- �— ❑- Federai ITCounty: ❑ State ❑ ;`Runrcipalih. e. Election Sum to Date f Account Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) j. Amount k Required Remarks $ 5. Total only this Page $ S 2 6. Total of ALL CRO -1310 Pages (This line goes in line Iia of Detailed Summary Page CRD -1100 if Operating Expenses) (This line goes in lime 13b of Detailed Summary Page CRO -1100 if Contrib to Candidates/Political Comm) (This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Parry Expenditures) 7. Purpose Codes (List detailed expenditure code in (h.) above) A* - Media l3* - Printing C* - Fundraising 1) - To Another Candidate E - Salaries F'`, - Equipment G - Political Party H* - Holding Public Office Expenses I - Postage J Penalties K* - Office Expenses QI: - Donation to Legal Expense Fund O* Other * Codes require detailed explanation in required remarks field k CRO -1310 NC State Board of Elections December 2009