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2019_Organizational ReportAmendment Disclosure Report Cover 13 Yea m No Use this form for general report and committee information, trust be signed and submitted along pith other detailed Coma. Do not use this fornto undate infnrmntion 1. a. Full Name c. ID Number A BETTER MARSHVILLE FOR TOMORROW b. Maiiiog Address (include City, State and Zip Code) d. Date Filed 3103 JULIAN GLEN CR W AXHAW, NC 28173 11/01/2019 e. Phone Number 18281776-2774 4. Pe r Fu11 N 2019 10/22/2019 10/31/2019 JINGER KFLLEY 6. Type of Committee (ChecM11111W 9. Type of Report (check only one type ofrepd mom o ❑ Candidate Campaign Party Municipal State/County Referendum ❑ Joint Fundraiser 11 PAC ® Orgw tional Organizational ❑ Organizational Q Referendmn r1l Legal Expense Fund ❑ Thirty-five day Quarterly Q Pre -referendum J ❑ Pre-primary ❑ First ❑ Final "Booster Food" ❑ Pre-election ❑ Second ❑ Supplemental Final Q Building Food ❑ Pre-nmoff Q Third ❑ Annul Q Presidential Election Year Candidates Fund Semi-annual Q Fourth ❑ Special ❑ NC Public Campaign Financing Food ❑ Mid Yeur Semi -annul ❑ Year End [3 Mid Year Q Other: ❑ Final ❑ Year End ❑ Special ❑ Final 0 ❑ Special 3. Account Information 3. Account information 7 a. Financial Institution Full Name a. Financial In stitutiun Full Name FIRST CITIZENS BANK L Purpose c. Account Code b.c. Account Code MAINTAIN RECORD OF 01 NEU CONTRIBUTIONS & EXPENSES NOV 01 2019 d. Period Begin Balance d. Period Begin Balance 0.00 S CERTIFICATION 1 certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B & 22113-22M of Chapter 163 ofthe 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 , i n A.l.f K l,� (.8,,, 11/01/2019 inted Name of Signer Sign eof AppointedTr surer Date FOR OFFICE USE ONLY Dale Received: il d ( q Delivery Method Empl [3 Normal Mail Date Postmarked: Employee: [Z Registered Mail Hand Delivered Date Scanned: Electronically Filed Employee: 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 inforrretion, or account information. You must amend the Statement of Onzanization CRO -2100A- to make committee changes. CRO -1000 NC State Board of Elections December 2007 IAmeadmtat Detailed Summary p Yts ® No Use this form to summaria all disclosure rcoortinp. forms and to total monetary in fomotion 1. Committee FLIT Name amd Frond it icable) of Report 13. ID Number A BETTER MARSHVILLE FOR TOMORROW 2019 Organizational Start of Election Cycle: January 1, _010I(o Total this Torsithis Re rtin Period Total Cycle 4) Cash on Hand at Start I S 0.00 s n nn RECEIPTS_ 5) Aggregated Contributions fromlodhiduals (CR0-1205) $ 0.00 $ 0.00 6) Contributions from In l-Aduals (CRO -1210) $ 1,800.00 $ 1,800.00 7) Contributions from Political Party Committees (CRO -1210) $ 0.00 $ 0.00 8) Contributions from Other Political Committees (CRO -1230) $ 0.00 $ 0.00 9) Loan Proceeds (CRO -1410) $ 0.00 $ 0.00 0) Refunds/Reimbursements to the Committee (CRO.1240) $ 0.00 $ 0.00 1) Other Receipt Sources Ola) Interest on Bank Accounts (CRO.1250) $ 0.00 $ 0.00 11 b) Contributions from Not -For -Profit Organizations (CRO -1250) $ 0.00 $ 0.00 Ile) Outside Sources of Income (CRO -1250) $ 2,500.00 $ 2,500.00 Old) Legal Eri ease Fund- Other Sources (CRO -1270) $ 0.00 $ 0.00 Ile) FlemptPurchase Price Sales (010-1165) $ 0.00 $ 0.00 2) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10,11 a, 11b,I Ic,I Id and l le) $ 4,300.00 $ 4,300.00 EXPENDITURES _ 3) Disbursements 139) Operating Expenditures (CRO -1310) $ 177.40 $ 177.40 13b) Contributions to Candidates/Political Committees (CRO -1310) $ 0.00 $ 0.00 13c) Coordinated Party Fhpenditures (CRO -1310) $ 0.00 $ 0.00 4)Aggregated Non -Meda lkpenditures (CRO -1315) $ 0.00 $ 0.00 S) Ivan Repayments KNO-1420) $ 0.00 S 0.00 6) Refunds/Reimbursements from the Committee (CRO -1320) $ 0.00 $ 0.00 7) hs -Wind Contributions (CRO -1510) $ 0.00 $ 0.00 8) TOTAL EXPENDI7114M (Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ 177.40 $ 177.40 9) Cas b on Hand at End (Add lines 4 and 12 together, then subtract line 18) $ 4,122.60 $ 4,122.60 DITIONAL INFORMATION Non -Monetary Gifts Given to Other Committees (CRO -1330) $ Outstanding Loam line[. ones from other campaigns) (CRO -1430) $ Debts and Obligations owed by the Committee Debts and Obligations owed to the Committee Account Tramsters- flC4',G V F D (CRO -1610) (CRO -1620) (CRO -1710) $ $ $ Administradwe Support (CRO -1710) $ Forgiwu Loans (CRO -1440) $ 48 -Hoar Notice Reports6f" Co. Board ons(CRO-2220) $ Contributions to be Refunded (CRO -1215) $ 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 Contributions from Individuals Pg I of 2 p YC mens No Use this form to report individual contributions over $50 or contributions under $50 if lbrin CRO 1205 is not used ONSUMdUee FWI Name(and Flmdif A BETTER NIARSI MLLE FOR TOMORROW 3. Contributor Information a. Full --Name, Mailing Address & Phone b.Job 7itle/Professioa (include city, state, & zi p) CATERING KATHERYN E DAVIS 511 BIVENS ST a Hoployer's Name/Specific Field WINGATE, NC 28174 SELF &Comments e. Election Sum to Date $ 300.00 L Prior g. Account Code It. Form of Payment i. In-IGnd Description j. Date (mm/dd/yyyy) it. Amount ❑ 01 Check 10/22/2019 $ 300.00 ❑ $ 3. Contributor Information 40L. ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Jitlefl'rofession it. Comments OWNIi R ANTHONY HELMS 1142 HIGHWAY 205 N MARSHVILLE, NC 28103 a Employer's Name/Specific Held HELM'S METALS e. Deetion Som to Date $ 300.00 f. Prior ❑ g. account Code It. Form of Payment i. to-IGnd Description J. Date (mm/dd(yyyy) it. Amount Check 10/31/2019 $ 300.00 ❑ 3. Contributor Information a. Full Name, Mailing Address & Phone (include city, state, & zip) A Job'Dtle/Profession $ & Comments PRESIDENT MATTHEW MILLS 723 OLD WHY 74 MARSHVILLE, NC 28103 c. Employer's Name/Specific Field PEP INC e. Fieetioa Sam to Date $ 300.00 L Prior O S. Account Code 01-- It. Form of Payment _ - Check i. In -Ki nd llescription j. Date(mm/dd/yyyy) 10/31/2019 Is. Amount $ 300.00 E3 $ ❑ S 4. Total only this PA 900.00 5. Total of ALL CR 1,800.00 (This fine must wazikyEaq Page CRO -110 . CRQI210 NC State Board of Elections April2007 NOV 01 2019 Union Co. Board of Elections Contributions from Individuals Amendment Pg of ' ❑ \es ®No Use this form to report indis-idual contributions over S50 or contributions under S50 it lixm CRO 1215 is not used A BETTER MARSHV ILLE FOR TOMORROW 3. Canlribdtar Information ❑ Add ❑ Remove a. Full Name. %tailing Address & Phone (include city, state,&zip) _..- ROBERTPALMER 1809 DOCTOR BLAIR RD MARSHVILLE, NC 28103 b. Job Tttle/Profession d. Comments ATTORNEY c. Employer's Name/Speeifie Field ROBERT PALMER PLLC e. Election Som to Date S 300.00 f. Prior g. Account Code b. Form of Payment i. In-10nd Description J. Date (mm/dd/yyyy) Is. Amount ❑ 01 Check 10/31/2019 $ 300.00 ❑ S ❑ g 3. Contributor Information ❑ Add ❑ Remove - a. Full Name, ,flailing Address & Phone (include city, state, & zip) _ KERRY K PIERCE 2015 CAMDEN RD WINGATE, NC 28174 b. Job Title/Profession d. Comments VICE PRES c. Employer's Name/Specific Field FIRST CITIZENS BANK e. Election Sum to Date $ 300.00 f. Prior g. Account Code h. Form of Payment i. to -Kind Description j. Date (mm/ddlyyyy) Is. Amount ❑ 01 Check 10/22/2019 $ 300.00 ❑ q ❑ S 3. Contributor Information ❑ Add ❑ Remove a. Full Name, )Sailing Address & Phone (inclade city, state, & zip) b. Job'litle/Profession PRESIDENT d. It ._. CHAD WHITLEY 16524 AUSTIN RD LOCUST, NC 28097 Nov 0 2019 c. tmploter's Name/Specific Feld --- WHITLEY INVESTMENTS e. Election Sam to Date S 300.00 f. Prior ❑ g. Account Code of b. Form of Payment Check i. In -land Description I. Date (mm/dd/yyyy) k. Amount 10/31/2019 $ 300.00 ❑ $ 4. Total only this Page $ 900.00 5. Total of ALL CRO -1210 Pages $ 1,800.00 (This line must bean fine 6 ojDemiled Summary Page CRO -11 CRU -1210 NC State Board of Elections April 2007 Other Receipt Sources pg I of 3 Amendment 0 Yea ® No Use this form to report income not reported on :mother lotrn. i.e. interest income, not for profit contributions etc. A BETTER MARSHVILLE FOR TOMORROW 3. Type of , _ r ❑ Interest Lj Contributions om Not-or-Profit Organvalions 0 Outside Sconces of Income 4. Contributor information - - Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Not-for-Profit Federal to # d. Comments BYRUM HEATING & A/C INC PO BOX 160 MARSHVILLE, NC 28103 c. Outside Source Explanation e. Election Sum to Date $ 500.00 L Aeeoot Code g. Form of Payment 1h. In-load Description I. Date (mm/dd/yyyy) j. Amount 01 Check 10/22/2019 $ 500.00 $ 4. Contributor Information ❑ Add ❑ Remove - ' a. Full Name, Mailing address & Phone (include eity,state. & iipt GAYECHEVEROLE"I-INC PO BOX 645 MARSHVILLE, NC 28103 h. Not-fur-Profit Federal to d. Comments c. Outside Source Uplanation e. Election Sum to Date $ 300.00 L Account Code g. Form of Payment Check h. In-Kind Description I. Date(mm/dd/yyyy) J. Amount of 10/22/2019 $ 300.00 -.Contributor Information ❑ \dd ❑ Renv%c a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Not-for-Profit Federal to # d. Comments H&S PAVING LLC PO BOX 766 ECE�VEp MARSHVILLE, NC 2811 NOV � i 2U19 c. Outside Source Explanation e. Election Som to Date $ 300.00 L Account Code Il. Formet Paym �t ptiou 1. Date (mm/ddlyyyy) j. Amoant 01 Ch 10/31/2019 $ 300.00 $ 5, Total only this Page g 1,100.00 6. Total of ALL CRO-1250 Pages (This line goes in tine Ila of Derailed Summary Page CRO-1100 iflnteres0 $ 2,500.00 !This line goes in line Iib of Dem Jed Summary Page CRO-1100 ifNot forvProfu (onrribudon) (This fine goes in line Ile ajD10emiledSummary Page C1iff Osm&e Soarca o !_neo CRO-1250 NC State Board of Elections December 2007 Amendment Other Receipt Sources pg 2 of 3 ❑ Nes ® No Use this form to report income not reported on another form i.e. interest income, not for pro lit con Irihtit ions etc. A BETTER MARSHVILLE FOR TOMORROW Interest Contributions from Not -for -Profit Organizations Outside Sources of Income 4. Contributor Inforttadm a. Full Name, Mailing Address & Phone (include city, state, & zip) Id 1i6d'164'� It. Not -for -Profit Federal to g d. Comments HALL'S AUCTION LLC 217N ELM ST MARSHVILLE, NC 28103 c. Outside Source Explanation e. flection Sam to Date $ 300.00 f. Account Code g. Form of Perm a nt 1h.In-IGod Description I. Date(mm/dd/yyyy) j. Amount 01 Check 10/31/2019 $ 300.00 . Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing :Address & Phone (include city, state. & lip) LANDPEDDLARS FLP PO BOX 723 MARSHVILLE, NC 28103 h. Nut -for -Profit Federal ID # _.------- d. ('omments --- c. Outside Source Explanation e. Election Sam to Date $ 300.00 f. lccou nI( -tide °i g. Donn of Pa) in e n t ,ccs h. In -Kind Description I. Date (mm/d&My)j. Amount 10/22/2019 $ 300.00 4. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Not -for -Profit Federal too d. Comments MARSHVILLE ROCK STORE BBQ 6608 E MARSHVILLE RD ECEN Ep MARSHVILLE,NC 281038 C. Outside Source Explanation e. t]eetioe Sam to Date $ 150.00 Atmamt Cmk g.Formof Payment 'tion 11. Date(mm/dd/yyyy) 10/31/2019 J. Amount $ 150.00 01 Chec 5. Total only this Page $ 750.00 6. Total of ALL CRO -1250 Pages (This fine goes in line Ila of Derailed Summary Page CRD -1100 #'Interest) $ 2,500.00 (This line goes in Rne Alb ofDemOed Summary Page CRO -1100 IfNot for-Proftr Contribution) IT" &e goes in fine Ile ofDemfied Summary Page CRO -1100 jf 0wa ide Sources of Income) 1 CRO -1250 NC -Sate Board of Elections December 2007 Amendment Other Receipt Sources Pg 3 of - ❑ ties ® No Use this form to report income not reported on another form i.e. interest income, not for profit contrihut ions etc. N4 A BETTER MARSHVILLE FOR TOMORROW Interest Contributions from N'nt-for-Profit Organizations Outside Sources of Income 4. Contributor Information ❑ Add Remove e. Full Name, Mailing Address & Phone (include city, state, & zip) b. Not -for -Profit Federal [DO d. Comments PIEDMONT FLOORING LLC 214 W MAIN ST MARSHVILLE, NC 28103 c. Outside Source Explanation e. Election Sum to Date $ 500.00 f.Account Code g. Form of Payment 1h. In -fund Description 1. Date (mm/dd/yyyy) J. Amount 01 Check 10/22/2019 $ 500.00 4. Contributor laformation ❑ Add ❑ Remove _ a. Full Name, Mailing Address & Phnne (include cit), state, & zip) STEGAL SMOKED TURKEY INC 6608 E MARSHVILLE RD MARSHVILLE, NC 28103 b. Not -Tor -Profit Federal ID# d. Comments r. Outside Source Explanation e. Election Sam to Date $ 150.00 E Accou nt(ode g. Form of Pay ment —Check h. In -turd DeseAption i. Data(mm/dd/yyyy) 10/31/2019 j. Amount $ 150.00 5, Total only this Page $ 650.00 6. Total of ALL CRO -1250 Pages (This One goes in One Ila of Detailed Summary Page CRO -1100 if Interest) (This linegoes in line 1 /b of Derailed Summary Page CR0./ /00 if Nat forvProfit Contribution)/This line goes in line Ile ofDetaded Summary Page CRO.1100 Ounide Soarces of Income) $ 2,500.00 t H0-1-'10 NL state Board of Elections December 2007 RECCNED Nov 01 2019 Union Co. Board d Electlons Ameadment Disbursements Pe i of I ❑ Yes ® No Use this formic, report expenditures from the committee lbroperating cspcnses, contributions to candidate/political committees and coordinated party expenditures A BE I IFR MARSHVII_LE FOR TOMORROW 3. Type of Disbursemente R Operumel. \pcnsca U ContnMnionSto Candidates/political Committees U Coordinated Party Expenditures 4. Payee htformation ❑mo,❑ Retmve a. Full Name, Mailing Address & Phone include city, state,&zi b. Coordinated Committee Name d. Comments CHECKS FOR LESS 200 RIVERSIDE INDUSTRIAL PKWY PORTLAND, ME 04103 c. Level Registered (Specify) L3Federal County: ❑ State ❑ Municipality: e. Heetiou Sam to Date $ 52.40 L Account Code g. Form of Payment 111a. Purpose Code If. Date (mm/dd/yyyy) j. Amount k. Required Remarks 10/28/2019 $ 52.40 ICIIECKSfDEPOSITBKS 01 Debit Card K 4. Payee %lbrmadan S 7177dd ❑ Remove a. F ull Narne,Mailing Address&Phone include city, state & zip) b.Coordinated Commiuee.Name d.Comments L2, INC 18912 NORTH CREEK PKWY BOTHELL, WA 98011 c. Level Registered (Specify) Federal L3 County: ❑ state ❑ Municipality: e. Rection Sum to Date $ 125.00 L Account Code 1g. Form Payment 1h. Purpose Code i. Date (mm/dd/yyyy) 1j. Amount k. Required Remarks 01 _of Check O 10/23/2019 IS 125.00 CONTACT LISTS .5. Total only this Page .... _:.... $ - _ � _... $ 177.40 6. Total of ALL CRO -1310 Pages (This line goes in line 13a ofDemiled Summary Page CRO -1100 if0perating Expenses) $ 177 40 (This line goes in One 13h ofDemiled Summary Page CRO -I 100 ifComrib m Candidateslpo4tieal Comm) (Thin line goes in litre 13c nfDetailed Summary Page CRO -1100 if Coordinated Pony Expenditures) 7. Purpose Codes (List detailed expendhuro A* - Media B* - Printing C* - Fundraising D -To Another Candidate E - Salaries I* - Equipment G - Political Party H* - Holding Public Office Expenses I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* Other c ii&i3iu NC mate tsoara or tiecuons December 2009 RECEIVED NOV 01 2019 Union co. Board of Elections