Alsobrooks,Clarence_2021-Year-endDisclosure Report Cover
[:3
yes ent 0 No
Use this form for general report and committee information, must he signed and submitted along with other detailed forms.
Do not u,e Ihl, (oris to a tdate information.
1. Committee Information
a. Dull Name
c. to Number
s nn<k k /eek i6''
l -5M1- ZZ
It. Mailing Address (include City, State and Zip Code)
it. Date Filed
r. Phone Number
2:'Reliort Year
3. Peiidd,r$, ate (mm/ad/yyl4. Period End Date (mm ddtyy)
5. Treasurer Full Name
,• a
- -�0
l�tt
��cI
0"
6-T __ f Committed Liteck One
9. T elof Re or[ check
on1 one e o re ort
rom one cote or )
Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑ Organizational
❑ Organizational
❑ organizational
❑ Independent Expenditure ❑ Joint Fundraiser
❑ Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pre-primary
❑ First
❑ Final
❑ Pre-election
❑ Pre -runoff
❑ Second
❑ Third
❑ Supplemental Final
❑ Annual
7. Type of Fund (ifapPli-able, check one)
❑ Booster Fund
Semi-annual
❑ Fourth
❑ Special
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year End
❑ Mid Year
10. Special Report Name
❑ otim
❑ Final
❑ Special
QYear End
❑ Final
8. Number of Fundraisers this Report
-
❑ Special
11. Account Information
11. Account Information
a. Financial Institution Full Nance
a. Financial Institution Full Name
b. Purpose
c. Account Code
h. Purpose ;:\I COUNTY
c. Account Code
Al :FiNANC
Z02-1
d. Period Begin Balance
d. Period Begin Balance
FEB 0 4 2022
$
$
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 traio NC State Board of Elections.
ned by t
Clarence t, gh6roA5 ,T� `( -&,b ZdZZ
Printed Name of Signer Signature of Appointed Treasurer Date
FOR OFFICE USE ONLY
Date Received: kla Delivery Method
Employee: ❑ Normal Mail
Date Postmarked: Employee: Registered Mail
Hand Delivered
Date Scanned: a Employee: Electronically Filed
E] 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.
You must amend the Statement of Organization (CRO -2100A -E) to make committee changes.
CRO -1000 NC State Board of Elections August 2008
Detailed Summary![3Yes
at ❑ Na_
I Ise this form to summarize all disclosure renorliii, Inrni� .ind to total iunnetary information
1. Committee Full Name (anti Fund if applicahle)
2. Type of Report
3.H) Number
f_ L11
Start of Election Cycle: January 1, ado
Total this
Reporting Period
Total this
Election Cycle
4) Cash on Hand at Start
$ nQ
$
RECEIPTS
5) Aggregated Contributions from Individuals
6) Contributions from Individuals
Committees Contributions from Political Party Conittees
8) Contributions from Other Political Committees
9) Loan Proceeds
10) Refunds/Reimbursements to the Committee
11) Other Receipt Sources
la) Interest on Bank Accounts
I I b) Contributions from Not -For -Profit Organizations
I lc) Outside Sources of Income
I1d) Legal Expense Fund - Other Sources
1 le) Exempt Purchase Price Sales
(CR04205)
(CRO -1210)
(CR04220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250}
(CRO -1220)
(CRO -1265)
$
$
$
$
$
$
aC��IL IL
-T �f
$
$
$
$
$
$
$
$
6NION COUNTY
$
$
$FEB 0 4 202Z$
.S ,__ ,.� C I� 1)—T.
$
12)TOTAL RECEIPTS (Add lines 5. 6, 7, 8, 9,10,1 la.l lb,llc,l lduud l lc)
C
j
EXPENDITURES
13) Disbursements
13a) Operating Expenditures
131)1 Contributions to Candidates/Political Committees
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)
(CRO4310)
(CRO -1315)
(CRO -1420)
(CRO -1320)
(CRO -1510)
;; ro-.k.-
$ $
_
$ $
$ $
$ $
$ $
$ Zoo OD $
$ $
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$
$
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$
$
ADDITIONAL INFORMATION
20) Non -Monetary Gifts Given to Other Committees
21) Outstanding Loans (incl. ones from other campaigns)
22) Debts and Obligations owed by the Committee
23) Debts and Obligations owed to the Committee
4) Account Transfers Within the Committee
25) Administrative Support
6) Forgiven Loans
7) 48 -Hour Notice Reports Sum
8) Contributions to be Refunded
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRO -1620)
(CRO -1720)
(CRO -1710)
(CRO -1440)
(CRO -2220)
(CRO -1215)
$
_ T
$
jL
$)'
,!
$
$
;t-
$
$
$
$
$
$
$
$
CRO -1100 NC State Board of Flections August 2008
Amendment
Refunds/Reimbursements From the Committee Pg of ❑ Yes ❑ No
Use this form to report refunds/reimbursements, including contributions returned to the contributor.
r" •bmiuittee Full N ' 'if a'" 'lieable)
2. IDNumber
zL2
3. Payee Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
400 °J IQ4nCq Y
� CSD 79
rpM Iv c, 0
d.a of Committee
Candidate PAC
❑ Referendum ❑ Pany
h. Original Receipt Dale
-Z Z-0 2
e. Level Registered
❑ Federal u County:
0
❑ State ❑ Municipality:
i. Original R dpt Amount
$
L Code
Sum to
J. Election Suto Date
$
b. Job Titie/Profession le.
Employer's Name/Specific Field
1g. CommentsII
k. Amount Code
Rc�trr4t
�re[f
`�etll2NP�
(�N ZO Zl
. Form of Payment m. Required Remarks In. Date (mm/dd/yyyy)
o. Amount
Full Name, Mailing Address & Phone
(include city, state, & zip)
d. Type of Committee h. Original Receipt Date
0 Candidate 0 PAC
❑ Referendum ❑ Party
UNION COUNTY
CAMPAIGN FINANCE
FEBQ 2�Z2
IVE-F,
e. Level Registered L Original Receipt Amount
Federal County: $
❑ sum ❑ Municipality:
f. Purpose Code . Election Sum to Date
$
b. Job Title/Profession [CEmployer's Name/Specific Field
g. Comments 1k. Account Code
L Form of Payment
Im. Required Remarks
n. Dale (mrn/dd/yyyy)
o. Amount
3. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
d. Type of Committee
h. Original Receipt Date
0 Candidate PAC
❑ Referendum ❑ Patty
e. Level Registered
1.Original Receipt Amount
$
Q Federal County:
❑ State ❑ Municipality:
E Purpose Code
'. Election Sum to Date
$
b. Job Tiae/Profession
c. Employer's Name/Specific Field
Ig. Comments
1k. Amount Code
1. Form of Payment
m Required Remarks
In. Date (mm/dd/yyyy)
o. Amount
4. Total only this Page
$
5. Total of ALL CRO -1320 Pages
(This line must be on line 16 of Detailed Summary Page CRO -1100)
$
fi. Purpose Codes (List detailed disbursement code in (f) above)
L - Returned to Contributor M - Overpayment for Service N - Exceeded Contribution Limit
P* - Reimbursement of In -Kind O* Other
* Codes re lire detailed ex lanation in re uired remarks field m
CRO -1320 NC State Board of Elections December 2007