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Anthony, Surluta_2021-Org - CopyHEUEIVED Disclosure Report Cover l - pm Amendment ❑ No Use this form for general report and committee information, must be signed and submitted along with other detailed fors. Do not use this for to update information. 1. Committee Information FW Name _ ammij c:c -6 �e�F Sw�lwfa , c m Nuom6v 3 -AA– We,3 MbW`g Addn=fm &Cly,BMkadZpGde) _ _dLawapsa dd aoTatleyr4&d 10..1- 2-' m O y vt e/ (JC 2 $ f (Z Phone Naber 2. Report Year 3. Period Start Date tame_ 4. Period End Date (a_Im/yy) 5. Tteasurer Fall Name aola `7 - -Z f -a(-z l n tf of _onlmiltee (Check Oa) ._ TM of R (check only ate of opo from one category) Candidate Campaign ❑ Partystatdcaaty ❑ PAC ❑ RefaeiWam Bdereodh® ❑ offal ❑ tagamnaoail ❑ Independent Expenditure ❑ Jam Pmdraiser ❑ TMAy-fire day Q-9015, ❑ Rnnfaendom ❑ regal Expense Fund ❑ Pre-pnmary ❑ First ❑ Final ❑ Pre- rai ❑ Pro-rmoff semi-annual ❑ Mid Year ❑ second ❑ Third ❑ Fourth serni-annual ❑ Suppl®mtal Final ❑ Annual ❑ Special a TW otFund i(fapp� cbackt) 0 Booster Pond ❑ Building Fund ❑ ocher. ❑ Year End ❑ Final ❑ special ❑ Mid Year ❑ Year End ❑Final El spec;,) 10. Name Nmolter of F%mdraixra Wit Rgmt - 11. Account Information 11. Account Information . F ruincial Institution Ful Name F-144�t M,i yd 6a6r- Financial Institution Full Name . Purposee. Amount Code Pmpme c Account Code d5 & 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 Creneral Statutes and that no funds are commingled with prohibited or other non -disclosed funds. I further certify that t}ps report is complete, true and correct and than I have been trained by the NC State Board of Elections. �L ((� (c s[ ClL� r"t A4CGAA(s IO ,Printed Name of Sig= sisnaturt, Trtamrer Date OR OFFICE USE ONLY Date Received: �O D/ �� Employer- Delivery Method ❑ Normal Mail Date Postmarked: Employee: Registered Mail Hand Delivered Date Scanned: 1 Elearonically Filed Date Data Entered:Employee: ❑ Signer has not received mandatory trami 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 most amend the Statement of Organization (CRO -2100A -E) to make committee changes. CRO -1000 NC Srac Boated of Elections August 2008 (Q 3Zbjrat ed Summa Amendment TeW 11ll Summary O Yes O no Use this form to summarize all disclosure renortine forms and to total monetary information 1. Committee Full Name (mid Fund Kapplicable) Z; 3. IDNumber CommNa-`b Qe a 6kylLk u l3. l o i7a+ Lal }(IT-c� PSS Start of Election Cycle: January 1,� Total this Reportip Period Total this Election Cycle 4) Cash on Hand at Start $ S 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 0) Refunds/Reimbursements to the Committee 1) Other Receipt Sources 11a) Interest on flank Accounts 11b) Contributions from Not -For -Profit Organizations Ile) Outside Sources of Income 11d) Legal Expense Fund - Other Sources Ile) Exempt Purchase Price Sales (CRO -1205) (CRO -1210) (CRO -1220) (CRO -1230) (CRO -1410) (CRO -1240) (Ca01250) (C)M-1250) (CRO -1250) (CRO -1270) (CRO -1265) $ 5,00 $ $ Ov $ $ $ $ $ $ $ 5 5 $ $ $ $ S $ $ $ S g 2)TOTAL RECEIPTS (Add lines 5,6,7,8,9,10,1la,llb,llglldand IIc $ 60 $ XPENDITURES 13) Disbursements 13a) Operating Expenditures (CRO -13),a) 13b) Contributions to Candidates/Political Committees (CRO -1310) 13c) Coordinated Party Expenditures (CRO -13M 14) Aggregated Non -Media Expenditures (CRO.1315) 5) Loan Repayments (0044x) 16) Refunds/Reimbursements from the Committee (rano-1320) 7) fo-llJnd Contributions (CEO -1510) $ 5 $ 65g, S $ $ $ $ $ S $ $ $ $ $ S 8) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c,14, 15, 16 and 17) $ $ 9) Cash on Hand at End (Add tis 4 and 12 togedw, tb>.hetst Ise 18 $ S DIMONAL 110'ORMATION 20) Non -Monetary Gifts Given to Other Committees 1) Outstanding Loan (incl ores from other campaigns) 2) Debts and Obligations owed by the Committee > Debts and Obligations owed to the Committee 24) Account Transfers Within the Committee 25) Administrative Support 6) Forgiven Loans 7) 48 -Hour Notice Reports Sum ) C mb ibutions to be Refunded (CRO -1330) KR&1430) (CRO -1610) (CRa1a0) (CRO -1720) (CJI&1710) (CR0.1440) (CRO -2220) tit anus $ $ $ $ $ $ $ $ $ $ $ $ $ CRO-1100 NC Soft Bond GtR6teen August 2008 RECEIVED U_ � r.., �:. Amendment .. Aggregated Contributions from Individuals Page of _ ❑ yes ❑ No Optional form used to report NC Contributions Fmm IntiMfimmk of vm i,.vv 1. Committee Fall Name (ate Ftirnd d a ) 2 ID Number XTM WQ OVYLM 6 7 lci7 �uv��fa �✓ Avt (ion 3. Contributor Information nd b. Account Code c. Form of Parnrnt d. In -Kind Description LAmountied U y/�Ch Te.D21=e(n—uWMd1�yyy) S5 0 t O6La ❑ Remove ❑ Add Remove Q (i - �Lyy� t� rt/� a u 1 V�(�� 1 • l JDa OO S 50, Add 1 ( r� tMM1 /a U I S (c) 00 Add VE3Remve ��[/ a [ .,y/� I^rL �'f�J%q�I� I f' W w'1lA l7't S ❑ Remove S ❑ Add Remove S ❑ Add Remove S El ❑ Add Remove S ❑ Add Remove S ❑ Add Remove S ❑ Add Remove S ❑ Add Remove S Ll ❑ Add Remove S ❑ Add Remove S ❑ Add Remove S ❑ Add Remove S ❑ Add Remove S Er-lu-M ❑ Remove S El ❑ Add Remove S ❑ Add Remove S ❑ 113 Add Remove S Add Remove S 4. Total only this Page- p 5. Total of ALL CRO -1205 Pages r S 1 ( O 0 (This line mast be online Sof Detailed Summary Page CRO -1100) J . LICV•rdOJ NC State Board of Elections April 2007 U., i '- ,\menament Contributions from Individuals Pg _ ar _ ❑ Yes ❑ N,, Use this form to report individual contributions over $50 or6mributions tinder $50 if form CRO I 20, s 1, not used 1. Committee Full Name (and Fnnd if applicable) 2. 11) Number 3. Contributor Information El Add ❑ Remove a. Full Name. Nailing Address & Phone (include city. state. &zip) b. Job Title/Profession Pale officer d. Comments _ - Tamara w i I I i am S 3209 Kirk land Cf, MOY1r0e NC 28110 c. Employer's NamdSpecHk FW pion µ�}� X30 1\1 �lr, IvlonwCING 2411 e.Election s®taDate $ A00•00 . Prior g. Account Code b. Form of Payment I. In Kiad Description ' Date (mtel ftyyy) L Amount ❑ q&81 che(,-K ❑ s 3. Contributor Information ❑ Add ❑ Remove . Full Name. Nailing Address & Phone (iuclmle city, slate. & zip) Lou�S3akw 5713 Avay/ Pwv Dr, Monycle `VG 28110CGI L Job Title/Profeasion m�nis+-cv d. Continents uEaoployer's NamdSpeci6e F9dd (7 e.©eatlw Sm to Date $ 100,00 . Prior ° g. Account Code h. Form of Payment i. In -Kind Description - Date (nddd(yyyy) L Ammat $ 100 DO 68 ChP,Gk 0�'mZS-ZI ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove . Full Name, Nailing Address & Phone (include city, slate, & zipl b. Job Title/Profession d. Commeals c. Employer's Name/SpedRe Field e. Election Sm to Date $ f. Prior g. Account Code L Form of Psymeol 1. fn -Kind Description - Date (mm/dd/yyyy) IL Amount ❑ $ ❑ 5 ❑ S 4. Total only this Page 00 5. Total of ALL CRO -1210 Pages (Thisline wait beonline 6ojDetailed .Sammare Page CRO -1100) �'-`�' Oo CRO -1210 NC Slate Board of Elections April 2007 HECE Disbursements Pg / at Amendment ❑ ❑ No Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political committees and coordinated oartv exoenditures 1. Cottee Faff Name (and Fuad N applicable) 12. ID Number xl-mw Co►n�ti e tv flu Suv�a+r< g. Atitii�or� y ztt[Ditbornmemt Wkwe use separate CRO -1310 fornu for asefl hoe of DisbursemeaC) oatimig Ey— 1:1Conrnbut.,mmCandidat6(PolibcalCommmftk= ❑ Comiinaud Party Ex 'tures Payees El Add Remove Full Name, Mailing Address & Phone e ty, eaq A #) OTree /V�o y,rve NC ZPIID � k Cwdlrled Camodtlx Nasse d. Commands c. Level ar8islered (Spedty) ❑ �'' iT ❑ stun E3PaitY- Hem Sb to Dde $ 27lWG AtawdClde &Fl efFayaast )l�I Cub baftli anIII&MO A>.� Ieerrtail�Y 6 C C -'-2 $ 2?,1 Cam ai n k' -oFf s (� tis . Payee hdormation ❑ Add ❑ Remove . Full Name, Mailing Address & Phone Dri e -h&t TraX n y, to m b. Coordinated Comatee Nue d. Comments is Land RegMeed (sPeeft) Aedmt Ex Canary: o ala o •may: tOad�t�t. Dale a StPrp0tat P.�CM& Da!OnidWSM) Assn" spook""' F PC $- 5-2 s tq i s 4. Payee information ❑ Add ❑ Remove . Full Name, Mailing Address & Phone (indade CwY. me, & >IiiP) b. Coordinated Commits" Name d. Co®ents LardRalodsad(SoK ty) E3 Fbiow E3 n F Q sl.e o bttaairipawr- &IIIIIIANNESIM1481111010 $ Wo -W Aarou*Cade &Pafft POWMCadg Dmftl—!Wy,yAAssam irtdlvlY I CG 0 U--2 1-21 7 6 St I falid s - o✓cuvn i 7�,8y �crVe itfertlul . Total only this Page $ 6. Total of ALL CRO -1310 Pages (This line goer in (are 13a of Detailed Sa••oy, rine CRO.1180 if Operating Expenses) (This tine goes in line Ilb of Detaded Summary Page CRO -1100 if Contrib to Candidates/Political Comm) (This line Zoes in line 13c of Detailed Summary Page CRO -I 100 if Coordinated Party Expenditures) ParpmCodes (List detailed expenditure code m (b.) above) •F - Media Bs - Printing C* - FUndraising D - To Another Candidate - Salaries F* - Equipment G - Political Party Ha - Holding Public Office Expenses Postage J - Penalties Ka - Office Expmaea Q' - Donation to legal Expense Fund • Other ' Codes re uire detailed a lavation al aired remarks field CRO -1310 NC State Board or Flections December 2009 n 111CUMVCL' Disbursements 2 Amendment P6 �L of _ ❑ Yes ❑ Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political committees and coordinated narts. exnendito,, L Committee FUR Name (and Fund He - - -- ---- ------ -- - mM-A#r- f l wecf (510,44a C Anfkon 2. ID Number --- -- XSMW83- of Disbursement _t(—Prlawe race geminle X720-/310 forms for tach tree o�ftDisb_Rrs mewl ) ratinc Ex •nses u Conirihutions to CandidateJPuliiical CommilLL•es r Qx)r, inaLLd Pm Expenditure, 4. Payee Infortnation El Add 13 Remove a. Full Name, Mailing Address & Phone include city, state, &i 1)-.--- _ - ,y�-f/rn ^ nnV, I eit- ^ I^ `'"✓"l /'r� m a9 n e fs of) fh e cheap, co t //y� It. Coordinated Committee Name d. Comments - -- c. Level Registered (Specify) �ideral County. ❑ swic 0 Municipality: e. Election Sum to Date a117raa . Account Code g. Form of Payment b- Purpose Code L Date (mndddlyyyy) J.Amomwl s k. Required Remarks ma hem -2 -21 . Payee Information ❑ Add ❑ Remove . Full Narne,'1lailing Address & Phone (include city, stale, & zip) lyhourwri'sfhgnds. eon b. Coordinated Committee Name it. Comments Level Regidemd(Spedfy) Fodetal county: 0 State ❑ Municipality: C Etectien Sum to Date $ 83.50 - Account Code - g. Form of Payment 1bparpowCoile L Dale (mmlddlyyyy) j.Amount k. Regaked Remarks r Ich 68- CC B 8-16 -ao21 $ 3.50 s . Payee Information Add Remove . Full Name, Mailing Address & Phone (include city, stage,&zipl OFFi Gc M a X 100 W, RDo5e Ve Lf SLd• Monroe, Ne a8ll a It. Coordinated Committee Name d. Continents - e. Level Registered (Specify) cou �-t my: IJ State - Q Municipality: e.EledfnaStataDale $ 31.31 . Anoount Codc g. Form of Payment C C h. purpose Code L Dale (aaaiYdlyyyy) Avo®t K q -I - Z $15.4 7,2141?1_—� L Required Remarks c v SfcriU -, 2-21-L Llo c lab S. Total only this Page q a 3 2 0 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Retailed .Summan Page CRO -1100 if Operating Expenses) / (This line goes in line lab of Retailed .Summon' Page CRO -1100 if Contrib to Candidates/Political Comm) S (Yn (This line goes in line 13c of Retailed Summarr Page CRO -1100 if Coordinated Party Expenditures) 7. Purpose Codes (List detailed expenditure code in (h.) above) Ax - Media B• - Printing C' - Fundraising D - To Another Candidate E - Salaries F' - Equipment G - Political Party Hs - Holding Public Office Expenses 1 - Postage J - Penalties K' - Office Expenses Qs - Donation to Legal Expense Fund O. Other * Codes uire detailed explanation in reguired remarks field k CRO -1310 NC State Board of Elections December 2009 Gl Le, RFCF[Va Amendment Disbursements _ (;, V-7 Pg of _ ❑ Yes ❑ No Use this form to report expenditures from the comrrrittee for operating expenses, contributions to candidate/political committees and coordinated Dartv expenditures 1. ConaiRee Pull Name (and Fund if t *pcmhle) 12. ID Nt®iher ommi ee * rlec-k Sw-htfr a. AAheln XSM Wf33 atDiebmseneat (Pleats mmnwv* CN04310 forms for each Lyne of ' barsemewt ) [in E uses ECOatflb¢tlWfi to CaodidatdPolitica]Committee:, ❑ Coordinated Party Fxpetiditures 4. Payee Information El Add ❑ Remove . Full Name, Mailing Address & Phone include city, state, & zip) Sane Cl r e h rod T. wc1av y Bld b. Ceord:oki OommilleeN d. CeEnsds c LA%vl R•gbillaredabodly) otae$ t[3 miecd.smbDoft Accomt Code g. Ferr1e of Pgetet 6 Ptmpm Cede t Date (eelddlyyyy) Ameft it. Required Rmarim _ ki Jt 1 -7,1-21 $ lt&?f 55ir5oag 1$31-21) Gk - Payee Information ❑ Add ❑ Remove Full Namr, Maaing Addrm & Plane Oadude city, etete.&zip)- OOG� Li b& l b0 • Su�ctef D,� Mon�C,N� 2�i1 Is. Ceedlint d Com itlee Nue d. CaMMemte 1&Vd Rellodomill 000clify) ❑ soft stale al 13- tel- ❑ Mmicipality. Da e. Rledir � ble $ 9o, ,5 -- . Account Code g. Fore o(Paymeut b. Purpose Code i Date (nmmWJyyyy) Amovt k Required Remarba C61 8 a7- 21 $ o 5-"a XI'6k-off 4. Payee Information ❑ Add ❑ Remove FW Name, Mailing Addrem & Phome (include dty, state. & lip) Un ►`bn CO, old /qrM oP� 60 S. �Tohnson Sf 0 )'De, Kc a8i�a b. Caard'aded Committee Name d. Con meats L..d— .0 - t2}a�f) S. Tom"' °° $ 5D,6o Aecowt Cede g. Fora of Payment h ee PurpCode t Date (mmld&yyyy) Aetut R Required Reaarb Deb► ° f-60"Aa $ kiG — 0 PF eVe 5. Total only this Page $ r 6. Total of ALL CRO -1310 Pages (This line goes in tine l3a of Detailed Summary Page CRO -1100 if Operating Expenses) $ (This line goes in time 13b of Detdlnd Sarmmy Page CRO-llM if CmW& m CaBdshr/Pslmcd Gram) (This linegoer in 1ue 13c of Decoded Sormoy Page CRO-1186if Coord netted Party EWn&btraw) 7. Purpose Codes (List detailed expenditure code in (h.) above) • - Media B" - Printing Cs - Fundrai®ng D - To Andrea Candidate - Salaries F• - Equipment G - Political Party Hs - Holding Public Office Expenses - Postage .) - Penalties Ks - Office Expenses Q" - Donation to Legal Expense Fund O" Other " Codes reunite detailed exnlanation in required remarks field it CRO -1310 NC State Board of Elections December 2009 r RE'CEIN/FCS Amendment Disbursements Pg t of _ ❑ es ❑ No Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political committees and coordinated ez enditures (and Fwd V applicable) 2. U) Number4o XTMw83 Occf w1u44 8• Anfhoi F11ame ent fPbm orae tines- to CRO -1310 torus Por each tvoe of Disbursement) Operating C�lbmions toC /Pobtial C®tta ❑ Cadinafcd Ex stores Add Remove a. Full Name, Mailing Address & Phone include qq, alae, & ) b. Caordbuded Cause Name d Coats Third Bank 20l N, UokloWe Ave. Ill o n' ue, N c akll2 `a ) , 0� o> T 1�ed��bD.e $ .q Acenod Cwie S1111wroseirm jh6lPa7m0nde 1.11oftboniffiftj7h &Amwmd l glad Lts•d. kI wi ►a.�A - -2 $I .4ic kbre'r w4hdkZo f)c 1 -3o-2 $37,00 0v ram . Payee Information ❑ Add ❑ Remove Fra Name, Mailing Address & Phone (fdnde dly, state, & sip) b. Coordiaatnl Committee None d. Comments c. Lerd> (Spedty) LI Pedmd 13 County: 0 stst 0 qtr- mmmsonsmsenni a .Aea®t Code & J13nnma[Pagmtat y1•Cde DAtOnAAdffyyy) Ammil lawk"A lb $ $ 4. Payee Information ❑ Add ❑ Remove Full Name, Mailing Address & Phone �e f3h..era a ow b. Coordinated Committee Name d. Comments _ a I"d> (8pady) Fadmd E3 cowAr- 0 am 0 m idpeitr. medam Smtanafa . Accoad I.AftimmU yyyy) Amaaat IL !e*id Yennui® $ 5. Total only this Page $ a Q 6. Total of ALL CRO -1310 Pages (This late goes in line 13a of Derailed Summery Flap CRO -1109 if OpefNsg E:pcwses) ',. (This fine goes in line 13b of Detailed Summasy Page CRO-ffoo if connib to Candidates/PoUa al Camm) (This line gon in line 13c of Detailed Sum Pg, CRO-11oo if Caofdisated prty E eldimns) $ / / • �� (� J 7. PRipilm Codes (List detailed experemure code in (b.) above) - Media B* - Printing C* - Fundraising D - To Another Candidate - Salaries F* - Equipment G - Political Party Hs - Holding Public Office Expenses Postage J - Penalties I(* - Office Expeines Q* - Donation to Legal Expense Fund * Other * Codes require detailed explanation in required remarks field f,A043t o NC Stale seam 01 Elecaens December 2009