Becker, Rick_2019-ThirtyFiveDayDisclosure Report Cover I penayes 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
a. Pop Name
c. ID Number
Committee to Elect Rick Becker
FJM29B
b. Mailing Address (indude City, State and Zip Code)
d. Date Filed
6603 Sadler Rd
Waxhaw, NC 28173
09/30/2019
e. Phone Number
(704)843-5870
2. Report Yeae Brod Staid mm!aa yy) 4. Period End Date 5. Treasurer Full Name
mm!dd
2019 07/01/2019 Or) 24
'WO Frederick Becker III
6.Typeoff Report
check
only one iypxe of
report
m one care ,1or
® Candidate Campaign ❑ Party Municipal
State/County
Referendum
❑ PAC ❑ Referendum ❑ Organizational
❑ Organizational
❑ organizational
Independent
El Expenditure E]Joint Fundraiser ® Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
7. T ❑ Pre-primary
❑ First
❑ Final
❑ "Booster Fund" ❑ Pre-election
❑ Second
❑ Supplemental Final
❑ Building Fund ❑ Pre -runoff
❑ Third
❑ Annual
Semi-annual
❑ Fourth
❑ Special
❑ Mid Year
Semi-annual
❑ Other: ❑ Year End
❑ Mid Year
--S aI it ort Name
❑ Final
❑ Year End
__
8. Number of Fundraisers this ❑ Special
❑ Final
0
❑ Special
11. Account Inform
.11. Account Information
a. Financial institution Full Name
a. Financial Institution Full Name
First National Bank
b. Purpose
c. Account Code
b. Purpose
c. Account Code
General
Campaign
1
Account
d. Period Begin Balance
d. Period Begin Balance
$
$ 304.47
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 Ell tions.
Frederick Becker III
09/30/2019
Printed Name of Signer Signature of Appointed Treasurer
Date
FOR OFFICE USE ONLY
Delivery Method
Date Received:001— Employee:
(t ❑ Normal Mail
❑ Registered Mail
Date Postmarked: Employee:
d S
; ® Hand Delivered
i ❑ Electronically Filed
Date Scanned: ((p_/ L1 Employee:
❑ Signer has not received
mandatory training
Date Data Entered: Employee:
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
Amendment
Detailed Summary _0 Yes ® No
Use this form to summarize all disclosure reporting forms and to total monetary information.
1. Committee
Committee to Elect Rick Becker 35 -Day
FJM29B
Start of Election Cycle: January 1, 2019
Total this
Reporting Period
Total this
Election C cle
4)
5)
6)
7)
8)
9)
10)
11)
Cash on Hand at Start
Aggregated Contributions from Individuals
Contributions from Individuals
Contributions from Political Party Committees
Contributions from Other Political Committees
Loan Proceeds
Refunds/Reimbursements To the Committee
Other Receipt Sources
Ila) Interest on Bank Accounts
lib) Contributions from Not -for -Profit Organizations
Ile) Outside Sources of Income
lid) Legal Expense Fund —Other Sources
11 e) Exempt Purchase Price Sales
(CRO -1205)
(CRO -1110)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$
309.47
$
304.47
$ $
$ $
5.00
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
12)
TOTAL RECEIPTS (Add lines 5,6,7,8,9,10,Ila, 11b,Ilglldand Ile)
$
$
5.00
13)
14)
15)
16)
17)
Disbursements
13a) Operating Expenditures
13b) Contributions to Candidates/Political Committees
13c) Coordinated Party Expenditures
Aggregated Non -Media Expenditures
Loan Repayments
Ref inds/Reimbursements From the Committee
In -Kind Contributions
(CRO -1310)
(CRO -1310)
(CRO -1310)
(CRO -1315)
(CRO -1420)
(CRO -1320)
(CRO -1510)
$
259.67
$
259.67
$ $
$ $
$ $
$ $
$ $
$ $
18)
TOTAL EXPENDITURES (Add lines 13x, 13b, 13c 14,15,16 and 17)
$
$
19)
20)
21)
22)
23)
24)
25)
26)
27)
28)
Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18)
Non -Monetary Gifts Given to Other Committees (CRO -1330)
Outstanding Loans (incl. ones from other campaigns) (CRO -1430)
Debts and Obligations owed By the Committee (CRO -1610)
Debts and Obligations owed To the Committee (CRO -1620)
Account Transfers Within the Committee (CRO -1720)
Administrative Support (CRO -1710)
Forgiven Loans (CRO -1440)
48 -Hour Notice Reports Sam (CRO -2200)
Contributions to be Refunded (CRO -1215)
$
49.80
$
49.80
$
$ 3185.01
$ 254.67
$
$
$
—`'- - $
-
$
$ E P 3 Q zM9
$
$
$ $
CRO -1100 NC State Board of Elections August 2008
amendment
Disbursements Pg 1 of 1 ❑ 1 es ® Na
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate political
committees and coordinated party expenditures
1. Committee Full Name and Fu@daapp6cable) - 2. ID Number
Committee to Elect Rick Becker E1M2913
3. Type of Dison e of Disbursement.)
® Operatine I spcnses Contributions to Candidates/Political Commiucc+ ❑ ('omdinaied PartsI cpendimres
4. Payee Information Remove
a. Full Name, Mailing Address & Phone
include city, eta & zip)
b. Coordinated Committee Name
d. Comments
Union County
316-B E Windsor St
Monroe, NC 28112
(704) 283-3809
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Flection Sum to Date
$ 5.00
f. Account Cade
g. Form of Payment
Is. Purpose Code
1. Date us midd/yyyy)
j. Amount
it. Required Remarks
1
Ck #982
O
07/05/2019
$5.00
Filing Fee
S
4. Payee Information Add Remove
a. Full Name, Mailing Address & Phone
include city, stat & zip)
It. Coordinated Committee Name
d. Comments
Credit card for
signs
Capital One
PO Box 71087
Charlotte, NC 28272-1087
c. Level Registered (Specify)
❑ Federal County:
❑ State Municipality:
e. Flection Sum to Date
$ 254.67
L Account Cade
g. Form of Payment
IL Purpose Code
1 Date (mm/dd/yyyy)
J. Amount
k. Required Remarks
1
Ck #983
A
09/18/2019
$254,67
signs
a. Fug Name, Mailing Address& Plume
include city, stn & a
Md
d Remove ''
b. Coordinated l:ommiltee Name
d. Comments
a Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Electien•SLL�mDate.,<.
$
E Account Code g. Form of Payment
It. Purpose Code
i. Date (mmldd/yyyy)
j. Amount
k Req R
$
Unloml .O- L: cc 10r;s
ti
10 Pages
(This finegoes in line 13a of Detailed S'umnmry Page CRO -1100 if Operating Fxpenses)
(This line goes in fine 13b of Detailed Summary Page CRO -1100 if Contrib to Candidates/Polifienl Comm)
(This line goes in line 13r of Detailed Summary Page CRO -1100 if Coordinated Parry Expenditures)
$ 259.67
$ 259.67
7. Purpose Codes List detailed ea enditure code in h, above
A* - Media B* - Printing C* - Fundraising D - To Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
I - Postage .l - Penalties K* - Office Expenses 0* - Other
* Codes require detailed explanation in required remarks field
(YIO-/?lO NC State Board of Elections April 2007
Outstanding Loans
Amendment
Pg 1 of $ ®_ Yes ❑ No
Use this form to report any outstanding loans received during a previous reporting period and until the loan is paid in full.
1. Co , 'Name and
Committee to Elect Rick Becker
3. Lender Information '
FJM29B
a. Full Name, Mailing Address & Phone b. Job 111107rofession
(include city, state, & zip) Woodworker
Frederick Becker III Candidate
6603 Sadler Rd
Waxhaw, NC 28173 c. Employer's Name/Specific Field
Self
d. Comments
a Start Date (mm/dd/yyyy)
04/07/2000
L End Date (mm/dd/yyyy)
g. Rate
h. Security Pledged
L Original Loan Amount
j. Remaining Loan Balance
0 %
None
$ 1,380.01
$ 1,380.01
k. Fult Name of Lending Institution
1. Loan Number
3. Lender Information ❑ ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Tide/Profession
d. Comments
Finance Offier
Candidate
Frederick Becker III
6603 Sadler Rd
Waxhaw, NC 28173
e. Start Date (mm/dd/yyyy)
c. Employer's Name/Specific Field
10/27/2011
Town of
Mineral Springs
L End Date (mm/dd/yyyy)
g. Rate
Is. Security Pledged
L origiw Loan Amount
J. Remaiming Loan Balance
0 %
None
$ 500.00
$ 500.00
L Full Name of Lending Institution
L Loan Number
3. Lender Information ❑ Add
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job TitleiProfession
d. Comments
Finance Officer
Candidate
Frederick Becker III
6603 Sadler Rd
Waxhaw, NC 28173
e. Start Date (mm/dd/yyyy)
a Employer's Name/Specific Field
2/28/2013
Town of
Mineral Springs
L End Date (mm/dd/yyyy)
g. (tate
It. Security Pledged
L Original Loan Amount
J. Remaining Loan Balance
0 ee
None
$ 5.()0
$ 5.00
IL Full Name of Lending Institution
L Loan Number
4. Total only this Paemmlm-�—
_ '�' $ 1885.01
5. Total of ALL CRO -1430 Pages $ 3,185.01
(This fine mus! be on line 2l of Detailed Summary Page CRD -1100) - -
CRO -1430 NI' 4,m nrd ,4 I log inns December 2007
Outstanding Loans
Amendment
Pg 2 or 3 ® Ses ❑ .No
Use this form to report any outstanding loans received during a previous reporting period and until the loan is paid in Cull.
1. Committee Fall Name and Ftind if applicable)--- 2. w Nmnbw
Committee to Elect Rick Becker FJM29B
3. Lender Information ❑ Add ❑ Remove
a. Fall Name, Mailing Address & Phone
(include city, state, & zip)
b. Job "ritleProfession
d. Comments
Finance Officer
Candidate
Frederick Becker III
6603 Sadler Rd
Waxhaw, NC 28173
e. Start Date (mm/dd/yyyy)
a Employer's Name/Specific Field
09/27/2013
Town of
Mineral Springs
L End Date (mm/dd/yyyy)
g. Rate
IL Security Pledged
L Original Lmn Amount
I. Remaining Lma Balance
0 %
None
$ 200.00
$ 200.00
It. Full Name of Lending Institution
1. Loan Number
3. [ender Information ❑ Add ❑ Remove
a. Full Name. Mailing .Address & Phone
(include city, state, & zip)
b. Job TitleTrofession
d. Comments
Finance Offier
Candidate
Frederick Becker III
6603 Sadler Rd
Waxhaw, NC 28173
e. Start Date (mm/dd/yyyy)
a Employer's Name/Specific Field
10/25/2013
Town of
Mineral Springs
L End Date (mm/dd/yyyy)
g. Rate
It. Security Pledged
L Original Loan Amount
J. Remaining Loan Balance
0 %
None
$ 200.00
$ 200.00
k. Fall Name of Lending Institution
L Loan Number
3. Lender Information ❑ Add ❑ Remove
a. Fullame, Mailing Address & Phone
(include city, state, & zip)
b. Job TitieProfession
d. Comments
Finance Officer
Candidate
Frederick Becker III
6603 Sadler Rd
Waxhaw, NC 28173
a Start Date (mm/dd/yyyy)
a Employer's Name/Specific Field
07/14/2015
Town of
Mineral Springs
t End Date (mm/dd/yyyy)
g. Rateh.
Security Pledged
L Original Loan Amount
j. Remaining Loan Balance
0 %
None
$ 500.00
$ 500.00
L Full Name of Lending Institution
I Loan Number
r
4. Total only this Pae $ 900.00
5. Total of ALL CRO -1430 Pages
(This fine mutt he on Gne 21 of Detailed Summary Page CRO -1100)
_
3,185.01
CRO -/430 N( Ya., lluahms "`�"`� December 2007
Outstanding Loans
Amendment
Pg i of 3 ❑ l'es ® Sn
Use this form to report any outstanding loans received during a precious reporting period and until the loan is paid in full.
ifapplicable) 2.IDNamlts
Committee to Elect Rick Becker FJM29B
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
Finance Officer
Candidate
Frederick Becker III
6603 Sadler Rd
Waxhaw, NC 28173
e. Stan Date (mmiddiyyyy)
a Employer's Name/Specific Field
10/15/2015
Town of
Mineral Springs
L End Date (mm/dd(yyyy)
g. Rate
b. Security Pledged
L Original Loan Amount
j. Remaining Loan Balance
0 %
None
$ 300.00
$ 300.00
It. Full Name of Lending Institution
L Loan Number
3. Lender Information ❑
❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title; Profession
d. Comment,
Finance Officer
Candidate
Frederick Becker III
6603 Sadler Rd
Waxhaw, NC 28173
e- Stan Date (mm/dd/yyyy)
a Employer's Name/Specific Field
10/30/2015
Town of
Mineral Springs
E End Date (mm/dd/yyyy)
g. Rate
h- Security Pledged
L Original Loan Amount
J. Remaining Loan Balance
0 %
None
$ 100.00
$ 100.00
Is. Full Name of Leading Institution
L Loan Number
3. Leader Information ❑ Add ❑ Remove
a. Full Name, \lalling Address & Phone
(include city, slate, & zip)
b. Job TiticePrefession
--
d. Comments
e. Start Date (mm/dd/yyyy)
c. Employer's Name/Specific Field
E End Date (mm/dd/yyyy)
g. Rate
h. Security Pledged
L Original Loan Amount
J. Remaining Loan Balance
It. Full Name of Unding Institution
L Loan Number
4. Total onlythis Pae
$ 400,00
5. Total of ALL CRO -1430 Pages y 3,185.01
(This line mast be on fine 21 of Detailed S ,.
('K0-14.30 NC State Board of Elttiool December 2007
Debts and Obligations Owed By the Committee Pg I of I ILI Yes U No�
Use this form to report any unpaid debts or obligations owed by the committee, to include campaign credit card nurchases.
IMmanittee Full Name (and
2. ID Number
Committee to Elect Rick Becker
l Jj%E29B
3. Creditor Information
ve
a. Full Name, Mailing Address & Phone
Note: All pac ments made tmand debts should be listed un livm CRO -
(include city, state, & zip)
1310 with the payee listed as this creditor.
h Description of Creditor
Capital One, PO Box 71087, Charlotte, NC 28272-1087
Capital One Mastercard
. Beginning Balance
d. Total Amount Paid
e. Total Amount Incurred
f. Remaining Balance
$ 0.00
$ 254.67
$
254.67
$ 0.00
. Incurred Debts (what the committee received this period)
1. Purchase Place Full Name, Mailing Address & Phone
g2. Date (mm/dd/yyyy)
- 5-201
g3. Amount
(include city, state, & zip)
- -
-
9/5/2019
$ 254.67
Signs on the Cheap - online (signsonthecheap.com), 866-664-
94. Purpose Code
. Rer aid Remarks _
9239
]Yard
O
Signs
1. Purchase Place Full Name, Mailing Address & Phone
g2. Date (mm/dd/yyyy)
-. _. - -
-
g3. Amount
(include city, slate, & zip) -
g4. Purpose Code
g5. Required Remarks
1. Purchase Place I" Nam, Mailing Address & Phone
g2. Date (mm/dd/yyyy)
g3. Amount
(include city, state, zip)
-&
94. Purpose Code
25. Required Remarks
1. Purchase Place Full Name, Mailing Address & Phone
g2. Date (m_m/dd/yyy_ y)
g_3. Amount
(include city, state, & zip)
-
_
$
g4. Purpose Code
g5. Required Remarks
1. Purchase Place Full Name, Mailing Address & Phone
g2. Date (mm/dd/yyyy)
-
g3. Amount
(include city, state, & zip)
- -
-�--
-
---
$
�3
g4. Purpose Code
Bred Remark;
�C. E
4. Total only this Page
('Phis should be the surd of all items'g3.' from'this page)
$ 254.67
5. Total of ALL CRO -1610 Pages
This line must be on line 22 of Detailed Summary Page CRO -1100)
$ 254.67
6. Pu ose Codes(List detailed expenditure code in 4.
A* - Media B* - Printing C*
- Fundraising
D --1 Another ( ondi'Lde
E - Salaries F* - Equipment G - Political Party
I Postage J - Penalties K* - Office Expenses
* Codes r uire detailed ex lanation in re uired remarks field
H* - Holding Public Office Expenses
O* - Other
CRO -1610 NC State Board of Elections February 2011
fCgD
1.019
?Ctlons