Becker, Rick_2021-35DayReportAmendment
Disclosure Report Cover ❑ lrex ® No
Use this form for general report and committee information, must be signed and submitted along with other detailed forms.
I)n not nae this form to update information
1. Committee Information
a. Full Name
c. ell Number
Committee to Elect Rick Becker
FJM29B
It. Mailing Address (include City, State and Zip Code)
d. Date Filed
6603 Sadler Rd
Waxhaw, NC 28173
09/27/2021
e. Phone Number
(704)843-5870
2. Report Year
3. Period Start Date (mmrddiyy)
. Period End Date
5. Treasurer Full Name
of ZO2(
Frederick Becker III
2021
(WtW�i w
09/21/2021
6. Type of Committee Check One
9. Type
of Report check only one type of report
om one category)
® Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑
Organizational
❑ Organizational
❑ Organizational
Independent
❑ Expenditure El Fundraiser
®
Thirty-five day
Quarterly
❑ Pre -referendum
Legal Expense Fund
❑
❑
Pre-primary
Preclection
❑ First
❑ Second
❑ Final
❑ Supplemental Final
7. Type of Fund (if applicable, check one)
❑ 'Booster i'und"
❑ Building Fund
❑
Pre -runoff
❑ Third
❑ Annual
Semi-annual
❑ Fourth
❑ Special
❑
Mid Year
Semi-annual
❑ Other:
❑
Year End
❑ Mid Year
10. Special Report Name
❑
❑
Final
Special
❑ Year End
❑ Final
❑ Special
8. Number oFundraisers this RepoM
0
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
First National Bank
b. Purpose
c. Account Code
b.tJNFY
a Account Code
General
�,,aA4PAIGIJ FIN
Campaign
1
Account
d. Period Begin Balance
SEP 2 7 2021
d. Period Begin Balance
$
$ 141.94 VED
CERTIFICATION
1 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 N e Boar�dy f FF]]��ctions.
Frederick Becker IIIL�r�e�
09/27/2021
Printed Name of Signer
Signature of Appointed Treasurer
Date
FOR OFFICE USE ONLY
Date Received:
Employee:
Delivery Method❑
Normal Mail
Date Postmarked:
Employee:
❑ Registered Mail
® Hand Delivered
Date Scanned:
Employee:
❑ Electronically Filed
❑ 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 ❑ Yes ® No
Use this form to summarize all disclosure reporting forms and to total nwnetary intormation.
1. Committee Full Name and Fund if applicable
1 2. Type
of Report
13.
ID Number
Committee to Elect Rick Becker
-"r--''
mar
35- I),17 y
FJM29B
Start of Election Cycle: January 1, -2m Z020
Total this
Reporting Period
Total this
Election C cle
4)
^I
6)
7)
8)
9)
10)
11)
Cash on Hand at Start
Aggregalcd ( ontributions 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
llb) Contributions from Not -for -Profit Organizations
Ile) Outside Sources of Income
lld) Legal Expense Fund — Other Sources
11 e) 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 -1265)
$
$
141.94
$
$
141.94
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
12)
TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10,110. 11 b, Ile, lld and Ile)
$
0
$
0
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
Refunds/Reimbursements From the Committee
In -Kind Contributions
(CRO -1310)
(CRO -1310)
(CRO -1310)
(CRO -1315)
(CRO -1420)
(CRO -1320)
(CRO -1510)
$
5.00
$
5.00
$ $
$ $
$ $
$ $
$ $
$ $
18)
TOTAL EXPENDITURES (Add lines 13µ 13b, 13c, 14,15,16 and 17)
$
5.00
$
5.00
19) Cash on Hand at End (Add lanes 4 and 12 together, them subtract line 18)
ADD'=
20) Nun -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 tue�CRT�%g4Ty (CRO -1620)
24) Account Transfers Within the ChirlBA WEE FINANCE (CRO -1720)
25) Administrative Support SEP 2 ) 2021 (CRO -1710)
26) Forgiven Loans(� `,r D (CRO -1440)
[�
27) 48 -Hour Notice Reports Sum ' `E `-' E' V r� (CRO.2200)
28) Contributions to be Refunded (CRO -1215)
$
136.94
$
136.94
$
$ 3185.01
$
$
$
$ $
$ $
$ $
$ $
CRO -1100 NC State Board of Elections August 2008
Amendment
Disbursements Pg i of 1 ❑ Yes ® >
Use this form to report expenditures from the committee for, operating expenses, contributions to candidate/political
conunitlCCI and QRirdlllatCd X1r1% cx pcndituic�
1. Committee Full Name (and Fund if applicable) 2. ID Number
C(mimillcc io Ilcct Rick licckcr 11M_'91i
3. Type of Disbursement _ Please use separate CRO -1310 forms for each Awe of Disbursement.)
® UDR Rtlii, 1 ApclUUe ❑ ❑ (nord'11"t''d '1 1' I AIX aI�IIUriS
4. Payee Information ❑ Add Remove
a. Full Name, :flailing Address & Phone
include city, state & zip)
b. Coordinated Committee Name
d. Comments
Union County Board of Election
316 E Windsor St
Monroe NC 28112
(704) 283-3809
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 5.00
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
J. Amount
It. Required Remarks
1
Bank Check
O
07/01/2021
$5.00
Filing Fee
4. Payee Information EI Add Remove
a. Full Name, Mailing Address & Phone
include city,stale & zip)
b. Coordinated Committee Name
_
d. Comments
e. Level Registered (Specify)
❑ Federal ❑ County:
❑ Stare ❑ Municipality:
e. Election Sum to Date
$
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
J. Amount
IL Required Remarks
$
$
4`il ee iaformatiari '' Add Remove
a. Full Name, Mailing Address & Phone
include city, stn & zip)
It. Coordinated Committee Name
d. Comments
UNIv
CAMPAIGN FINANCE
SEP 2 7 2021
RECEIVED
a Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Election Sam to Date
$
1. Account Code
g. Form of Payment
It. Purpose Code
1. Date (mm/dd/yyyy)
j. Amount
k Required Remarks
$
4
5. Total only this Pae
$ 5.00
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a ofDetailed Sanonary Page CRO -1100 if Operating Expenses)
(This line goes in line 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 Party Expenditures)
$ 5.00
7. Purpose Codes (List detailed expenditure 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 j - pun flies K* - Office Expenses O* - Other
* Codes require detailed explanation in required remarks field (k a =-
CRO -1310 NC State Board of Elections April 2007
Outstanding Loans
Amendment
Pg f of 3 ❑ Yes ® No
t'se this form to report :my outsumding loans received during a precious reporting period and until the Ivan is paid in full.
1. Committee Full Name (and Fund If applicable) 2. ID Number
( onunluu i � 1 L1I Ricl. B,ckcr 1JM2913
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
Woodworker
Candidate
Frederick Becker III
6603 Sadler Rd
Waxhaw, NC 28173
e. start Date (mm/dd/yyyy)
c. Employer's Name/Specific Field
04/07/2000
Self
E End Date (mm/dd/yyyy)
g. Rate
h. Security Pledged
i. Original Loan Amount
j. Remaining Loan Balance
0 r
None
$ 1,380.01
$ 1,380.01
It. Fug Name of Lending Institution
1. Loan Number
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
le Job Title/Profession
d. Comments
Finance Offier
Candidate
Frederick Becker III
6603 Sadler Rd UNION COUN i Y
Waxhaw, NC 28173 CAMPAIGN FINANCEc
SEP 2 7 2021
RECEIVE
e. Start Date (mm/amyyyy)
Employer's Name/Specific Field
10/27/2011
Town of
Mineral Springs
C End Dale (mm/dd/yyyy)
g. Rate
h. Security Pledged
I. Original Loan Amount
J. Remaining Loan Balance
0 %
None
$ 500.00
$ 500.00
k. Full Name of Lending Institution
1. Loan Number
3. Lender Information ❑ Acid ❑ 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
c. Start Date (mm/dd/yyyy)
c. Employer's Name/Specific Field
2/28/2013
Town of
Mineral Springs
E End Date (mm/dd/yyyy)
g. Rate
h. Security Pledged
L Original Loan Amount
I. Remaining Loan Balance
0 yn
I None
$ 5.00
$ 5.00
IL Full Name of Lending Institution
1. Loan Number
4. Total only this Page $ 1,885.01
5. Total of ALL CRO -1430 Pages
(This line mus( he on tine 21 of Detailed Summary Page CRO -1100) $ 3,185.01
(R0-1430 vi tic ; 14 [d i I I"I"", December 2007
Outstanding Loans
Amendment
Pg 2 of 3 ❑ 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. Committee Fall Name aW Ftmd if livable) 2. ID Number
Committee to Elect Rick Becker FJM29B
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & rip)
b. Job Title/Profession
d. Comments
Finance Officer
Candidate
Frederick Becker 111
6603 Sadler Rd
Waxhaw, NC 28173
a Start Date (mm/dd/yyyy)
c. Employer's Name/Specific Field
09/27/2013
Town of
Mineral Springs
t End Date (mm/dd/yyyy)
g. Rate
Is. Security Pledged
L Original Loan Amount
J. Remaining Loan Balance
0 %
None
$ 200.00
$ 200.00
L Full Name of Lending Institution
1. Loan Number
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
Finance Offier
Candidate
Frederick Becker III
6603 Sadler Rd UNION COUNTY
Waxhaw, NC 28173 CAMPAIGN FINANCE
SEP 2 7 2021
RECEIVED
e.Start [lau(mmjWd/yyyy)
c. Employer's Name/Specific Field
10/25/2013
Town of
Mineral Springs
a End nate (mm/dd/yyyy)
g. Rate
h. Security Pledgedi.
Original Loan Amount
J. Remaining Loan Balance
0 %
None
$ 200.00
$ 200.00
IL Fall Name of Lending Institution
1. Loan Number
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. Start Date (mm/dd/yyyy)
a Employer's Name/Specific Field
07/14/2015
Town of
Mineral Springs
L End Date (mm/dd/yyyy)
g. Rate
h. Security Pledged
L Original Loan Amount
J. Remaining Loan Balance
0 �e
None
$ 500.00
$ 500.00
k. Full Name of Lending Institution
I. Loan Number
4. Total only this Pae
$ 900,00
5. Total of ALL CRO -1430 Pages $ 3,185.01
(This kne must be on fine 21 of Detailed Summary Page CRO -1100)
CRO -14.30 V( (io,rd al I cm,11, December 2007
Outstanding Loans
Amendment
Pg 3 of 3 ❑ Yen ® Sn
Use this form to report any outstanding loans received during a previouS reporting period and until the loan is paid in full.
Full Name and Fund if applicable)
2. ID Number
Committee to Elect Rick Becker
P1M29I3
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
Is. Job Title/Profession
d. Comments
Finance Officer
Candidate
Frederick Becker III
6603 Sadler Rd
Waxhaw, NC 28173
e. Stan Date (mm/dd/yyyy)
c Employer's Name/Specific Field
10/15/2015
Town of
Mineral Springs
f. End Date (mm/dd/yyyy)
g. Rate
It. Security Pledged
L Original Loan Amount
j. Remaining Loan Balance
0 %n
None
$ 300.00
$ 300.00
Is. Fug Name of Lending Institution
1. Loan Number
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job fine/Profession
d. Comments
Finance Officer
Candidate
Frederick Becker III
6603 Sadler Rd
Waxhaw, NC 28173
e. Stan Date (mm/dd/yyyy)
Q Employer's Name/Specific Field
10/30/2015
Town of
Mineral Springs
G End Date (mm/dd/yyyy)
g. Rate
h. Security Pledged
i. OrlgioaI Loan Amount
j. Remaining Loan Balance
0 %
one
$ 100.00
$ 100.00
L Fug Name of Leading Institution
L Loan Number
3. Lender information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, s t
b. ,lob Tine/Profession
d. Comments
–X0PPIGN FINANC__
SEP 2r7 2012-1
RECEIVED
e. Start Date (mm/dd/yyyy)
a Employer's Name/Speciac Field
L End Date (mm/dd/yyyy)
g. Rate
h. Security Pledged
i. Original Loan Amount
J. Remaining Loan Balance
%
$
$
k Fug Name of Lending Institution
1. Loan Number
4. Total only this Page
$ 400.00
5. Total of ALL CRO -1430 Pages
(This line must be online 21 ofOetailed Summary Page CRO -1100) $ 3,18$.01
CRO-M.iv N(Sime 13uurd til Llccnans December 2007