Bention,Jimmy_2022-2nd-qtrAmendment
Disclosure Report Cover ❑ Yes ® 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 uodate information
1. Committee Information
a. Full Name
c. ID Number
Committee to Elect Rev. Bention, Sr.
b. Mai6og Address (include City, State and Zip D
d. Date Filed
302 Tucker Street JUL 022
07/05/2022
Monroe, NC 28110
e Plume Number
Union Co:. Elections
UFi
704-572-0879
2. Report Year
3. Period Start Date (mm/dd/yy)
4. Period End Date
5. Treasurer Full Name
mm/d
Latoya L.Bention
2022 105/01/2022
0630/2022
6. Type of Committee Check One
9. Type of Report
check on!v one tvpe o re ort
om one category)
® Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑ Organizational
❑ Organizational
❑ Organizational
Independent ❑ Joint Fundraiser
❑ Expenditure
❑ Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pre-primary
❑ Pre-election
❑ First
® Second
❑ Final
❑ Supplemental Final
7. Type of Fund (if applicabk, check ore)
❑ "Booster Fund-
❑ 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 of Fundraisers this Report
0
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
Wells Fargo
b. Purpose
c. Account Code
b. Purpose
a Account Code
Election
104
Committee
d. Period Begin Balance
d. Period Begin Balance
Donations
S 2,642.90
S
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 1 have been trained by the NC State Board of Elections.
Lw+o_c.. L. f3r__}.oti tj:n_
L. fzm SuI•, -5020ILa.-
Printed Name of Signer
% nature of Appointed Treasurer
Date
FOR OFFICE USE ONLY
Delivery
Method
Date Received: Employee:
ElNormal Mail
14*
❑ Registered Mail
Date Postmarked: Employee:
❑ Hand Delivered
❑ Electronically Filed
Date Scanned: 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 -2 100A -E) to make committee changes.
CRO -1000 NC State Board of Elections August 2009
Amendment
Detailed Summary p yes ® %o
Use this form to summarize all disclosure reoortime forms and to total monetary information.
1. Committee Full Name and Fund if applicable)
2.
of Report
3. ID Number
Committee to Elect Rev. Bention, Sr.
Second Quarter
Report
Start of Election Cycle: January 1, 2022
Total this
Report uPeriod
Total this
Election Cycle
4) Cash on Hand at Start
RECEI
5) Aggregated Contributions from Individuals
6) Contributions from Individuals
7) Contributions from Political Party Committees
8) Contributions from Other Political Committees
9) Loan Proceeds
10) Refunds/Reimbursements To the Committee
11) Other Receipt Sources
Ila) Interest on Bank Accounts
11 b) Contributions from Not -for -Profit Organizations
1 le) Outside Sources of Income
11d) Legal Expense Fund — Other Sources
11 e) Exempt Purchase Price Sales
(CRO -1205)
(CRO -1210)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1140)
(CRO -1150)
(CRO -1250)
(CRO -1150)
(CRO -1170)
(CRO -1165)
$
$
2,642.90
25
ti
S
0
360
$ 0 $
2,640
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
12) TOTAL RECEIPTS (Addlines5. 6.7.8, 9. 10, Ila, l/b. 11c. lldand lie)
EXPENDITURES _
13) Disbursements
13a) Operating Expenditures (CRO -1310)
13b) Contributions to Candidates/Political Committees (CRO -1310)
13c) Coordinated Party Expenditures (CRO -1310)
14) Aggregated Non -Media Expenditures (CRO -1315)
15) Loan Repayments (CRO -1410)
16) Refunds/Reimbursements From the Committee (CRO -1310)
17) In -Kind Contributions (CRO -1510)
$
25
$
3000
$ 99.03 $
404.54
$ $
$ $
26.59
$ $
$ $
$ $
$ $
18)
TOTAL EXPENDITURES (Add lines 13a. 13b. 13c. 14. 15. 16and 17)
$
99.03
$
431.13
19) Cash on Hand at End 1.-1,0lmc%4 and 12together. ihensubtractline 18)
ADD - , INFORMA
20) Non -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 the Committee (CSO -1620)
24) Account Transfers Within the Committee (CRO -1720)
25) Administrative Support (CRO -1710)
26) Forgiven Loans (CRO -1440)
27) 48 -Hour Notice Reports Sum (CRO -1110)
28) Contributions to be Refunded (CRO -1115)
$
$
$
$
$
$
$
2,568.87
$ 2,568.87
REMEIVED
$ $
fit, r
$
$ Unior go. Board Of El .,,, >
CRO -1100 NC State Board of Elections August 2008
Amendment
Aggregated Contributions from Individuals Page , of 1 ❑ Yes ® .a
Optional form used to report NC Contributions From Individuals of $50 or less
1. Committee Full Name and Fund if applicable)
2. ID Number
Committee to Elect Rev. Bention, Sr.
3. Contributor Information
a. Amend
b. Account
Code
C. Form of Payment
d. In -Kind
Description
e. Dale
mm/dd/
f, Amount
Add
104
Credit Card
N/A
06/08/2022
$ 25
Remove
Add
$
❑ Remove
❑ Add
$
Remove
Add
$
Remove
Add
$
Remove
Add
$
Remove
Add
$
Remove
❑ Add
$
❑ Remove
Add
$
Remove
Add
$
Remove
Add
$
❑ Remove
Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
Add
$
Remove
Add
$
Remove
Add
$
E] Remove
Add
$
❑ Remove
Add
$
❑ Remove
❑ Add
$
❑ Remove
❑ Add
$
❑ Remove
4. Total only this Page
$ 25
5. Total of ALL CRO -1205 Pages
(This fine must be on fine 5 ojDetailed Sununarp PageCRO-1100)
$ 25
CRO -1205 NC State Board of Elections April 2007
Amendment
Disbursements Pg I of I ❑ ves
Use this form to report expenditures from the committee for: operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Fall Name and Fund if applicable) 2. ID Number
Committee to Elect Rev. Bention, Sr.
3. Type of Disbursement Please use se rate CRO -1310 form for eaelt nwe of Disbursement
® Operating Expenses ❑ Contributions to Cwdidates/Poiaical Committee, ❑ C'o..nimated Partx Expenditures
4. Payee Information R Add Remove
a. Full Name, Mailing Address & Phone
include city, state & a
b. Coordinated Committee Name
d. Comments
Campaignpartners.com
PO Box 118
Still River, MA 01467
617-500-7251
c. level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 201
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
L Required Remarks
104
CreditCard
O
05/08/22
$49
Monthly website
fee
104
CreditCard
O
06/08/22
$49
Monthly website
fee
4. Payee Information Add El Remove
a. Full Name, Mailing Address & Phone
include city, state & a
b. Coordinated Committee Name
d. Comments
Online Platform
for accepting
donations
https://stripe.com/
185 Berry St #550
San Francisco, CA 94107
c. IAvd Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 48.51
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
L Required Remarks
104
Bank Draft
O
06/08/22
$1.03
Stripe
processing fee
4. Payee Information F Add Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Election Sum to Date
f, Account Code
g. Form of Payment
h. Purpose Code
L Date (mm/dd/yyyy)
j. Amount
k. Required Remar
$
JUL 0 5 2022
$
Union Co. Board of Elections
5. Total only this Pae
$ 99.03
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses)
(This fine goes in line 13b of Detailed Summary Page CRO -1100 if Contrib to Candidates/Pnfifical Comm) $ 99.03
(This line goes in line 13c of Detailed Summon, Page CRO -1100 if Coordinated Party Expenditures)
7. Purpose Codes(List detailed expenditure code in h. above
A* - Media B* - Printing C* - Fundraising D -'I o Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
1 - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field k
CRO -1310 NC State Board of Elections December 2009