Elam,Edwin_2022-2nd-qtr!Amendment /
Disclosure Report Cover (❑- a
Use this form for general report and committee information, must be signed and submitted along with other detailed forms.
Du mu u1C 11111 liirm to a 1da1C infomnnliun.
1. Comrtdttee Information
. Full Name
c. IU Somber
Us.rs] A
. Mailing Address (include City, State and Zip Code)
d. Date Filed
1 Z3
e. Phone Numbdr
Year,
3, -ret, _S rt Date dd yy),
4. Period End Date (mm/dd/yy)
5. Treasurer Full Name
12_Report
S. Type of Commit (Che' One)
91Type of Rep rt _(check
only one type of report
from one category)
[2,eandmarc Campaign ❑Parry
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑ Organizational
❑ Organisational
❑ Organizational
❑ Independent Expenditure ❑ Joint Fundraiser
❑ Thirty-five day
Quarterly
❑ Pre- referendum
❑ Legal Expense Fund
❑ Pre-primary
❑ First
❑ Final
❑ Pre-election
[3" Second
❑ Supplemental Final
❑ Pro -runoff
❑ Third
❑ Annual
❑ Booster Fund
Semi-annual
❑ Fourth
❑ Special
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year End
❑ Mid Year
10. Special Report Name
❑ Oiher.
❑ Final
❑ Special
❑ Year End
❑ Final
S. Number of Fundraisers this Report
- ---
❑
11. Account Information
11. Account hd'orniation
a. Financial Institution Full Name
a. Financial hslituliun Full Name
t „J
b. Purpose
c. Account Code
b. Purpose
c. Account Code
Fl)tii CA��/�A.ya
Ll(Et 7-7,(
e d NIE �1
R
R 1
-e1 I�Tr t,A,
P. Period Begin Balance
\l
d. Period Begin Balance
$
$
CERTIFICATION
I certify that the Committee or Fund is in compliance with all a licable prqnsrticle 22A. 22B & 22D-22Mof Chapter 163
of the NC General Statutes and that no funds are com ed rohibion-disclosed
funds. I further certify that this
report is complete, true and correct and that 1 have been y he NCf
Elections.
Citi W rte FI4At-
IS ZCZZ
Printed Name of Signer Signature of
116pfmipked Treasurer Date
FOR OFFICE USE ONLYp
�—
Date Received: O / ! y l Employee:
Delivery Method
❑Normal Mail
Date Postmarked: Employee:
Registered Mail
Hand Delivered
Date Scanned: Employee:
Electronically Filed
Date Data Entered: Employee:
❑ miandato ha notreceived
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-2l00A-E) to make committee changes.
CRO -1000 NC State Board of Elections August 2008
Detailed Summary oe1es o
Use this form to summarize all disclosure reoortine forms and to total monetary information
1. Committee Full Name (and Fund if applicable)
r
Edw,,. c(AY },2 L �.,+� <c
2. Type of Report
3. ID Number
A0'1n32_
Start of Election Cycle: January 1,
Total this
Reporting Period
Total this
Election Cycle
4) Cash on Hand at Start
I
$
0,19 Is
45 e
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
10) Refunds/Reimbursements to the Committee
11) Other Receipt Sources
l la) Interest on Bank Accounts
116) Contributions from Not -For -Profit Organizations
l lc) Outside Sources of Income
I1d) Legal Expense Fund -Other Sources
Ile) 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)
$
$
-
$ S b '
$
$
$
$
$
$
$
$
$$
$
$
$
$
$
$
$
$
$
12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9,10,11 a,1 lb.] I c.1 I d and I I e)
$
EXPENDITURES
13) Disbursements
13a) Operating Expenditures
13b) 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)
(CRO -1310)
(CRO -1315)
(CRO -1420)
(CRO -1320)
(CRO -1510)
$
$
$
$
$
$
$
JV. (JJ
$
$
$
$
$
$
ej'+1, 00
$
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15,16 and 17)
$
a
$
r
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 181
$
$
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
....... .... ..,..._,
3) Debts and Obligations owed to the Comtdnee r=
4) Account Transfers Within the Commit teg.: ,
17
5) Administrative Support
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRO -1620)
(CRO -1720)
(CRO -1710)
$
$
$
$
$
$
$
T++tettf
26) Forgiven Loans fl G V C I V L)
7) 48 -Hour Notice Reports Sum
Contributions to be Refunded
wm-i440)
(CRO -2220)
(CRO -1215)
$
$
$
$
$
$
CRO -1100 NC State Board of Elections August 2009
Refunds/Reimbursements From the Committee Pg _ or amendment _ ❑ Yes ❑
Use this form to report refunds/reimbursements, including amtributiuns returned to the conn ibutoi
1. Committee Full Name (and'Fuhd lfiigfillcolbleY
2. ID Number
3. Payee Information ❑ Acid ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
T
Mr- D o W el I t
-JC 2&'/0K
l
d. Type of Committee
EQ Candidate 0 PAC
❑ Referendum ❑ Party
In. Original Receipt Date
2 2d 1 Z
e. Level Registered
i. Origins Receipt Amount
Federal County:
[3 State ❑ Municipality:
$
f. Purpose Code
J. Election Sum to Date
$
o[ession
c. Employer's Name(Speclflc Field
g. Comments
it. Account Code
w n/eCe�-
�Q . rJ Qs _j ('�
-i
�E—E 2Z
I. Form of Payment Im. Required Remarks
n. Date (mm/ddtyyyy)
o. Amount
1
3. Payee I» formation ❑ .Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
d. Type of Conurnftee
❑ Candidate ❑ PAC
❑ Referendum ❑ Party
h. Original Receipt Date
e. Level Registered
i. Original Receipt Amount
$
Federal County:
❑ State ❑ Municipality:
f. Purpose Code
,j. Election Sum to Date
b. Job Tifle/Profession
c. Employer's Name/Specific Field
g. Comments
k. Account Code
1. Form of Payment
m. Required Remarks
n. Date (mmldd/yyyy)
o. Amount
_. _---_—__.____......_........— _
3. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & yip) ; alC:F
AUG 15 2022
d. Type of Committee
❑ Candidate ❑ PAC
❑ Referendum ❑ Party
h. Original Receipt Date
e. Level Registered
Federal O—C-unty
13State 13 Municipality
i. Original Receipt Amount
$
L Purpose
j. Election Sum to Date
$
b. Job'fide/Profession
c. F-mployer's Name/Specinc Field
g. Cornmems
k. Account Code
I. Form of Payment
m. Required Remarks
n. Date (mm/dd/yyyy) jo.Amount
d. Total only this Page $
5. Total of ALL CRO -1320 Pages
(This lirrenntst be at, line IG alfDetailed Summary Pae CRO -[loth
6. Purpose Codes (List detailed disbursement code in (t) above)
L - Returned to Contributor M - OcerpmInent lot Service N- Exceeded Contribution l.imil
P* - Reimbursement of In -bind O* Other
*.Codes require detailed explanation in required remarks field (m
CRO -1320 NC State Board of Elections December 2007
Amendment
Contributions from Individuals Pg _ nr❑ Yes p -N
Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used
I ;',Committee Full Name (and'Fund if applicable} -,12.
c�lw
ED Number-
3
.`Contributor Information ❑'Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
It. job Title/Profession
,-
d6
d. Comments
i
�L
/
eA d0,n�-t'
c. Employer's Name/Specific Field-
e. Election Sum to Date
I. Prior
❑
g. Account Code
h. Form of Payment
i. In -Kind Descriptionj.
—
Date (mmtddlyyyy)
k Amotmt
$ lCo
LICLcZz
�c,a -
, a� 2ezZ
❑
$
❑
$
3, Contributor Information - ❑ Add ❑ Rennase
a. Full Name, Mailing Address &Phone
(include city, state, & zip)
SInll�iil�+1 DA✓c.k al.;�
L j .
I I /�%. M e b,)j z l( S T( T
S a it-�g -1,LV ( /
b..loh] isle/Profcs+iun
d. Coni n in,
c. Employer's Name/Specific Field
U
e. Election Sum to Date-
-
f. Prior
❑
g. Account Code h. Form of Payment I. to -Kind Description J. Date (mtnld&yyyy) k. Amount
UCECL Clan �, ' iC $
❑
$
❑
. Fall Name, Mailing Address & Phone
(include city, state, & tip) i
AUG 15 2022
$
It. Job TitleRkotession : d. Comments
c. Employer's Name/Specific Field
-----____
a. Election Sum to Date
$
f.Prior
❑
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (tmn/dd/yyyy)
k Amouat
$
❑
$
4_otal
only this Page i,
; %
$ a 6
otal of ALL CRO -1210 Pages '
0ijlins must be on tiq'4 d o,%Detaired Summary Page CRD -1100)
$j,M
CRO -1210 NC Slate Board 4 Elections April 2007
Forgiven Loans Pg Amendment _ ar _ o yes
Use this form to report any loan which has been forgiven by the lender.
A Forgiven loan statement (CRO -6200) must accommmv each forgiven loan.
L"'O t mittee FullNatile'(and Mind if applicable) _41A&L_
I
/" vL ��>'`n Ii1/6-.-1
7
2. ID Numb'"11112
T%1') C1
3. Lender Information ' = ❑ Add -. L] Remove A
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
0 W ,+� C` `�n"� , `�S•
cu Lj06GxV,At� pArf g., ��a3
7 (j/ V
b. Comments
c. Original Loan Date (naWdd/yyyy)
F. Election Sum to Date
$ y5 i
�, i 2,
d. Original Loan Am6unt
g. Date (mmldd/yyyy)
$ Yy5 �
— �a,LL
e, Remaining Loan Balance
$ 4o
h. ForgGen Amount
$ C
3, Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, --& zip) ('
�PL.J )' Zl/ W, Pec !�4 j fit
Lot
r 3
b. Conunenls
c. Original Loau Date (mWdd/yyyy)
F. Election Sum to Date
d. Origin Lo o tat
— —_ `-___
$ �ttcv
g. Date (mn/dd/yyyy)
z�ZL
e. Remaining Loan Balance
h. Fo 'ven Amount
$ _2531—
$ L v,ai�1
3. Lender Information Add Remove
a. Full Name, Mailing Address & Phonc
(include city, state, & zip)
�!Ai , //� "1 J g
r�N 1A`'" #'47 0-/7--3/
1/j44
33
b. Comments
c. Original Loan Date mm/dd/yyyy)
L Election Sum to Date ' `
6b�.
$ (�0
d. Orifinal Loan Ainount
g. Date (mm/dd/yyyy)
$ ---f k
e. Remaining Loan Balance
$
h. F rgiven omt
$ lbv._.�
4. Total only this Page
5. ,notal of ALL CRO -1440 Pages
(This line must bean line 26 of Detailed Suaunary YgAe C'RO-1100!
The lender information should contain the same information as supplied on the original loan proceed statement.
CRO -1440
UNION COUNTY
CAMPAIGN FINANCE
AUG 15 2022
RECEIVED
NC State Board of Elections
December 2007
_.1
Forgiven Loans Pg _ or _ ro
Use this form to report any loan which has been forgiven by the lender.
A For iven loan statement CRO -6200 must acconinattv each for iven loan.
1. Committee Full Name (and Fund if applicable)
ct�
2. ID Number
7 1�
3.LeiiderInformation ❑ Add �❑ Remove
a. Full Name, flailing Address & Phone
(include city, state, & zip) /
2-1
L
a�tl� �KW
�l 2?
b. Comments
c. Original Loan Date (roro/dd/yyyy)
_
_.�, z� Zt
L Election Sum to Date _.
,�C^.
$ 6 z
d. Origir 1 Loan otmt
g. Date (mmlddlyyyy)<
$ Z-`
_
247
e. Remaining Loan Balance
It. Fo iven Amount
$
$.2'�
3. Lender Information < .. Add ,,[] Remove
,i. Fall Name, Mailing Address & Phone
(includeKity, state, & zip)
b. Comments
c. Original Lona Date (mntldd/yyyy).
L Election Sum to Date
d. Original Loan Amount
$
g, Date (mm/d(UN pr i
e. Remaining Loan Balance
$
It. Forgiven Amou tit
$
3. Lender Information Add Lj Remove
a. Full N:upe, flailing Address & Phone
(include city, state, & zip)
UNI COUNTY
GAMPAIGNy PNCE
AUG 15 7022 ��
RECEIVED\`�
b. Comments
c. Original Loan Date (nmlOdlyyyy)
L Election Som to Date
d. Original Loan Amount
g. Date ( yyy)
\
e. Remaining Loan Balance
$
h. Forgiven Amount`
$
4. Total only this Page
It
5. Total of ALL CRO -1440 Pages
(This line mast be mm line 26 of Derailed Summary Page CRO -1100)
It 7 7
/ Z
The lender information should contain the same information as supplied on the original loan proceed statement.
CRO- 1440 NC State Board of Flections December 2007
VOTE
rT1Ti
NORTH CAROLINA
STATE BOARD OF ELECTIONS
Forgiven Loan Statement
This form is used to report a loan that has been forgiven by the lender. The lender's signature is required
on this form and it must accompany the next filed report.
This Statement is to be filed with the Election Board where the committee's reports are filed.
Name of Lender: „a 4,+, rS-r4q
Committee receiving loan:
EciLA, tA, j"r 'CeuJ
Date of loan:
/ d Z'
Amount of original loan:
* yy, /('
"Amount of loan to be for
iven: `5, va
do not wish to be reimbursed for the amount
of the loan indicated above' and will consider the amount loaned a contribution to the
committee.
I understand and confirm no other parties are responsible for payment of this loan.
may not forgive a loan for which thea -inn outstanding balance owed to any source.
/JY;;k-,ZL
CRO -6200
AUG 15 2022
RECEIVED
Forgiven Loan Statement
r—
vol NORTH CAROLINA
STATE BOARD OF ELECTIONS
AUG i 5 %Ct1
Forgiven Loan Statement
This form is used to report a loan that has been forgiven by the lender. The lender's signature is required
on this form and it must accompany the next filed report.
This Statement is to be filed with the Election Board where the committee's reports are filed.
Name of Lender:
-j+9'
Committee receivingloan: w„ ji
Cs�
Date of loan: !K/-z4.7,2-
ZsZAmount
Amountof original loan:
�a --
*Amount of loan to be forgiven:
z;b
I,
C do not wish to be reimbursed for the amount
of the loan indicated above* and will consider the amount loaned a contribution to the
committee.
I understand and confirm no other parties are responsible for payment of this loan. I
may not forgive a loan for which re I an outstanding balance owed to any source.
Signature of Len&4
Signature of Committee Treasurer
CRO -6200
Forgiven Loan Statement
2L
2e 2
VOTE
NORTH CAROLINA
STATE BOARD OF ELECTIONS
UNION G;'U>; I
,AMPAIGH F ';ANCi
AUG 1 2022
RECEIVED
Forgiven Loan Statement
This form is used to report a loan that has been forgiven by the lender. The lender's signature is required
on this form and it must accompany the next filed report.
This Statement is to be filed with the Election Board where the committee's reports are filed.
Name of Lender: 64W
-. 41. . jor(
Committee receivingloan:
w to /q,... Cs, ( ctlu
Date of loan:
2
Amount of original loan:
O `�
"Amount of loan to be forgiven:
a
/i
I, � '"`I"t C��A,- , do not wish to be reimbursed for the amount
of the loan indicated above' and will consider the amount loaned a contribution to the
committee.
I understand and confirm no other parties are responsible for payment of this loan. I
may not forgive a loan for which there is anaVfscling balance owed to any source.
Signature of Lender n
Signature of Committee Treasurer
CRO -6200 Forgiven Loan Statemeni
Itr
I
NOR
STATE
�N COUNly
IGN FINANCE
AUG 15 2022
RECEIVED
TH CAROLINA
BOARD OF ELECTIONS
Forgiven Loan Statement
This form is used to report a loan that has been forgiven by the lender. The lender's signature is required
on this form and it must accompany the next filed report.
This Statement is to be filed with the Election Board where the committee's reports are filed.
Name of Lender: alwI,�
Committee receiving loan: wta f+r Cry C�
Date of loan:
Amount of original loan: "L
*Amount of loan to be for iven:-
I, �D-"t ' ^ ��I , do not wish to be reimbursed for the amount
of the loan indicated above* and will consider the amount loaned a contribution to the
committee.
I understand and confirm no other parties are responsible for payment of this loan. I
may not for an for which there'ending balance owed to any source.
n
Signature of Lender y L
Signature of Committee Treasurer
liPIii . & O'
Forgiven Loan Statement