Hall, Jason_2021-OrgReportUNION COUNTY
,AMPAIGN FINANCE
Disclosure Report Cover APR 2 0 2021 AmA.�mt 16 Nn
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. 7 r— f' r— I t i — r-..
Committee IDfotmation
FW Name
c. m Number
FFaLL 4 WaAaw _Qasow MCCto I-taLL)
b. Ff'Yng Adder pedude C9y, Sterne and Zip Cede)
d. DateFBed
100 Wa,Chaw Pari¢wad, I vLzt 606
WaXhaw, NC 291713
/ `L0 Z t
`per Nubabor
Y`04 -255--5`f 87
2. Rqkmt Year 3. PwW Start Date (_-- 0. Per ffitl Date w Fug
2021 I �- Lp L l t_ 9 202. Aavad F. L.iscwsOL
of (heck Ones
9. Type 4f ReWrt (check only one type of reportfrom one category)
Candidate Campaign 0 Parry
Maddpsl
Stale/County
Referendum
PAC ❑ Referendum�Organianceal
[j(kganvstimal
E]Organirauonal
❑ Independem ❑ Expenditure loint Fundraiser
Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pre-primary
❑ Fust
Final
❑ Pnaeleeuon
❑ P -nmoff
Semi-annual
❑ Second
❑ nird
❑ Fourth
❑ Supplemental Final
❑ Annual
❑ Special
7- TYpe Of Fand ((feppooebte.cke&—)
Booster Fund
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year End
❑ Mid Year
10. Special Report Name
❑ Other
❑ Final
❑ Special
❑ Year End
❑ Final
Number of Fmdrallom t6b
❑ Special
11. Account Information 11. Account Information _
Flauu ml Nsfitudon Full Name & F9oaurLl Iustimaon Full Name
"k TM%rol Sav-k �%{iM Third Saw¢
Pop.
Pmpae
e. Aema d Cede
G 2vfr �a t t;,,-1
f
Tftonld—�
ttwxWOz
r) dS
d.
d. Period Begin Balance
$ 0.00
$
CERTIFICATION
1 certify that the Committee or Fund is in compliance with all appli pmvistom of Article 22A, 22B & 22D -22M of Chapter 163
of the NC General Statutes and that no funds ate cowningled wi'bited or no isclosed funds. 1 further certify that this
report is complete, titre and correct and that I have been (airedZprNClectio
Dawi.cl �. L-istwsl¢i c
Primed Name of Sigae,,Si re nted Trnzsmc Dale
R OFFICE USE ONLY
Date Received: - oa I Employee: ppliveryMethod
Normal Mail
to Registered Mail
Date Postawked:'
❑ Hand Delivered
Date Scanned: Employee: ❑ Electronically Filed
Date Data Fileted: Employee: [3 Signa has not received
mandato
Please Note: This form cannot be used to amend committce information such as the committee address, treastum,
assistant treasurer, custodian of books information, or account information.
You must amend the Statement of Organization (CRO -2100A -E) to make committee changes.
CRO -loco NC Stare Bund of Election August 2008
J(JIOIV COUNTY
CAMPAIGN FINANCE
4fR Z 0 2021 Amndment
De♦aied Summary ❑ Yes JA
No
Use this form to summarize all disclosure reoortine forms and to Rota utbiteiary 06mation
Committee Full Name (and Fund if applicable)
3. H) Number
iia Ll 4 WQXhaW o 2
Start of Election Cycle: January 1, �zr z,,tg�
Total this
Re Period
Total this
Election Cycle
4) Cash on Hand at Start
$ 0.00
$ 0.00
RECEIPTS
5) Aggregated Contributions from Individuals (CRO -1205)
6) Contributions from Individuals (CE67L1)
7) Contributions from Political Party Committees (020.1320)
8) Contributions from Other Political Committees icso n;s)
f) LAM Proceeds ([1001411)
0) Retbnde/Reimbursements to the Committee (ce"W)
1) Other Receipt Sources
11a) Interest on Bank Accounts (CRO -1250)
116) Contributions from Not -For -Profit Orpntratiooe (CRO -1250)
11e) Outside Sources of Income (CR01250)
11d) Legal Expense Fund - Other Sources (c10-1270)
Ile) Exempt Purchase Price Sales (CRO -1265)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
2) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9,10,1 la,11b,11 c, 1 Id and I le
$ (0,
$
ITURES
Disbursements
L%) Operating Expenditures (CR&1310)
13b) Contributions to Candidates/Political Committees (CR0.1310)
13e) Coordinated Party Expenditures ((10-1370)
4) Aggregated Non -Melt I+spenditmcs ([.&1313)
1115) Loan Repayments ((100/44)0)
6) Refunds/Reimbaraments from the Cottee (M19s)
7) In -Kind Contributions (CR0.1310)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
8) TOTAL EXPENDITURES (Add tines 13a, 13b, 13c, 14,15,16 and 17)
S O • (`>O
$
9) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$
DITIONAL ]TOURMATION
0) Non -Monetary Gifts Given to Other Committees (CRO -1330)
1) Outstanding Loans (incl. ones from other campaigns) (0101430)
22) Debts and Obligations owed by the Committee (C201610)
23) Debts and Obligations owed to the Committee (C10100)
Account Transfers Within the Committee (QO.1710)
25) Administrative Support (1101710)
26) Forgiven Loans (CRO.14440)
7) 48 -Hoar Notice Reports Sam ((10-2220)
28) Contributions to be Refunded (CR0-1215)
$
$
$
$
$
$ $
$ $
$ $
$ $
UKU-11111 NC ]tare Hoard of Hmtioos August 2W8