Hall,Jason_2021-PreElection-amendmentAmendment
Disclosure Report Cover I \'ea ❑ No
Use this form for general report and committee information, must be signed and submitted along with dfheT detailed fortes.
Do not use this form to update information
CRO -1000 NC State Board of Elections August 2008
a. Full Name
e. ID Number
Pr -L4 4y 4AW.TtA:sdN /UC C
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
v�,A-xy�"4V v_ *-wAy, chic 666
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04-X"J NO— O' -?/-7_3
e. Pbooe Number
-7 ass -5-777
2. Report Year 3. Period Start Date (mm/dd/y),) 4. Period Ender Full Nam
mm/d
iy l D. i gi
F Li see-wSKI
Candidate Campaign ❑ Party
9. Type of Replarl
Municipal
check
only one npe o re
on rota
one tate o
State/('ount)
Referendum
PAC ❑ Referendum
❑ Organizational
❑ Organizational
❑ Organizational
Independent Joint
El Expenditure E]int Fdi
Thirty-five da
❑ rtY` Y
Quarterly
❑ Pre -referendum
Legal Expense Fund
❑ Pre-primary
❑ First
❑ Final
❑ "Booster Fund"
❑ Building Fund
Preelection
Pre-mnoff
❑ Second
❑ Third
❑ Supplemental Final
❑ Annual
Semi-annual
❑ Fourth
❑ Special
❑ Mid Year
Semi-annual
❑ Other:
❑ Year End
❑ Mid Year
❑ 1 incl
❑ Year End
�.
❑ Special
❑ Final
N 0 N F,
❑ Special
11. Account Information
a. Financial Institution Full Name
a. Financial
Institution Foil Name
f
b. Purpose
c. Account Code
b. Purpose
c. Account Code
C_AM�/PA*'/d
P (r � K S
4PJA e ^'NC e�
�•'�i i
f�N/Xw 1
d. Period Begin Balance
d. Period Begin Balance
$�g oo
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 INC General Statutes and that no funds are commingled with proh'
ed or ther n-disclo d funds. I further certify that this report
is complete, true and con)qct an that 1 ve been trained by the N
_�IcFL f- �IS6WK�f
t e Bo ctions.
Printed Name of Signer
AF Date
FOR OFFICE USE ONLY
Date Received: {Jd�f/�_ Employee:
1�
Delivery Method
❑ Normal Mail
Date Postmarked: Employee:
Registered Mail
Hand Delivered
Date Scanned: Employee:
Electronically Filed
❑ Signer has not received
Date Data Entered: Employee:
mandatory training
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
UNION COUN
04APAIGN FINAtd.
Detailed Summary (` �
Use this form to summarize all disclosure reporting forms and to total monetarv%T 2af 2021
\ III elid III ent
❑ N e,
Z5 M
CRO -1100 VC State Board of Elections August 2008
Fu if a licable 2. T
+ .T�g mltwtion
e of Re
3. ID Number"I+A
Cycle: January 1, ti°a)
Z4)Cash
Total this
Re ortin Period
Total this
Election C cle
5)
6)
7)
8)
9)
10)
11)
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
Its) Interest on Bank Accounts
11b) Contributions from Not -for -Profit Organizations
Ile) Outside Sources of Income
lid) Legal Expense Fund — Other Sources
11 e) Exempt Purchase Price Sales
(CRO -1105)
(CRO -1210)
(CRO -1220)
(CRO -1130)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1150)
(CRO -1250)
(CRO -1170)
(CRO -1265)
$
$
feLf. Q 0
$
$
it 5.00
$ 'l,' s
$
17, 59. tO
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
12)
13)
14)
15)
16)
17)
TOTAL RECEIPTS (Add lines 5.6, 7.8.9, 10. Ila. I1b. IIc. Ildand Ile)
Disbursements
13a) Operating Expenditures (CRO -1310)
13b) Contributions to Candidates/Political Committees (CRO -1310)
13c) Coordinated Party Expenditures (CRO -1310)
Aggregated Non -Media Expenditures (CRO -1315)
Loan Repayments (CRO -1420)
Refunds/Reimbursements From the Committee (CRO -1320)
In -Kind Contributions (CRO -1510)
$
7AS, 00
$
' -71, ,O
$ 7331 v.)
$
$
$
7 IDS
$
$
$
$
$
$
$
$
$
$
34,0
18)
TOTAL EXPENDITURES (Add lines 13a. 13b, 13e, 14. 15. 16and 17)
$
,Q,.qr
$
1-7 03. 11 11
19)
Cash on Hand at End (Add lines 4 and 11 together. then subtract line 18)
$
60, 9
$
aa3,7A
20)
21)
22)
23)
24)
25)
26)
27)
28)
Non -Monetary Gifts Given to Other Committees
Outstanding Loans (incl. ones from other campaigns)
Debts and Obligations owed By the Committee
Debts and Obligations owed To the Committee
Account Transfers Within the Committee
Administrative Support
Forgiven Loans
48 -Hour Notice Reports Sum
Contributions to be Refunded
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRO -1620)
(CRO -1720)
(CRO -1710)
(CRO -1440)
(CRO -2220)
(CRO -1215)
$
$
$
$
$
$
$
$
$
$
$
I $
$
CRO -1100 VC State Board of Elections August 2008
Amendment
Contributions from Individuals 119 / „f X les ❑ so
Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used
1. Committee Full Name and Fund if applicable)
W % 44 f J��rnl Pl %4z dL
3. Contributor Information
a. Full Tame, Mailing :Wdress&Phone
(include city, state, & zip)
R
b. Job Tide/Profession
d. Comments`
N a .7Va,-.Ti.aF
NI j4�rl- yyoNS
M/ fht,N�ON S. LLC.
f"O FW
WAxn/, tuL` ��n3
c. Employer's Name Specific Field
JVoTEAAPZY&-b
e. Election Sum to Date
$ 5'04).466
f. Prior
Account Code
It. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
El1
{{g.
' ttv X Wp(j
C µ'tin
/� �% aq�.�
$ S-vO, O
❑
$
❑
3.` ontr utorinforroation
a. Full Name, %[ailing Address & Phone
(include city, state, & zip[
dd ❑ Rem"
b. Jab "Title/Profession
$
d. Comments
�-
IT ExEt_u�r✓t
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6 5 0 ; �[ �
d,.. rL�l. /z N %. -� pn •7
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c. Employer's Name/Specific Field
IWAD AG1/E14L'iPM4W17
!) CA-U—Pw ( S
/v*CS4--5-,/S�l
e. Election Sum to Date
$ ao
f. Prior
g. Account Code
It. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
❑
HWXW
C
to o� atm/
$ A")S. d.)o
❑
$
3. Contributor Informatjo
a. Full Name, )tailing Address & Phone
(include cit%, state, & zip)
It. Job Titie/Professhm
d. Comments
c. Employer's Name/Specific Field
e. Election Sum to Date
$
E Prior
g. Account Code
h. Form of Payment i, In -Kind Description j. Date (mm/dd/yyyy)
k. Amount
❑
$
❑ $
4. To ` 'oaiy - .. Wge $ -7g:;k,5-.
5. Total of ALL CRO -1210 Pages 7a� p0
(This fine nme/ he on line 6 of Derailed Summary Page CRO -1100)
( RO-121 /l N(Statc Board of Elections April 2007
Amendment eeeyyy
bi$bursements Pg of ❑ Yes Nu
Use this form to report expenditures from the committee for: operating expenses, contributions to candidate/political
committees and coordinated pirtN expenditures.
1. Committ Name and Fu d if a lieable
t-fAr-L4ALI
3. T e of DisbPursement ease uses orate CRO -1310 ohms
llperning I yxnsc� 14 PvT1MRRwJFW-
(''nlrihtjtionx to (andidale. Polilic'd t-bmmittees ❑ (lmrdinxc,l Parr Prpendinues
4. Payee Information n Add Nowhamilliol..
a. Fall Name. \lalling Address & Phone
include city, stale. &zi
b. ('oordinated Committee Name
d. Comments CAMPAU. �CONN
OCT 25 202
E C E I V
F► fen 13
X le 0 !4r1V5t N(ru A(P2(VE
N4 35 A-
NA-)L&A'NJ (V L
c. Level Registered (Specify)
E] Federal County
❑ State 54 Municipality:
e. Election Sum to Date
$ #7 00
E Account Code
g. Form of Payment
It. Purpose Code —Ti. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
HrvxW /
CA-< t�
p /%3 l
$ m -t o
F471e-5
$
a. Full Name, Mailing Address & Phone
(include city, state. &[ zip)
b. Coordinated Committee Name
d. Comments
V prv�
$6�-8�3G7�3
c. Level Registered S
� (Specify)
❑ Federal ❑�p County:
[3State[g Municipality:
e. Election Sum to Date
zf$ .955. D..—L-
f.. Account Code
g. Form of Payment
It. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
Is. Required Remarks
1
64$ff
$e
CAUKS
-'i
ee Inform",
a. Full Name. Nailing .Address & Phone
include city, state. & zip)
R
b. Coordinated (nmmillee Name
d. Comments
5)&N-5 N6UJ
p
p4wflOFf �l L
e. level Registered (Specify)
❑ Fedemt ❑ County:
State Municipality:
a Election Sum to Date
L Account Code g. Form of Payment
h. Purpose Code i. Date (mm/dd/yyyy) j. Amount
k Required Remarks
+iyv
$ to D� .^a l s44-76-3
4m(s t 16AJS
$
S.To $ ,p
& To 1310 Poe"
(This line goes in line /3a ul Detailed Summary Page CRO -1100 if Operating Expenses) $
S(Thu(This line goes in line lab of Detailed Summary Page CRO -1100 if Comrib to Candidates/Polidcal Comm) 133, 05—
(This line goes in line 13c of Detailed Suoumty Page CRO -1100 if Coordinated Parte Expenditures)
Codes a in h. above
A* - Media B* - Printing C* - Fundraising D- To Another Candidate
F. - Salaries F* - Equipment G - Political Parp H* - Holding Public Office Expenses
I - Postage .1 - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field k
CRO -1310 NC Slate Huard of Flections December 2009
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