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Helms,Richard_2020-3rdQtrDisclosure Report Cover o vent o 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 update information. 1. Committee Information a. Full Name e ;� c. 1D Number b. Mailing Address (Include City, State and Zip Code) d. Date Filed iz12- �2Dselutc � io z��Z�z� e. Phone Number 2. Report Ycar 3. Period Start Date (mndddlvy) �4. Period End Date Treasurer Full Name 6. T pe of Committee (C'ftcck Once 9. Type of Report (chrck unlp one 0711' rf rzga07 lr(u,r r,n( r(11r1;"?0 Cundld;ne Campaign ❑ Puny Municipal State/Gnmh Referendum ❑ PAC ❑ Referendum ❑ Independent Expenditure ❑ Joint Fundraiser ❑ orv:mizational ❑ Thirty-five day ❑ org.mv.ui11i 1..l Qamter 1} ❑ Organizational ❑ Pre -referendum ❑ Legal Expense Fund ❑ Pre-primary ❑ First ❑ Final ❑ Preelection ❑ Pre -runoff Semi-annual ❑ Second ❑ Third ❑ Fourth ❑ Supplemental Final [3 Annual ❑ Special 7. Type of Fund Rfnpplfi,J,ir-, rhek nue) ❑ Booster Fund ❑ Building Fund ❑ Mid Year Semi-annual ❑ Year End ❑ Mid Year 10. Special Report Namc ❑ other. ❑ Final ❑ Spuial ❑ Year End ❑ Final 8. Number of Fundraisers this Report ❑ Special 11. Account Information 11. Account Information a. Financiaal/ll' lnstitution Full Name a. Financial Institution Full Name h. Purpose c. Account Code b. Purpose c. Account Code it. Period Begin Balance $ d. Period Begin Balance $ /fD ' Hyl yPi (i CERTIFICATION I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B & 22D -22M of Chapter 11, 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, we and correct and that I have been trainby the NC State Board of Elections. el r*LT SiZ �-�ir,.'J ��1- �� %l0 7 020 Printed Name of Si ner Si nature el Appointed Treasurer Date FOR OFFICE USE ONLY qq Date Received: �� a� Employee: 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 Detailed Summar Amendment Y E3 Yes ❑ N" I Ise this form to summarize all disclosure renortin¢ forms and to total mnne-tary informatinn 1. Committee Full Name (and Fund N applicable) 2. a of Report 3. II) Number L//N,flIle >o 4,fer�/I'i�.aec� rySJc<_ a3rn9B , Start of Election Cycle: January 1, Total this Reporting Period Total this Election Cycle 4) Cash on Hand at Start $ $ 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 I la) Interest on Bank Accounts I lb) Contributions from Not -For -Profit Organizations l lc) Outside Sources of Income 1ld) Legal Expense Fund - Other Sources 11e) Exempt Purchase Price Sales (CBO -1205) (CRO -1210) (CRO -1220) (CRO -1230) (CRO -1410) (CRO -1240) (CRO -1150) (CRO -1250) (CRO -1250) (CRO -1270) (CRO -1265) $ $ $ QS'� o o $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9,10,1 1 a, I I b, I I c, l 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) $ 1 p $ $ $ $ $ $ $ $ $ $ $ $ $ 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ $ t9) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18 $ d-'7-5'/, $ 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 23) Debts and Obligations owed to the Committee 24) Account Transfers Within the Committee 25) Administrative Support 26) Forgiven Loans 7) 48 -Hour Notice Reports Sum (CRD -1330) (CRO -1430) (CRO -1610) (CRO -1620) (CRO -1720) (CR04710) (CRO -1440) (CRO -2220) $ _ $ C $ $ $ $ $ $ $ $ $ 28) Contributions to be Refunded (CRO -1215) $ $ CRO -1100 NC State Board of Elections August 2008 Amendment Contributions from Individuals Pg _ of _ ❑ Yes ❑ No Use this form to reoort individual contributions over $50 or contributions under $50 if form CRO 1205 is not used 1. FundCommittee fitll//NLLame and d N applicable) 2. ID Number C,P/il w,, le 1'o ?%e l` is it12-d 1 eIII 1S Zl C C 25rA Q B 3. Contributor Information ❑ Add ❑ Remove . Full Name, Mailing Address & Phone (include city, slate, & rip) b. Job T1tl~emioa d. Comments l t.2 l/,ed r +—T 7 —3 c, Ereop/yee. NamdSpeuifieFieNeld e. FJeetran S®to Date $ Vo . Prior g. Account Code d Forma of Pajymeat i. In -Kind Description i- Date (mmiddlyyyy) t Amount ❑ $ ❑ $ . Contributor Information ❑ Add ❑ Remove . Fug Name, Mailing Addrrss & Phone (include city, statatee,, & zip)) r(y�+ L" / ��� �t ya 906 �2io'q�l��ft-ti,c�ti /� /� AIC a Ah A.) QOQ, 6�%/2-dr%1% b. Job Tide/Prefession d. Comments Employer's Name/5pe�c F�Id MedianScor to Date $ 300, 00 Prior & Account Code h Form of Payment Cit�aJL L In -Kind Description '. Date (mmldd/my) t Anu mt E3-- D9 1— y'�a 00 $ 3DD ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove . Full Name, Mailing Address & Phone (include city, state, & zip)S,u °�s y� d 741 N)/C" ' /L ` •R Litt 0�iA t) %�,4 / O b. Job IndelProfession d. Comments CS 4 Itl-e) l loved e C. Employer's NamelSpecific eld e. Election Sum to Date $ Prier lg.AwqmAC9de h. Form of Payment L In -Kind Description _ '. Date (nm/dd)yyyy) Aoatmt E3$ C/t ee eo a ❑ $ ❑ $ 4. Total only this Page &=— 5. Total of ALL CRO -1210 Pages $ (This line must be on line 6 of Detailed Summary Page CRO -1100) CRO -1210 NC State Board of Elections npm unit Amendment Disbursements Pg _ of _ ❑ Yes ❑ No Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political committees and coordinated party expenditures ittee Frill Name (and Frmd N applicab e) '// p n,0J4/ �7c -v G/ec 1/C1C�A2 cL hcl r15 GfeC Number ,2SN1 �3of Disbursemeat (Please use separate CRO -1310 forms for each rine ofDfsbtusemelit) V tio Ex nses Contributions to Candidates/Political CommitteesCoordinated Ex ditures Information Add L3 Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) a„/,e adu 'LY Gwr b. Coordinated Committee Name d. Comments c. Level Registered (Specify) El Federal 0 County: ❑ State ❑ Municipality: e. Flection Sam to Date $ U �(J O b . Acrnmt Code g. Forty o[ Paymem h. Purpose Code L Date (mm/dd/yyyy) D.Amount k. Required Remarks cb, t _ G 9.3D aDzo $ 010 my Is 4. Payee Information U Add Ej Remove . Full Name, Mailing Address & Phone (include city, state, & zip) 0 % �,¢G1.<e aE('d 10 / Y� It Coordinated Committee Name d. Comments c. Level Registered (Specify) ❑ral Fede --- ❑ .-- County: ❑ State - ❑ Municipality: e. Flection sum m Date - $ 3s • °a . Accmmt Code g. Form of Paymenth. Purpose Code r. Date (mmlddlyyyy) . Amount 1k. Required Remarks 'I /0 5 zozv $ 3r- °� 4. Payee Information L3 Add 0 Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) e// 9 �✓L' 3/,-1 � e pa r S �V D N 2 e „ l C b. Coordinated Committee Name d. Comments c. Level Registered (Specify) ❑ Federal CYCounty: 13 State 13 Municipality: e. Election Sum to Date $ . Account Code g. Form of Payment Its. Propose Code1. Date (mmtdd/yyyy) ►o �3 sa D. Amount $3ta.ii L Required Remarks Is 5. Total only this Page $ y S, 14.)- v6. 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses) (This line goes in line 131, 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) $ 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 - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* Other * Codes rettuire detailed explanation in required remarks field W CR043M NC State Board of Elections December 2009 Disbursements Amendment Pg _ of _ ❑ Yes ❑ No Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political committees and coordinated Darty expenditures ommittee Full Name (and Fnnd if applicable) 2. ED Number `d e/er 7tn 2ePosC< AWypeof Disbursement (Please use senarate CRO -1310 farmsfar each type of Disbursement.) [a.Full O eratin Ez nses ContributiontoCandidatestPoliticalCommittees -0 Coordinated Pan Ex nditures ayee Information Add Remove Name, Mailing Address & Phone b. Coordinated Committee Name d. Comments (include city, state, & zip) �{ U5 A / c. Level Registered (Specify) ❑ Federal 2 County: tM / r0 (.1� lj e .Q I 1 J t L ❑ State ❑ Municipality: e. Election Sum to Date S 7m, 00 f. Account Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) /e3 . Amount $��OD k. Required Remarks Is 4. Payee Information U Add Remove a. If Name, Mailing Address & Phone b. Coordinated Committee Name d. Comments (include city, state, & zip) {^J CN / K/ e—1'� /�- / d -� (/ 1 S / 2 � r'7 O D tJ N e N 4- - c. Level Registered (Specify) ❑ Federal ❑ County: ,/lra D -h , C 73/// Y � l� ❑ State [3 Municipality: e. Election Sum to Date $ r. Account Code g. Form of Payment h. Purpose Code I. Date (mm/ddtyyyy) j. Amount k. Required Remarks is 4. Payee Information Ll Add Lj Remove . Full Name, Mailing Address & Phone b. Coordinated Committee Name d. Comments (include city, state, & zip) c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date . Account Code g. Form of Paymen[ h. Purpose Code i. Date (mm/dd/yyyy) J. Amount k. Required Remarks Is 1$ 5. Total only this Page $ 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Summary Page CR04100 if Operating Expenses) $ (This line goes in line lab of Detailed Summary Page CRO -1100 if Cantrib to Candidates/Political Comm) (This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures) 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 Part' H* - Holding Public Office Expenses I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* Other * Codes re vire detailed ex lanation in required remarks field k CRO -1310 NC State Board of Elections December 2009 Amendment Outstanding Loans Pg of _ ❑ I"e. ❑ No Use this form to report any outstandin, I0tII1S received durin_ a previous reporting period and until the loan is paid in full. 1,. Committee Full Name: and Fund if applicable) ; 2. ID Number snt 9 a 3 Lender Informatidn' El Add ;❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) 611, ',ti ASN AN-) / N L -Z-& % b. Job Title/Profession d. Comments e. Start Date (mmld(Vyyyy) c. Employer's Name/Specific Field. uu /) t1 044Z47/7 f. End Date (mm/dd/yyyy) . Rate h. Security Pledged — --__ i. Original Loan Amount $,JVS7.0a j. Remaining Loan Balance $v2 Oe 7. 01 k. Full Name of Lending Institution 1. Loan Number ❑ . Full Name, Mailing Address & Phone (include city, state, & zip) II 11 L) �h 1'I -R (Y 4 pt,- .Z ( 4i R O S L Y/ 73 201PY 4A-�3/ Add, `ji3. Reoibvez It. Job Title/Profession _ ' 4" - d. Comments e. Stare Date cmm/dd/yyyy) c. Employer's Name/Specific Field /✓ 20 2 f. End Date (mm/dd/yyyy) G;11 / � /.Z0 ZD g. Rate It. Security Pledged i. Original Loan Amount e1 $ / 00 O C21 j. Remaining Loan Balance $ k. Full Name of Lending Institution 1. Loan Number 3.1enderInformati6n,•'"" ` ❑ Add Remove a. Full Name, Mailing Address At Phone (include city, state, & zip) b. Job Title/Profession d. Comments -- -_- e. Start Date (mm/dd/yyyy) c. Employer's Name/Specific Field f. End Date (mm/dd/yyyy) . Rale h. Security pledged i. (trivinal Loan Amount 1 j. Remaining Loan Balance $ ,7 k. Fall Name of Lending Institution 1. Loan Number 4. Total only this Page $ 5. Total of ALL CRO -1430 Pages j (this line must be on line 21 of Detailed Summary Page CRO -1100) $ CRU-14JO N( S it, [1 1,1 .n 17eai„n, December 2007