Helms,Richard_2021-midyearDisclosure Report Cover o nt o No
Use this form for general report and committee information, must be signed and submitted along with other detailed 1'orm�
Do not use this form to update information.
1. Committee Information
. Full Name
r. m Number
b. Mailing Address (indole City, State aval Zip Code) _
6SC�N
d. Date Filed
(�/1>•1Gh �'W/ ' " c-
e. Phone Number
2. Report Year
3. Period(romfdd/yy)
— --- —
4. Period End Date (®Iddtyy)
`j3a j1i -
5. Treasarer Frill Name
Clypeof Committee (Check Ones _
® Candidate Campaign [3PartyMunicipal
6 PAC [3 Referendum
9. Type of Report _ (check
11 Organisational
only one type of report
Smte/County
from one categurr t
- --— — .
Referendum
13 Organiser pool
E3 Organizational
Independent Expenditure ❑ Joint Fundraiser
Legal Expense Fund
❑ Thirty-five day
❑ Pre-primary
Quarterly
13 First
0 Pre- referendum
❑ Final
❑ Pre-election
i] Prrmnoff
Semi-annual
❑ Mid Year
❑ Year End
❑ Final
❑ special
i3 Second
❑ Third
❑ Fourth
Semi-annual
Mid Year
Year End
❑ Final
-�t
iJ Supplemental Final
[j Annual
i] Special
7. Type of Fund (If applicable, check one)
0 Booster Fund
Building Fund
❑ Other:
10. Special Report Name
8. Number of Fundraisers this Report
40
❑ Special
11. Account Information
11. Account Information
. Financial Institution Full Name
a. Financial Institution Full Name
. Purpose
tit
�C.
c. Account Code
b. Purpose
c. Account Code
R E r E I
1Lv
d. Period Begin Balance
Begin Balance
$ n��'` O�
oc
$
CERTIFICATION
I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B & 2213-22M of Chapter It):
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 I have been train the NC State Board of Elections.
Printed Name of Signer Signature of Appointed Treasurer Date
OR OFFICE USE ONLY
J
Date Received: � � �1 Employee: Delivery Method
❑ Normal Mail
Date Postmarked: Employee: Registered Mail
Hand Delivered
Date Scanned: Employee: Electronically Filed
Date Data Entered: Employee: ❑ Signer has not received
mandatory trafmn
Please Note: Thisform 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-lOOo NC State Board of Elections August 2008
Axnewhoer
Detailed Summary p ` p No
Use this form to summarize all disclosure rennin¢ forms and to total monetary infnrmatinn
1. Committee Full Name (and Fundapplicable)
12. Type of Report
3. H) Number
Start of Election Cycle: January 1, A e 7--/
Total this
Re ortin Period
Total this
Election Cycle
4) Cash on Hand at Start
$ a
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
Ila) Interest on Bank Accounts
11b) Contributions from Not -For -Profit Organizations
llc) Outside Sources of Income
lid) Legal Expense Fund - Other Sources
11e) Exempt Purchase Price Sales
(CRO -1205)
(CRO -1210)
(CRO -1220)
(CRO -1130)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$
>
$ p b 0 0
S
$
ti
$
$
y
$
$
$
S
$
$
$
ti
$
j
12) TOTAL RECEIPTS (Add lines 5,6.7,8,9,10,1 la,l Ib,I le,I ld and I le
$
S`00. •''
S
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-IGnd Contributions
(CRO -1310)
(CRO.1310)
(CRO -1310)
(CRO -1315)
(CRO -1420)
(CRO -1320)
(CRO -1510)
$
$
ti
$
j
$
ti
$ 2 D g l- p
O
S
$
$
ti
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$
gAU 37. 00
S
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$
/ (• 0 �p
ADDPI'IONAL INFORMATION
0) Non -Monetary Gifts Given to Other Committees
1) Outstanding Loans (incl. ones from other campaigns)
2) Debts and Obligations owed by the Committee
3) Debts and Obligations owed to the Committee
4) Account Transfers WithinShed . �QNI CE
5) Administrative Support
6) Forgiven Loans JUL2 0 2021
7) 48 -Hour Notice Reports SuH F C ; F RIF D
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRa1620)
(CRO -1710)
(CRO -1710)
(CRo-1440)
(CRO-22201
$
$
$
$
$
$
$
$
$
$
$
8) Contributions to be Rd[mded
(CR0.1215)
$
CRO -1100 NC State Board of Elecdons August 2008
Amendment
Contributions from Individuals Pg _ of _ ❑ Ta ❑ No
Use this form to report individual contributions over $50 or contributions under $50 if form CRO 126-is—not—used
1. Committee Fan Name (_anti Fond if a ble_
2/e -t
2 ID Nt®ber
ATM 9 /3 f�
3. Contributor Information Add Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
,3)4 A b e /I/ a pti
/7-3
b. Job TitletProfession
GJr1/C.P—
d. Comments
c Employer's NamdSpecific Fleld
- �- --
y,/o es a es+t
e. Election Sum to Date
$ OoO.o,-
1. Prior
it. Account Code
h. Form of Payment
i. In -Kind Deecrlption
'. Date (mmfddlyyyy)
k Amount
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, states & zip)
b. Job Title/Profession
d. Comments
e- Employer's Name/Specific Field
e. Ekcflon Sum to Date
$
. Prior
& Account Code
Is. from of Payment
L In -Kim Description
J. Date (mmfddlyyyy)
k Amount
❑
$
❑
$
3. Contributor Information ❑ Add 0 Remove
. Full Name, Mailing address & Phone
(include city, stale, ,#kE,,1.1..,;.1a-
JUL 20 2021
RECEIVEDe.
b. Job Title/Professicn
d. Comment,
c. Employer's NanWSpecific Field
Election Sum to Date
$
. Prior
❑
g. Account Code
h- Form of Payment
L Io-Klad Dacripdm
J. Date (mm lddlyyyy)
k Amount
$
❑
$
❑
$
4. Total only this Page
$ � 0 I
5. Total of ALL CRO -1210 Pages
(This fine must be online 6 of Detailed Summary Page C'RO-/100)
5
CRO -1210 NC Statc Hoard of Elections Apnl 2007
Loan Repayments
Use this form to report oavments on an existing loan
Amendment
Pg _ of _ ❑ Yes ❑ No
1. Committee Full Name and Fund if applicable)
2. ID Number
eepw Mi/ �.— -1-4 FSG e�'7l /Get R-.2 < r �MS LCGG
m 7
3. Lender Information Add Remove
. Full Name, Mailing Address & Phone
(include ty, state, & zip)
b. Comments
/Gfjg2Ig 041,eAs
� 2 /-L- 'OQos..h. /I Ore.
W 4.7e It .-v, Ne- z.g 173
c. Original Loan Date
d. Original loan Amount
e. Remaining Loan Balance
r. Account Code
g. Form or Payment
h. Date (mm/dd/yyyy)
L Repayment Amount
$ 87. 00
/
L i
Y// r1,2 /
$ Y7
3. Lender Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Comments
c. Original Loan Date
d. Original Loan Amount
$
. Retaining Loan Balance
L Account Code
g. Form of Payment
h. Date (mm/dd/yyyy)
i. Repayment Amount
3. Lender Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, & Xepi
b. Comments
CAMPAIGN FINANCE
JUL 2 0 2021
RECEIVEDd.
c. original Loan Date
Original Loan Amount
$
e. Remaining Loan Balance.
L Account Code
g. Form of Payment
11s. Date (mrdddlyyyy)
1. Repayment Amount
$
5
$
4. Total only this Page
$ oZ p �-7
5. Total of ALL CRO -1420 Pages
line must be on line 15 of Detailed Summary Page CRO -1100)
s a D -7(This
CRO -14m NC State Board of Elections December 2(X17