James, Angelia_2021-Org-DisclosureDisclosure Report Cover Anar mien` Yes ❑ 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
c. ID Number
C6 MiM; e A -D Qoct� Atv
k, G" tn--tl
G TM 6-
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
PD>z 2s4
7' 7-A /
e. Phone Number
lay 3lQr7(e.9D
2. Report Year
3. Period Start Date (mtn/dd/ )
4. Period End Date (mm/dd/yy)
15. Treasurer Full Name
o
AV\.geh -3-0,W\e�
6. T e of Committee Check One
9. Type of Report (check only one type of report from one category)
Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
[!]'Organizational
❑ Organizational
❑ Organizational
❑ Independent Expenditure ❑ Joint Fundraiser
❑ Tbirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pro -primary
❑ First
❑ Final
❑ Pre-election
❑ Pte -runoff
Semi-annual
❑ Second
❑ Third
❑ Fourth
❑ Supplemental Final
❑ Annual
❑ Special
7. Type of Fund (if applicable, check one)
❑ Booster Fund
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year End
❑ Mid Year
10. Special Report Name
❑ Other:
❑ Final
[3Special
❑ Year End
13Final
113 Special
g. Number of Fundraisers this Report
0
11. Account Information
11. Account Information
a. Financial Instituution Name
a. Financial Imal 1
Full
tYS t l '\ lZ r
CAMPAIGN FINANCE
Is Purpose
c. Account Code
b. Purpose
c. Account Code
6
R E C E I V
d. Period Begin Balance
eriod Begin Balance
CERTIFICATION
I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B & 2213-22M of Chapter 163
of the NC General Statutes and that no funds are
commingled with prohibit or other non -disclosed funds. I further certify that this
report is complete, true and correct and that I have been tr fined by the NCtae Board of Elections.
eJ
' `\
N A 2' l — (Yy
��� /Printed rName of Signer
Signature o ointed Treasurer Date
FOR OFFICE USE ONLY
Date Received: o ' I Employee: Delivery Method
❑ Normal Mail
Date Postmarked:
Employee: [j Registered Mail
Hand Delivered
Date Scanned:
Employee: Electronically Filed
Date Data Entered:
Employee: r3 Signer has not receivedmandatory umumi
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 '. ❑ yes [91N.
Use this form to summarize all disclosure re ortin forms and to total monctary information
Name (and Fund if applicable)
1. Committee''
2. Type of Report
3. Number
(Full
C0'r �j HYD' o 1.11�T �;e �%iW 9
i�4h'�r` 1t°�
/ID
IY�M Y1
Start of Election Cycle: January 1, a o
Reporting
Total this
Period
Total this
Election Cycle
4) Cash on Hand at Start
$
$
0
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
11c) Outside Sources of Income
lld) Legal Expense Fund - Other Sources
11e) Exempt Purchase Price Sales
(C)?O-1205)
(CRO -1210)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$
$
$ U
$
a ( p
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10,11a,11b,11c,1 Id and I le)
$
- i , O `
$
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)
(CR0.1420)
(CRO -1320)
(CRO -1510)
$
$
$
$
$
$
$
$
$
$
$
$
$ 01 I , O
$
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$
I 0 (
$
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$
$
0
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 thbl CUA tmiittkb f Y
CAMPAIGN FINANCE
24) Account Transfers Within the Committee
25) Administrative Support JUL 0 7 2021
26) Forgiven Loans RECEIVED
27) 48 -Hour Notice Reports Sum
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRO -1620)
(CRO -1720)
(cRo-171o)
(ce0-1440)
(CRO -2220)
$
$
$
$
$
$
$
$
$
$
$
28) Contributions to be Refunded
(CRO -1215)
$
$
CRO -1100 NC State Board of Elections August 2008
1 Amendment
Contributions from Individuals Pg L -!
of — 1 ❑Yea
Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used
(and Fund if applicable)
1. Committee FulllI
2. ID Number
"Name
GO iMVv �i ( E��(� i z 1� -/�w eS
T
�T 1 M �J/
3. Contributor Information I❑ Add [3 Remove
a. Fall Name, Mailing Address & Phone
(Include city, state; & zip)
b. Job Title/Profession
d. Comments
11'C.WV�.'hin+.
�vtiPytLa aw.PS
Pa OD?( SQ 6
'Jo`P32� 7�PS�
c. Employer's Name/Specific Field
�zWn2� ZhG
e, Election Sum to Date
$ f
f. Prim
g. Account Cade
It. Form of Payment
1, Ln --Kind Description
J. Date (mm/dd/yyyy)
k. Amount
❑
Ct(S �
h l � {�'t {
�' a- 2A-21
$ 5, 0 0
❑
$
❑
$
3. Contributor Information ❑ Add I❑ Remove
a. Full Name, Mailing Address & Phmte
(include city, slate, & zip)
b. Job Title/Profession
d. Comments
,11f.GtNn i
!Y^e tllA ��ha,5
azo Zte Y-0
c. Employer's Name/Speeifie Field
a. Election Sum to Date
$ 2 f.')t
f. Prior
g. Account: Code-.
h. Form of Payment
1.In-Kind Description (
J; Date (mm/dd/yyyy)
k. Amount
❑
C'tls
l,v(>ks� Cd,4)
'1-3--2,I
$ 16'a 1
❑
$
❑
$
3. Contributor information ❑ Add ;❑ Remove
a. Fill Name, Mailing Address & Phone
(include city, state, 4JONDN COUNTY
b. Job Tifle/Profession
d. Cotmuents
CAMPAIGN FINANUL
JUL 0 7 2021
RECEIVED
c. Employer'sName/Specifie Field
e. Election Sum to Date
$
f. Prior
g. Account Code
h. Form of Payment
i. L -Ehul Description
J. Date (mmfddtyyyy)
It. Amount
o
$
❑
$
❑
$
4. Total only this Page
$ ( o
S. Total of ALL CRO -1210 Pages
(This line must be on line 6 of Detailed Smmnaty Page CRO -1100)
$ -21
CRO -1210 NC State Board of elections April 2007
Amendment � �-_.. ' I
In -Kind Contributions Pg _. of �_ 113 Yes patio
Use this form to report non -monetary contributions, donations, goods or services provided to the committee or fund.
Tiee CRO -1215 if Tn-Kind Contributions were or will be refunded within 7 days.
1. Committee Full Name and Fund if applicable)
2. ID Number
`o VV, vv i'f lit
3, Contributor Information '❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(Include city, state, & zip)
b. Type of Contributor
c, Comments
Lj(Individual
1y Candidate
❑ Party
❑PAC
Referendum
Q Other Receipt Source
Vz) t2 p*.. ��G /
J��7 yy 1 N
rrWhvut lu-- /i0 `l'
AnG� (,-o, TC( lt'tes
cS ki i (p 0
d. Election Sum to Date
$ OI
D. Description
I. Date (mmlddlyyyy)
It. Fair Market Amount
�{ c
7• � L4ZI
$ 5-106
i�c co��cl1
`1 3 2-,% -14
$ 1'p. 1
$
3. Contributor Information ❑ Add ❑ Remove
a, Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Type of Contributor
c. Comments
Individual
❑ candidate
Q Party
❑ PAC
❑ Referendum
Other Receipt Source
UNION COUNTY
CAMPAIGN FINANCE
U 0 I 1
JUL7 q q 202
d. Election Sum to Date
$
e. Descriplior -
fi:Date (mm/dd/yyyy)
Ig. Fair Market Amount
$
$
$
3. Contributor Information ❑ Add ,❑ Remove
a, Full Name; Mailing Address & Phone
(include city, state, &zip)
b. Type of Contributor
c. Comments
U Individual
❑ Candidate
13 Party
❑ PAC
❑ Referendum
❑ Other Receipt Source
d. Election Sum to Date
$
e, Description
f. Date (mm/dd/yyyy)
g. Fair Market Amount
$
4. Total only this Page
$ (. 1
5. Total of ALL CRO -1510 Pages
(This line trust be an litre 17 of Detailed Samntaq Page CRD -1100)
CRO -1510 NC State Board of Elections December 2007