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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