James, Angelia_2021-PreElectionReportAmendment
Disclosure Report Cover ❑ Yea ® 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
a to Number
Committee to Elect An elia James
GTMBDF
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
PO Box 2596, Monroe NC 28111
(0-25-21
e. Phone Number
704-320-7650
2. Report Year
3. Period Start Date (mm/dd/yy)
4. Period End Date
mm/d
5. Treasurer Full Name
2021
09-22-2021
10-18-2021
Angelis James
6. Type of Committee (Check One)
9. Type
of Report check only
one toype of re ort om one category)
® Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑
Organizational
❑ Organizational
❑ Organizations]
Independent ❑ Joint Fundraiser
❑ Expenditure
❑
Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fond
❑
®
Pre-primary
Pre-election
❑ First
❑ Second
❑ Final
❑ Supplemental Final
7. Type of Fund (ifapplimble, check one)
❑ 'Booster Fund'
❑ Building Fond
❑
Pre -runoff
❑ Third
❑ Annual
Semi-annual
❑ Fourth
❑ Special
❑
Mid Year
Semi-annual
❑ Other:
❑
Year End
❑ Mid Year
10. Special Report Name
❑
❑
Final
Special
❑ Yew End
❑ Final
❑ Special
8. Number of Fundraisers this Report
0
11. Account Information
11. Account Information
a. Financial Institution FWI Name
a. Financial Institution Full Name
First Citizens
UN
b. Purpose
c. Account Code
b. P
e. Account Code
All campaign
Expenses
01
OCT 2 5 2021
d. Period Begin Balance
d. Period Begin Balance
RECEIVED
$ 871.68
$
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 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 1 have been trained
by the N,Q State BoaN of Elections.
Angelia lames
10-25-2021
Printed Name of Signer
Signature of pointed Treasurer
Date
FOR OFFICE USE ONLY
Date Received: D a S 8 I
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 -2 100A -E) to make committee changes.
CRO -10/10 NC State Board of Elections August 2008
Amendment
Detailed Summary ❑ Yes ® No
Use this form to summarize all disclosure reDortine forms and to total monetary information.
1. Committee Full Name and Fund if a licable
2.
of Re ort
3. ID Number
Committee to Elect Angelia James
Pre -Election
GJMBDF
Start of Election Cycle: January 1, 2020
Total this
Re ortin Period
Total
Election Cycle cle
4)
Cash on Hand at Start
$
871.68
S
871.68
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
ilb) Contributions from Not -for -Profit Organizations
Ile) Outside Sources of Income
lld) Legal Expense Fund—Other Sources
11 e) Exempt Purchase Price Sales
(CRO -1205)
(CRO -1210)
(CRO -1120)
(CRO.1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CR&12S0)
(CRO -1270)
(CRO -1265)
$
$
5171.01
$
$ 2400.00
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
12)
TOTAL RECEIPTS (Add lines 5, 6, 7, 8.9, 10, Ila, Iib, Ile, IIdand Ile)
$
2400.00
$
5171.01
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)
$
$
$
$
$ 2530.70
$
4409.02
$
$
$
$
$
$
$ 500.00
$
21.01
18)
TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$
3030.70
$
4430.03
19)
Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18)
$
740.98
$
740.98
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
27) 48 -Hour Notice Reports Sum
28) Contributions to be Refunded
(CRO -1330)
(CRO -1430)
(cRo-mo)
(CRO -1620)
(CR04720)
(CRO -1710)
(CRO -1440)
(CRO -2220)
(CRO -1215)
$ UNION COUNTY
CAMPAIGN FINAN UL
$ OCT 2 5 2021
$
$
$
$
$
$
$
$
$
$
CRO -1100 NC State Board of Elections August 2008
Amendment
Contributions from Individuals Pg I of 2 ❑ Yes ® No
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 ap licable)
2. ED Number
Committee to Elect Angelia James
GTMBDF
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & rap)
b. Job Title/Profession
it. Comments
Broker
Venkat Sakhamuri
10010 Allyson Park Dr
Charlotte, NC 28277
704-659-3730
c. Employer's Name/Specific Field
Sona Reality
e. Election Sum to Date
$ 2000.00
E Prior
g. Account Code
It. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k Amount
❑
01
check
10-05-2021
$ 2000.00
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & tip)
It. Job Title/Profession
it. Comments
President
DWUC U&0 -y Ar"
7905 Tottenham Ct
Waxhaw, NC 28173
704-698-2602
c. Employer's Name/Specific Field
Democratic Women of UC
e. Election Sum to Date
$ 200.00
f. Prior
g. Account Code
h. Form of Payment
1. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
❑
01
check
10-12-2021
$ 200.00
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
it. Comments
Information Analyst
Satish Vankeneni
8027 Tottenham Dr
Harrisburg, NC 28075
954-668-7284
c. Employer's Name/Specific Field
PNC
e. Election Sum to Date
$ 200.00
E Prior
g. Account Code
h. Form of Payment
I. In -Kind Description
J. Date (mm/dd/yyyy)
k. Amount
❑
01
check
UNION COUNTY
10-18-2021
$ 200.00
CAMPAIGN FINANCE
❑
OCT 25 2021
$
4. Total only this Page RE $ 2400.00
5. Total of ALL CRO -1210 Pages
$ 2400.00
(This line must be on Gne 6 ofDeiaifedSananmy Page CR&I100)
CRO -1210 NC State Board of Elections April 2007
Amendment
Disbursements Pg 1 of 8 ❑ Yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Full Name and Fund if applicable) 2.1D Number
Committee to Elect An elia James I GJMBDF
3. Type of Disbursement Please use separate CRO -1310 forrm for each type of Disbursement
® Operating Expenses ❑ Contributions to Candidales/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information ❑ Add Remove
a. Full Name, Mailing Address & Phone
include city, state, & a
b. Coordinated Committee Name
d. Comments
USPS
101 S Charlotte Ave
Monroe, NC 28112
800-275-8777
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 11.60
L Account Code
g. Form of Payment
h. Purpose Code
1. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
01
Electronic
I
104-21
$11.60
stamps
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & a
b. Coordinated Committee Name
d. Comments
Lowe's
2350 W Roosevelt Blvd
Monroe, NC 28110
704-226-1744
a Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 7.43
L Account Code
g. Form of Payment
h. Purpose Code
I. Date (mmldd/yyyy)
j. Amount
k. Required Remarks
01
Electronic
O
104-21
$7.43
magnets
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & ti
b. Coordinated Committee Name
d. Comments
MRH Dezign & Photography
4219 Wolf Pond Rd
Monroe, NC 28112
704-219-1739
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ Stare ® Municipality:
e. Election Sum to Date
$ 240.00
L Account Code
g. Form of Payment
h. Purpose Code
i. fate (mm/dd/yyyy)
j. Amount
k. Required Remarks
01
Electronic
O
10-5-21
$160.00
car magnets
UNION
CAMPAIGN FINA SE
5. Total only this Pae $ 179.03
292i/
6. Total of ALL CRO -1310 Pages ON
(This fine you in fine 13a of Detailed Summary Page CRO-1100if Operodt�g L �dl r .,
(This line goes in fine 13h of Detailed Summary Page CRO -1100 ifConftiA4 Dow $ 2530.70
(This finegoes in Rne 13c of DetailedSummmy Page CRO -1100 ijCoordinated Party FWendauruJ
7. Pur ose 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
1 - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field k
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg 2 of 8 ❑ Yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated Darty expenditures.
1. Committee Full Name and Fund if applicable) 2. ED Number
Committee to Elect Angelia James GJMBDF
3. Type of Disbursement Please use sevarate CRO -1310 form for each type of Disbursement
® Operating Expenses ❑ Contributions to Candidmes/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information Lj Add Lj Remove
a. Full Name, Mailing Address & Phone
include city, state, & a
b. Coordinated Committee Name
d. Comments
Shania Kreationz
1919 Old Lawyers Rd
Marshville, NC 28103
704-8904723
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 43.00
L Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
L Required Remarks
01
Electronic
B
10-5-21
$43,00
design postcard
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & a
b. Coordinated Committee Name
d. Comments
Franklin Grille
232 E Franklin
Monroe NC 28112
704-774-1154
e. Level Registered (Specify)
❑ Federal ❑ county:
❑ State ® Municipality:
e. Election Sum to Date
$ 69.97
L Account Code
g. Form of Payment
It. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
01
Electronic
O
10-8-2021
$69.97
food
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & ti
b. Coordinated Committee Name
d. Comments
Office Max
1030 W Roosevelt Blvd UNION G� NPGE
Monroe, NC 28110 GPMPPIGPI
704-226-9977 QCT 25 2p21
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 125.10
L Account Code
g. Form of
W PuTp—me Code
i. Date (mm/ddlyyyy)
j. Amount
k. Required Remarks
01
Electronic
B
10-8-2021
$125.10
ballots, flyers
5. Total only this Pae $ 238.07
6. Total of ALL CRO -1310 Pages
(This line goes in line Ma of DetailedSuaunary Page CRO -1100 if Operating Expenses) $ 2530.70
(This line goes in fine 13b of DelaffedSummary Page CRO -1100 if Contrib to Candidates/Polifical Comm)
(This fine goes in fine 13c of DetailedSummany Page CRO -1100 ifCoordinated 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 require detailed explanation in required remarks field (k)
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg 3 of 8 ❑ Yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Fu6 Name and Fund if applicable) 2. ID Number
Committee to Elect An elia James GJMBDF
3. Type of Disbursement Please use separate CRO -1310 forms for each type of Disbursement
® Operating Expenses ❑ Contributions to Candidmcs/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information ❑ Add El Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
KL Heavenly
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 217.00
E Account Code
g. Form of Payment
Is. Purpose Code
1. Date (mm/dd/yyyy)
j. Amount
L Required Remarks
01
Electronic
O
10-08-2021
$217.00
shirts
$
4. Payee Information ❑ Add ❑ Remove
a. Fall Name, Mailing Address & Phone
include city, state, & a
b. Coordinated Committee Name
d. Comments
Christina's Customize Designs
Monroe, NC 28110
980-328-3900
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ state ® Municipality:
e. Election Sum to Date
$ 40.00
L Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
L Required Remarks
01
Electronic
B
10-10-2021
$40.00
postcards
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
T'
include city, state, & ti COIjNA OiCE
b. Coordinated Committee Name
d. Comments
Tamara Jones C,,MpNG
5906 Coral Ridge Lane5 2QZ'
Indian Trail, NC 28079 QCT
803-603-7517ED
FRECE1�
c. Levo Registered (Specify)
❑ Federal ❑ county:
❑ State ® Municipality:
e. Election Sum to Date
$ 60.00
f. Account Code
g. Form of Payment
I h. Purpose Code
i. Date (mm/ddlyyyy)
I j. Amount
j It. Required Remarks
01
Electronic
O
10-12-2021
$60.00
To and shirts
5. Total only this Pae $ 317.00
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of DetailedSummary Page CRO -1100 if Operating Expenses) $ 2530.70
(This fine goes in line 13b of DemUed Summary Page CRO-II00 ijComrib to Candidatex/Political Comm)
(This fine goes in line 13c ojDdailed Summary Page CRO -1100 iiCmrdinated Party Expenditures)
7. Purpose Codes(List detailed expenditure code in above)
A* - Media B* - Printing C* - Fundraising D - To Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
1 - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field (k)
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg 4 of 8 ❑ Yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated nartv exnenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Committee to Elect Angelis James GJMBDF
3. Type of Disbursement Please use separate CRO -1310 fornn for each tPoe of Disbursement
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information Add Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Walmart
2406 W Roosevelt Blvd
Monroe, NC 28110
704-289-5478
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ state ® Municipality:
e. Election Sum to Date
$ 213.67
f. Account Cade
g. Form of Payment
h. Purpose Code
's Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
01
Electronic
O
10-12-21
$213.67
food, paper pro
tent, table
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Zaxby's
2232 W Roosevelt Blvd
Monroe, NC 28110
704-283-0100
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 21.33
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
01
Electronic
O
10-13-21
$21.33
fOod
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
Is. Coordinated Committee Name
d. Comments
Kash Consignments UNION
545 Morgan Mill Rd CAMPAIGN FINANCE
Monroe, NC 28110
980-210-3649 OCT 2 5 2021
RECEIVED
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 76.20
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
01
Electronic
O
10-13-21
$76.20
giveaway bags
$
5. Total only this Pae $ 311.20
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Summary Page CRO.1100 if Operating Expenses) $ 2530.70
(This line goes in line 136 of Detailed Summary Page CRO -1100 iiComrib to CandidateslPol%acal Comm)
(This line goes in line 13e of Detailed Summary Page CRO -1100 6fCoordinaled 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 require detailed explanation in required remarks field k
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg S of 8 ❑ Yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Committee to Elect Angelia James I GJMBDF
3. Type of Disbursement Please use sevarate CRO -1310 fomn for each type of Disbursement
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Part Expenditures
4. Payee Information ❑ Add Lj Remove
a. Full Name, Mailing Address & Phone
include city, sate, & zip)
b. Coordinated Committee Name
d. Comments
The Spot Eatery
1513 Concord Ave
Monroe, NC 28110
704-218-2482
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 288.80
E Account Code
g. Form of Payment
h. Purpose Code
1. Date (mm/ddlyyyy)
j. Amount
k. Required Remarks
01
Electronic
O
10-13-21
$288.80
food
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
e. Election Sum to Date
Zaxby
2232 W Roosevelt Blvd
Monroe NC 28110
704-283-0100
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
$ 21.33
f. Account Code
g. Form of Payment
h. Purpose Code
I. Date (mm/ddlyyyy)
j. Amount
L Required Remarks
01
Electronic
O
10-13-2021
$21.33
food
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & v
b. Coordinated Committee Name
d. Comments
Chick Fil A
2592 W Roosevelt Blvd UNION COUNTY
Monroe,NC28110 CAMPAIGNFINANCE
704-225-8630 OCT 2 5 2021
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 23.44
E Account Code
g. Form
Code
I. Date (mm/dd/yyyy)
j. Amount
L Required Remarks
01
Electronic
0
10-15-2021
$23.44
food
$
5. Total only this Pae $ 333.57
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Summary Page CRO -11007f Opemdng Expenses) $ 2530.70
(This line goes in line lab of Detailed Summary Page CR0.1100 if Coni ib to Candidates/Political Comm)
(This fine goes in ane 13c of DetailedSummary Page CR0.1100 if Coordinated Parry Etpenditures)
7. Pur se 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 3 - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field k
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg 6 of 8 ❑ Yes N No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Committee to Elect An elia James I GJMBDF
3. Type of Disbursement Please use separate CRO -1310 fomn for each type of Disbursement
N Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state,& ti
It. Coordinated Committee Name
it. Comments
Urban Voiced Media
704-530-4920
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State N Municipality:
e. Election Sum to Date
$ 100.00
E Account Code
g. Form of Payment
b. Purpose Code
i. Date (mm/ddlyyyy)
j. Amount
L Required Remarks
01
Electronic
A
10-15-21
$100.00
media
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & a
b. Coordinated Committee Name
d. Comments
Food Lion
250 N MLK Jr Blvd
Monroe NC 28112
704-225-006
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State N Municipality:
e. Election Sum to Date
$ 109.06
E Account Code
g. Form of Payment
b. Purpose Code
1. Date (mm/dd/yyyy)
j. Amount
L Required Remarks
01
Electronic
O
I0-15-2021
$109.06
fruit and veg
tray
4. Payee Information ❑ Add ❑ Remove
s. Full Name, Mailing Address & Phone
include city, state. & zip)
b. Coordinated Committee Name
it. Comments
Office Max UNION
1030 W Roosevelt Blvd CAMPAIGN FINANCE
Monroe, NC 28110 OCT 2 5 2021
704-226-9977
RECEIVED
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State N Municipality:
e. Election Sum to Date
$ 148.32
L Account Code
g. Form of Payment
I It. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
L Required Remarks
01
Electronic
0
10-15-2021
$148.32
flyers, postcar
cards
$
5. Total only this Pae $ 357.38
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses) $ 2530.70
(This linegoer in lime 13b of Detailed Summary Page CRO -1100 iiContrib to Candidates/Political Comm)
(This lingoes in Gn 13c of DetailedSummary Page CRO-11001if Coordinated Party Expenditures)
7. Purpose Codes (List detailed expenditure code in .) above)
A* - Media B* - Printing C* - Fundraising D - To Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
1 - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field k)
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg 2 of 8 ❑ Yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Committee to Elect Angelis James GJMBDF
3. of Disbursement Please use separate CRO -1310 forms for each type of Disbursement
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information Add Ej Remove
a. Full Name, Mailing Address & Phone
include city, state, & zi
b. Coordinated Committee Name
it. Comments
East Frank and Superette
209 E Franklin St
Monroe, NC 28112
704-776-9451
c. Level Registered (Specify)
❑ Federal ❑ County
❑ State ® Municipality:
e. Election Sum to Date
$ 38.00
E Account Code
g. Form of Payment
h. Purpose Code
L Date (mm/ddlyyyy)
j. Amount
k. Required Remarks
01
Electronic
O
10-15-21
$38.00
food
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & ti
b. Coordinated Committee Name
it. Comments
Palace Restaurant
1000 Lancaster Ave
Monroe NC 28112
704-283-1123
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ state ® Municipality:
e. Election Sum to Date
$ 22.40
L Account Code
g. Form of Payment
h. Purpose Code
L Date (mm/dd/yyyy)
J. Amount
k. Required Remarks
01
Electronic
O
10-22-2021
$22.40
fruit and veg
tray
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city,state,&zi UNION COUNTY
b. Coordinated Committee Name
it. Comments
Shania Kreationz C
1919 Old Lawyers Rd OCT 2 5 2021
Marshville, NC 28103
704-8904723 RECEIVED
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 254.05
t Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
L Required Remarks
01
Electronic
O
10-22-21
$254.05
shirts
5. Total onlythis Pae $ 314.45
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of DeradledSummamy Page CRO -1100 if Operating Expenses) $ 2530.70
(This linegoes in line 13b of Detailed Summary Page CRO -1100 ifComrih to CandidatedPolilical Comm)
(This lingoes in line 13c of DelatledSuninnary 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 require detailed explanation in required remarks field (k
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg g of W ❑ yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Committee to Elect An elia James GJMBDF
3. Type of Disbursement Please use separate CRO -1310 fornis for each type of Disbursement
® Operating Expenses ❑ Contributions to Cmdidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information ❑ Add Lj Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Christina's Customize Designs
Monroe, NC 28110
980-328-3900
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ® Municipality:
e. Election Sum to Date
$ 480.00
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/ddtyyyy)
j. Amount
L Required Remarks
01
Electronic
O
10-22-21
$480.00
button, badges,
magnets
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
e. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Election Sum to Date
$
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
L Required Remarks
$
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip) Y
b. Coordinated Committee Name
d. Comments
CAMPA.IGl" FINANCE
OCT 2 5 2021
RECEI\/ED
c. Level Registered (Specify)
❑ Federal p County:
❑ State ❑ Municipality:
e. Election Sum to Date
$
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (moddd/yyyy)
j. Amount
L Required Remarks
$
5. Total only this Pae $ 480.00
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of DemiledSurronary Page CRO -1100 if Operating E.Wenses) $ 2530.70
(This fine goes in line 131, of Detailed Summary Page CRO -1100 fComrib to Candidates/Polideal Comm)
(This line goes in line 13c ojDetailed Summary Page CRO -1100 iiCsordinated Parry 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
1 - Postage J - Penalties K* - Office Expenses Q* -Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field k)
CRO -1310 NC State Board of Elections December 2009
Amendment
In -Kind Contributions Pg of 1 ❑ Yes ® No
Use this form to report non -monetary contributions, donations, goods or services provided to the committee or fund.
use cxu-It a it m -Irmo i,omrloutlons were or win oe rerunaeo wmmn i ua s.
1. Committee Full Name and Fund if applicable) 2. ED Number
Committee to Elect Angelia James GTMBDF
a. Full Name, Mailing Address & Phone
(include city, state, & nip)
Angelia James
PO Box 2596
Monroe NC 28111
704-320-7650
e. i)cmnp
website
3. Contributor Information
a. Full Name, Mailing Address & Phone
(include city, state. & zip)
e. Description
3. Contributor Information
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
UNION COUNTY
e. Description CAMPAIGN
OCT 2 5 2021
RFC;EIVED
4. Total only this Page
5. Total of ALL CRO -1510 Pages
(This line must be on fine 17 ojDetafied
b. Type of Contributor
❑
Individual
®
Candidate
❑
Part
❑
PAC
❑
Referendum
❑
Other Receipt Source
L Date (mm/dc
09-22-201
In. Type of Contributor
❑
Individual
❑
Candidate
❑
Party
❑
PAC
❑
Referendum
❑
Other Receipt Source
L Date (mm/dt
b. Type of Contributor
❑
Individual
❑
Candidate
❑
Part
❑
PAC
❑
Referendum
❑
Other Receipt Source
E Date (mm/di
c. Comments
d. Election Sum to Date
$ 521.01
g. Fair Market Amount
$ 500.00
c. Comments
it. Election Sum to Date
$
Fair Market Amount
$
$
c. Comments
d. Election Sum to Date
$
g. Fair Market Amount
$
$
$
$ 500.00
$ 500.00
RO-1510 NC State Board of Elections December 20(