Kindley,Patricia_2022-FinalDisclosure Report Cover Amendment
wren® No
Use this form for general report and comrmittee information, nest be signed and submitted along with other detailed fours.
Do not use this form to uodate infornution.
I. Committee Information
a. Full Name
c. ID Number
COMMITTEE TO RE-ELECT PATRICIA HELMS KINDLEY
b. libiling Address (include City, State and Zip Code)
d. Date Fled
9108 UNIONVILLE-BRIEF RD
02/09/2022
MONROE, NC 28110
e. Phone Number
(704)753-4782
2. Report Year
13. Period Start Date (mm/ddtvy)
14. Period End Date (mm/dd/yy)
15. Treasurer Full Name
3022
01 M 201_2
02/09/3023
JOHN KIBLER
6. T of Committee (Check One)
9.
of Report (check only one type o rertfrom one category)
® Candidate Campaign ❑ Par"
Municipal
State/County
Referendum
❑ Joint Fundraiser ❑ PAC
❑
Organizational
❑ Organizational
❑ Organizational
❑ Referendum ❑ Legal Expense Food
❑
❑
❑
Thirty-five day
Pre-primary
Pre-election
Quarterly
❑ Fust
❑ Second
❑ Pre -referendum
❑ Final
❑ Supplemental Final
7. Type of Fund (IaP➢/icobte. check one)
❑ " Boostcr I und"
❑ Building Feud
❑
Pre -runoff
❑ Third
❑ Annual
❑ Presidential Election Year Candidates Fund
Semi-annual
❑ Forth
❑ Special
❑ NC Public Campaign Financing Food
❑
Mid Year
Semi-annual
❑
Yew End
❑ Mid Year
10. Special Re rt Name
❑ (niter
®
Final
Special
❑ Year End
[3Feral
❑ Special
8. Number of Fundraisers❑
p
!!!!!!
3. Account Information
3. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
U W HARRIE BANK
b. Purpose
e. Account Code
b. Purpose
c. Account Code
CHECKING ACCOUNT
228
FOR CAMPAIGN
d. Period Begin Balance
d. Period Begin Balance
$
$
CER71MATION
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 I have been trained by the NC State Board
!xzol/ J,4:. L94�c
02/09/2022
Panted Name of Signer
signature ol'AplTointcd Treasurer Date
FO E Y Ur
Date Re
Received:
Date Received:
Employee: Delivery Method
❑ Normal Mad
Registered Mail
Date Postmarked:
Employee:
Hand Delivered
1
Date Scanned: `�
Employee: Electronically Filed
❑ Signer has not received
Date Data Entered:
Employee:
mandatory trainin
Please Note: This formcannot be used to amend committee information such as the committee address, treasurer,
assistant treasurer, custodian
of books information, oraccount information.
You must amend the Statement of Organization
CRO -2100A- to make committee changes.
CRO -1000 NC State Board of Elections December 2007
Detailed Summa Amendment
I'y ❑Yes ®No
Use this fonnto sutrumtia all disclosure renortina forms and to total monetary infortnation
1. Committee Full Name and Fund if applicable)
2. Tym of Report
3. ID Number
COMMITTEE TO RE-ELECT PATRICIA HELMS
2022 Final
Start of Election Cycle: January 1, 2021
Re
Total this
rtio Period
Total this
Election QVcle
4) Cas It on Hand at Start
$
2,132.20
$
0.00
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
0) Refunds/Reimbursements to the Committee
1) Other Receipt Sources
11 a) Interest on Bank Accounts
11 b) Contributions from Not -For -Profit Organizations
11c) Outside Sources of Income
IId) Legal Expense Fund- Other Sources
I Ie) Exempt Purchase Price Sales
(CRO -1205)
(CRO -1210)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$ 0.00
$
1,215.00
$ 0.00
$
2,731.12
$ 0.00
$
350.00
$ 0.00
$
0.00
$ 0.00
$
0.00
$ 0.00
$
S
12.00
0.00
$ 0.00
$ 0.00
$
0.00
$ 0.00
$
0.00
$ 0.00
$
0.00
$ 0.00
$
0.00
2) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10,11 a, I I b, I I c, I I d and I I c)
$
0.00
$
4,308.12
EXPENDITURES
3) Disbursements
13a) Operating Expenditures
13b) Contributions to Candidates/Political Committees
13c) Coordinated Party Expenditures
4) Aggregated Non -Media Expenditures
5) Loan Repayments
6) Refunds/Reimbursements from the Committee
7) In-lUnd Contributions
(CRO -1310)
(CRO -1310)
(CRO -1310)
(CRO -1315)
(CRO -1410)
(CRO -1320)
(CRO -1510)
$
2,132.20
$
3,863.19
$ 0.00
$
0.00
$ 0.00
$
0.00
$ 0.00
$
318.81
$ 0.00
$
0.00
$ 0.00
$
0.00
$ 0.00
$
126.12
8) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$
2,132.20
$
4,308.12
9) Cash on Eland at End (Add lines 4 and 12 together, then subtract line 18)
$
0.00
$
0.00
ADDITIONAL INFORMATION
0) Non -Monetary Gifts Given to Other Committees
1) Outstanding Loans (incl. ones from other campaigns)
2) Debts and Obligations ovtedbythe Committee
3)Debts and Obligations ovtedtothe Committee
4) Account Transfers Within the Committee
5) Administrative Support
6) Forgiven Loans
7) 48 -Hour Notice Reports Sum
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRO -1620)
(CRO -1720)
(CRO -1710)
(CRO -1440)
(CRO -2220)
$
-- -• - -
0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$
0.00
$ 0.00
$
0.00
8) Contributions to be Refunded
(CRO -1215)
$
0.00
$
0.00
CRO -1100 NC Sate Board of Elections August 2008
Disbursements
Amendment
Pg 1 of l ❑ Yes ® No
Use this form to report expenditures from the cormtittee 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 RE-ELECT PATRICIA I IELMS KINDLEY
3. Type of Disbursement (Please use separate CRO -1310 forms for each tune of Disbursement.)
IM Operating Expenses Contributions to Candidates/PuGGcal Convnittces Coordinated Party Expenditures
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing .Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
TOWN OF FAIRVIEW
7516 CONCORD HWY
MONROE, NC 28110
(704) 753-1981
c. Level Registered (Specify)
Federal 13 County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 2,232.20
C Account Code
g. Form of Payment
h. Purpose Code
i. Date (mmlddlyyyy)
I. Amount
k. Required Remarks
228
Check
O
02/08/2022
$ 2,132.20
SPECIFIED FAIRVIEW
$
5. Total only this Page
S 2,132.20
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 13b of Detailed Summon Page CRO -I 100 ifContrib to Candidates/Political Comm)
(This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures)
$ 2,132 20
7. Purpose Codes (List detailed expenditure code in (h.) above)
A* - Media B* - Printing C* - Fundraising D- To Another Candidate
E - Salaries F* - Equipment C - 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
CRO -1310 NC State Board of Elections December 2009
VOTE
`TTT�
NORTH CAROLINA
STATE BOARD OF ELECTIONS
Certification to Close Committee
This Certification is used to express the intent to close the committee after all funds have been properly
disbursed.
This Certification is filed at the Board of Elections office where the committee's campaign reports
are filed.
FILED BY:
Committee Name: Committee to ReElect Patricia Helms Kindley
Treasurer Name: John Kibler
Treasurer Address: 3614 S. Rocky River Rd
(include city, state, & zip) Monroe, NC 28112
Treasurer Phone: 704-219-3087
I certify that the above mentioned Committee intends to close and cease existence. Upon signing this
certification, I declare that all funds have been distributed and reported (if required). In addition, no
contributions will be accepted or disbursements made after the "Final Report' is filed or this form is
signed. If the Committee at any future time intends to accept or spend funds in support or opposition of
any candidate or ballot issue, a new political committee must be formed and registered with the Board of
Elections before such activities may commence.
Committees that have filed under the $1,000 threshold will only be required to sign this Certification. No
"Final Report" will be required for committees meeting this criterion. Any Committee that did not file
under the $1,000 threshold must submit a "Final Report" with this Certification. This report must have a
zero balance with no outstanding loans or debts.
02/09/2022ak Z10�LZ/C'
Date Signed signature
CRO -3400 Cerrification to Close Committee