King, Michele_2021-35DayReportRECEIVEL)
Disclosure Report Cover SEP 2 8 2021 10
At Na
Use this form for general report and committee info rtr g u�0�d OJ ped .end submitted along with other detailed forms.
Do not use this form to update information. �!
1. Committee Information
. Full Name
c ID Number
Committee to Elect Michele King
CIM24C
. Missing Address (include City, State and Zip Code)
& late Filed
802 E. Franklin Street, Monroe NC 28112
09/28/2021
e. Phone Number
704-791-6365
, Report Year
3. Period Start Date (mwdd/yyl 14. Period End
--
Date (m mi S. Treasurer Full Name
2021
07/15/2021 09/21/2021 Michele King
6. TYPe of Committee (Check_
9. Type ofRepo rt
(check only one type of reportfrom one category)
® Candidate Campaign ❑ Party
Municipal
StatelCoanty
Referend®
❑ PAC [3 Referendum
❑ Organizational
❑ Organizational
[:]Organizational
❑ Independent Expenditure ❑ Joint Fundraiser
® Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pre-primary
❑ Fust
❑ Final
❑ Pre-election
❑ Pre-mnoff
❑ Second
❑ Third
❑ Supplemental Final
❑ Annual
. Type of (if applicable. check one)
_Fund
❑ Booster Fund
Semi-annual
❑ Fourth
❑ Special
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year End
❑ Mid Year
❑ Other:
❑ Final
❑ Special
❑ Year End
❑ Final
S. Number of Fuudraisers this Report
❑ Special
11. Account Information
11. Account Information
a. Financial Im;dmdon Full Name
a. Financial Institution Foil Name
BB&T now Truist
. Purpose
c. Account Code
b. Purpose
c. Account Code
campaign account for
01
receipts and expenditures
it. Period Begin Balance
it. Period Begin Baleuce
$ $975.15
$ —
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
ited or other non -disclosed funds. I further certify that this
report is complete, true and correct and that I have been trained by
C State Board of Elections.
P(0ACAe Kc.rtt�
4 - a$ - 2oa-I
Printed Name of Si er qgnatu
of pointed Treasurer Date
OR OFFICE USE ONLY
Date Received: Q r Employee:
Delivery Method
❑ Normal Mail
Date Postmarked: Employee:
Registered MailHand
Delivered
Date Scanned: Employee:
Electronically Filed
Date Data Entered: Employee:
❑ Signer has not received
mandatory trainin
Please Note: This form cannot he 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 [Hake committee changes.
r.,rrv-r vvu NC state Boum of Elections August 2008
ncur—wtu
Detailed Summary SEP 2 8 2021 o Yea 91 No
Use this form to summarize all disclosure re orting forms and to total monetary information
1. Committeeft-ft-Name and kland. It app scab e)
Committee to Elect Michele King
35-
Number
CJM24C
Start of Election Cycle: January 1, 2020
Reporting
Total this
Period
Total this
Election Cycle
4) Cash on Hand at Start
$
975.15
$
975.15
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
A(RO-1205)
(CRO -1210)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
$ 50.00
$
50.00
$
$
1,005.00
$
$
$
$
$
S
$
$
S
$
Ila) Interest on Bank Accounts
11b) Contributions from Not -For -Profit Organizations
11c) Outside Sources of Income
11d) Legal Expense Fund - Other Sources
l le) Exempt Purchase Price Sales
(CRO.1250)
(CR0.1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$
$
$
$
$
$
S
12) TOTAL RECEIPTS (Add lines 5, 6.7, 8, 9,10,1 la.l lb,l lc,l Id and Ile)
$
1,025.15
$
1,055.00
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (CRO -1310)
13b) Contributions to Candidates/Political Committees (CRO -1310)
13c) Coordinated Party Expenditures (CRO -/310)
4) Aggregated Non -Media Expenditures (CRO -1315)
$
729.35
$
754.20
$
$
$
$
$
$
5) Loan Repayments
(CRO -1420)
$
$
6) Refunds/Reimbursements from the Committee
7) In -Hind Contributions
(CRO -1320)
(CRO -1510)
$
$
$
$
5.00
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14,15.16 and 17)
$
729.35
$
759.20
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
S
295.80
S
295.80
ADDITIONAL INFORMATION
0) Non -Monetary Gifts Given to Other Committees
1) Outstanding Loans (hid. ones from other campaigns)
2) Debts and Obligations owed by the Committee
3) Debts and Obligations owed to the Committee
24) Account Transfers Within the Committee
5) Administrative Support
6) Forgiven Loans
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRo-1620)
(CRO -1720)
(CRO -1710)
(CRO -1440)
$
$
$
$
$
$
$
1,524.74
$
$
M -48 -Hour Notice Reports Sum
(CRO -2220)
$
$
8) Contributions to be Refunded
(CRO -1215)
$
$
CRO-iiw NC State Bosh of Elections Au-n,t 2W8
RECEIVED
Aggregated Contributions from Individ�u{,,�al�sp EP rage2021 1 of
Optional form used to report NC Contributions FfoniUdWiduW .of$50 or less
Amendment
❑ Yes 19 Ne
1. Committee Full Name (and Fund if applicable)
2. ID Number
Committee to Elect Michele King
CJM24C
3. Contributor Information
• ..Amend
b. Account Code
e. Form of Payment
d. In -Kind Description
e. Date (mmtdd/yyyy)
L Amount
❑ Add
❑ Remove
01
Cash
09/01/2021
$ 50.00
Add
❑ Remove
$
Add
$
❑ Remove
Add
$
❑ Remove
Add
❑ Remove
$
Add
$
❑ Remove
Add
❑ Remove
$
Add
❑ Remove
$
Add
❑ Remove
$
Add
❑ Remove
$
El Add
❑ Remove
$
Add
❑ Remove
$
Add
❑ Remove
$
ET Add
11Remove$
Add
1:1 Remove
$
El Add
❑ Remove
$
Add
❑ Remove
$
El—Add
❑ Remove
$
Add
❑ Remove
$
Add
❑ Remove
$
11FAdd
❑ Remove
$
Add
❑ Remove
$
Add
$
❑ Remove
4. Total only this Page
$ 50.00
5. Total of ALL CRO -1205 Pages
$
(This line mus[ he online 5 of Detailed Summary Page CRO -1100)
50.00
CRO -1205 NC State Board of Elections April 2007
Disbursements R E C E i V L _ 1 of 1_ p ` Q No
Use this form to report expenditures from the committeEEpo2eft"2cpenses, contributions to candidate/political
committees and coordinated party expenditures
11. o ttee ame a _ Prilnr, rRjjjj1ksWa:.-.,..., -
Committee to Elect Michele King
umber
.24C
3. Type of Disbursement lease use separate CRO -1310 forms for each type of Disbursement.)
®Operating Ex enses ❑ Contributionsto Candidate,/Political Committees ❑ (,wolinated I'anp Fs)enditures
4. Payee Information Add Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip) _
BB&T now Truist
PO Box 580340
Charlotte, NC 28258-0340
b. Coordinated Committee Name
d. Comments
a Level Registered (specify)
Federal �[5'
❑ state ® Municipality:
e. Election Sum to Date
. Account Code
01
g. Form of PaymentL
transfer
14rpose Code
0
L Date (m(d&yyyy)
Amount
L RequiredRemarks
07/29/2021$
74.90
BB&T cc payment
01
transfer
0
07/29/20211$
4.50
BB&T cc payment
4. Payee Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
BB&T now Truist
PO Box 580340
Charlotte, NC 28258-0340
b. Coordinated Committee Name
d. Conarmads
c Level Registered (Specify)
[3 Federal ❑County:
❑ State ® Municipality:
e. Election Sum to Date
$
. Account Code
01
g. Form of Payment
L Purpme Code
0
i. Date (nun/dd/yyyy)
08/23/2021
I. AmountL
$ 149.95
Required Rosaries
BB&T cc payment
transfer
01
transfer
1 0
1 09/20/20211$
500.00
BB&T cc payment
4. Payee Information ❑ Add 0 Remove
a. Fail Name, Mailing Address & Phone
l include city, state, & zip)
b. Coordinated Committee Name
--
d. Comments
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Election Sum to Date
. Account Code
g. Form of Payment
L Pspose Code
IL Date (mmldd/yyyy)
Amort
11t. Regolnd Remarks
5. Total only this Page $
729.35
6. Total of ALL CRO -1310 Pages
(Thi, line goes in line 13a of Detailed Summary Page CRO -1106 if Operating Expenses) i ��' 729.35
(This line goes in line 13b of Detailed Summary Page CRO -1100 if Condib to Candidates/Pohncal Comm)
(This line goes in line 13c of Detailed .Summary Page CRO61100 if Coordinated Party Expenditures)
7. Purpose Codes (List detailed expenditure code in (h.) above)
A* - Media Be - Printing C* - Fundraising D - To Another Candidate
Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* Other
* Codes revire detailed explanation in re mired remarks field W
CRO -1310 NC State Board of Flections December 2009
RECEIVEi.:
SEP 2 8 2021 Amendment
Debts and Obligations Owed By the Committee.'
_1 of 2_ ❑ yes ® No
Use this form to report any unpaid debts or oblieations o1W6&b6th Vcomminee. to include camnni�n credit rard nurrhaare
1. Committee Full Name (and Fund if app Ira a)
2. D Number
Committee to Elect Michele King
CJM24C
3. Creditor Information
LJ A0 LJ Remove
. Full Name, Mailing Address & Phone
Note: All payments made toward debts should he listed on form CRO -
(Include city, stale, & zip)
1310 with the payee listed as this creditor.
Is. Description of Creditor
BBB:T
PO Box 3580340
financial institution - credit card
Charlotte, NC 28258-0340
• Beginning Balance
Id. Total Amount Paid
& Total Amoanl Incurred
f. Remaining Balance
$ 0
$ 729.35
S 1,524.74
S 795.39
. Furred Debts (what the committee received this period)
1. Purchase Place Full Name, Melling Address & Phone
g2. Date Imtn/ddlyyyy)
Ig3. Amount
(include city, i
state, & zip) -- ---- — —
07/17/2021
$18.00
Wix.com, LTD
g4, Purpose Codeg5.
Repaired Remarks
40 Namal Tel Aviv 6350671
Israel
A
web premium plan - monthly
1. Purchase Place Full Name, Mailing Address & Phone
g2 Date (nmdddfyyyy)
g3. Amount
(include city, state, &zip)
--
08/23/2021
---
- _-- -----
,122.03
Signs.eom
1550 South Gladiola Street
64. Purpose Code
gs• Required Remarks
Salt Lake City, UT 84104
B
signs, business cards
1. Purchase Place Full Name, Malang Address & Phone
g2. Date (mm/dd/yyyy)
jg3. Amount
(include city, state, & zip)
- - - _ ---
08/17/2021
$ 18.00
Wix.com, LTD
40 Namal Tel Aviv 6350671
g4, Purpose Code
-
Z& Required Remarks
Israel
A
web premium plan - monthly
1. Purchase Place Full Name, Mailing Address & Phone
g2, Date (umdtWyyyy)
g3. Amount
(include M.N. state, & zip(
`' 60.00
08/09/2021
Wix.com, LTD
40 Namal Tel Aviv 6350671
g4. Pmpote Code
$5. Required Remarks
Israel
A
mailbox for wix web account
1. Purchase Place Full Name, Mailing Address & Phone
g2. Date (maddd/yyyy)
jigll. Amomt
(include city, state, &zip)
Poster My Wall
08/09/2021
$ 89.95
g4. Purpose Code
g5. Requited Rmnb
250 Mils LLC
6965 EI Camino Real, Suite 105 #518
A
web graphic design
Carlsbad, CA 92009
for online media account
4. Total only this Page
(This should be the stem of all items'g3.' from this page)
$ 1,307.98
S. Total of ALL CRO -1610 Pages
(This line must be on line 22 of Detailed Summary Page CRO -1100)
$ 1,524.74
Codes (List detailed expenditure
A - Media B* - Printing C
- Fundraising
D - To Another Candidate
Salaries F* - Equipment G - Political Party
Postage J - Penalties K* - Office Expenses
* Codes require detailed explanation in required remarks field .)
H* - Holding Public Office Expenses
O* - Other
a,nv-z of v Nf- Stare Board of Elections February 2011
RECEIVED
SEP 2 8 2021
Amendment
Debts and Obligations Owed By }�j� a Committee ee Pg z or 2 _ ❑ yes ® No
Use this form to report anv unpaid debts or oblicta til QeMgl' alar"ce. to include camoaitm credit card nurchase
1. Committee Full Name (and Fundif app ices lel
ID Number
Committee to Elect Michele King
CJM24C
7
3. Creditor Information
LJ Add LJ Remove
. Full Name, Mailing Address & Phone
Note: All payments made toward debts should he listed on form C'RO-
(include city, state, & zip)
--_ - _
1310 with
the payee listed as this creditor.
b. Description of Creditor
BB&T
PO Box 3580340
financial institution - credit card
Charlotte, NC 28258-0340
. Beginning Balance
d. Total Amount Paid
e. Total Ataount Incurred
f. Rte Balance
$ 0
$ 729.35
$ 1,524.
795.39
. Incurred Debts (what the committee received this period)
1. Purchase Place Full Name, Mailing Address & Phone
gi Date (mmlddfyyyy)
IS3. Amount
09/17/2021
liodude city, state, & zip)
$18.00
Wix.com, LTD
40 Namal Tel Aviv 6350671
g4.PurposeCode
g5.Required Remarks
Israel
A
web premium plan - monthly
1. Purchase Place Full Name, Mailing Address & Phone
92. Date (umiddlyyyy)
jg3. Amount
(include city, state, & zip)
08/7/2021
1 $198.21
Signs.eom
1550 South Gladiola Street
94. purpose Code
gS. Required Remarks
Salt Lake City, UT 84104
B
retractable banner
g1. Purchase Place Full Name, Mailing Address & Phone
g2. Date (mmldd/yyyy)
g3. .-amount
(include city, state, & alp)
-__
`h .55
07/26/2021
BB&T
PO Box 580340
VC purpose Cade
gS. Required Remarks
Charlotte, NC 28258-0340
0
cc finance charge
1. Purchase Place Full Name, Mailing Addevs & Phone
g2. Date Imm/dd/yyyy)
g3. Amount
(include city, state. & zip(
$
g4. Purpose Code
g5. Required Remarks
1. Purchase Place Full Name, Mailing Address & Phone
gt Dale (tmaiddlyyyy)g3.
- -—
Ammmt
(include city, state, & zip)
--------_--
$
g0. Purpose Code
gS. Begdred Remarka
4. Total only this Page
This should be the sum of all items 'g3 ' from this page)
$ 216.76
5. Total of ALL CRO -1610 Pages
his line must be on line 22 of Detailed Summary Page CRO -1100)
1,524.74
6. Pupose Codes (List detailed expenditure
A* - Media 6* - Printing C*
- Fundraising
D - To Another Candidate
E - Salmies F* - Equipment G -
Political Party
H* - Holding Public Office Expenses
Postage J - Penalties K* - Office Expenses
• Codes uire detailed explanation in required remarks field ( .)
O' - Other
RO- 610 NC State Board of Elections February 2011