Loading...
King,Michele_2021-PreElectionReportDisclosure Report Cover Amendment yes°` No Use this form for general report and committee information, must be signed and submitted along with other detailed fors. Do not use this for to update information. 1. Committee Information . Full Name c. tD Number n �C�[ltlilt�.ttCL+b 9� IVl(C�l.�i� k JM �L-'- . Mailing Address (Include City, state and ZIP Code) d Date Filed B() A i. -F—VOL-,, k fk �j��t i o n a's 7 e. Phone Number 2.Report Year 3. Period Start Date mm/di4. Period End Date (,,Vddryy) 5. Treasurer Full Now ro Goal C6) as '-a Io i� _�C) 6.of Committee Check One 9. of Report (_check only one type of report Stale/County from one category Referendum Candidate Campaign ❑ Party Municipal ❑ PAC ❑ Referendum ❑ Organisational ❑ Organizational ❑ Organizational ❑ Independent Expenditure ❑ Joint Fundraiser ❑ Thirty-five day Quarterly ❑ Pre -referendum ❑ Legal Expense Fund ❑ primary -election ❑ Pre -runoff Semi-annual ❑ First ❑ Second ❑ Third ❑ Fourth [3 Final ❑ Supplemental Final ❑ Annual ❑ Special 7. Type of Fuad ((r applicable, check one) ❑ Booster Fund ❑ Building Fund ❑ Mid Year Semi-annual ❑ Year End ❑ Mid Year 10. Special Report Irt Name ❑ Other: ❑ Final ❑ Special ❑ Year End nal ❑ Final ❑ Special S. Number of Fundraisers this Report 11. Account Information 11. Account Information . Financial Institution Full Name a. Financial Institution Full Name 13 i3 4- I h b w KLLk'S-t- Purpose c. Account Code b. P � "�G OCT� c. Account Code C &M Par CLe o lC�q d. Period Begin Balance d. Period Begin Balance 4WP13 t W a nd l $ $ 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 ibited or other non -disclosed funds. I further certify that this report is complete, we and correct and that I have been trained C State Board of Elections. M C -,(F -(i- I�CrI� (oIaslaoal Printed Name of Si nes Si r of Ap oi0q Treasurer Date FOR OFFICE USE ONLY Date Received: �� a Employee:Delivery Method Normal Mail Date Postmarked: Employee: Date Scanned: �� Employee: Registered Mail Hand Delivered Electronically Filed Date Data Entered: Employee: hot Smandatory train neived 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-210OA-E) to make committee changes. CRO -1000 NC State Board of Elections August 2008 Amendment Detailed Summary 0 yes Q No Use this form to summarize all disclosure reoortinc forms and to total monetary information 1. Committee Full Name (and Fund if applicable) _ Type o Report t1 e 9 eco. Number ___Type ID JUJ rr i�} u f i 1 0 J �� Start of Election Cycle: January 1,o� b O Total this Reporting Period Total this Election Cycle 4) Cash on Hand at Start $ 13 q 5 . $ �� S RECEIPTS 5) Aggregated Contributions from Individuals 6) Contributions from Individuals 7) Contributions from Political Party Committees S) Contributions from Other Political Committees 9) Loan Proceeds 10) Refunds/Reimbursements to the Committee 1) Other Receipt Sources lla) Interest on Bank Accounts 11b) Contributions from Not -For -Profit Organizations Ile) Outside Sources of Income lld) Legal Expense Fund - Other Sources Ile) Exempt Purchase Price Sales (CRO -1205) (CRO -1210) (CRO -1210) (CRO -1230) (CRO -1410) (CRO -1240) (CRO -1250) (CRO -1250) (CRO -1250) (CRO -1270) (CRO -1265) $ $ , 00 $ LlA(,55 '75 $ 5 (oO -25 $ $ $ $ $ 5 5 5 S $ $ $ $ 5 $ $ 12) TOTAL RECEIPTS (Add lines 5,6,7,8,9,10,1 Ia.] lb,l lc,l Id and l le $ A $ 6 to,151 EXPENDULTRES 13) Disbursements 13a) Operating Expenditures (CRO -1310) 13b) Contributions to Candidates/Political Committees (CRO -1310) 13c) Coordinated Party Expenditures (CRO -1310) 14) Aggregated Non -Media Expenditures (CRO -1315) 15) Loan Repayments (CRO -1420) 16) Refunds/Reimbursements from the Committee (CRO -1320) 17) In -Kind Contributions (CRO -151o) $ $ 1'642Z $ 5 $ 5 $ 5 $ 5 $ $ $ I ---� 5. 00 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ 0OD $ -a0 19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18 $'15 LS I$rs ADDITIONAL INFORMATION 20) Non -Monetary Gifts Given to Other Committees 1) Outstanding Loans (incl. ones from other campaigns) 2) Debts and Obligations owed by the Committee 3) Debts and Obligations owed to the CotrtyllNN 4) Account Transfers Within the Committee') 5) Administrative Support 1101 2 5220— 26) Forgiven Loans 748 -Hour Notice Reports Sum Contributions to be Refunded (CRO -1330) (CRO -1430) (CRO -1610) (CRO -1620) (CRO -1720) (CRO -1710) (CRO -1440) (CRO -2220) (CRO -1215) $ $ $ CI rJ t 5.3 �G $ $ $ $ $ $ HO -1100 NC State Board of Elections Amendment i� Contributions from Individuals Pg � of � Oyes N.. 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 applieable) 2. 11D Number C' o�ullkt Ne- h� (c�� c�«.t IC n� 3. Contributor Information ❑ Add ❑ Rt44ovc a. Full Name, Mailing Address & Phone b. Job Title/Profession d. Comments (include city, state, & zip) Jl� lit l� q 04. 54. g x479 c Employer's Name/Specific Field u I n . (n�! pa It S f • �u (.a Q i oma' ` 1 . i I ... j ^ / e. Election Sum to Date — — — 1Ylonrot �I 1� rt 11� r r' I $ 100.00 . Prior g. Account Code IL Form of Payment i. In -Kind Description j. Date (mnddd/yyyy) 4 ate ai k. Amount ❑ of Ch $ rocs -o0 ❑ $ 11 3. Contributor Information [9 Add ❑ Remove a. Full Name, Mailing Address & Phone b. Job' Title/Profession d. Comments (include city, stale, & zip) T T n i LLr• T 1� tom' V}�� I � v I c. Employ'er's NametSpedfic Field `J�ei r� /"� e. Election Sum to Date - C� 1 on 17) P-tUG �S I I /0" $ �,l"i5'75 f. Prior g. Account Code h. Form of Payment I. In -Kind Description '. Date (mm/dd/yyyy) It. Amount Ch 2o1C. I D $ J4I r15 `76 ❑ C� I ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone b. Job Title/Profession d. Comments (include city, state, & zip) ' vo ci 5�t r7O.'lq L (RM, Employer's Name/Specifc Field I e. Election Sum to Date Monrok. Is I. Prior g. Account Code h. Fo ymenl 1. In -Kind Description to (mm/dd/yyyy) k. Amount AGNM C,6YK04`rqrUfI a I a I l a ❑ 5 24 $ ❑ $ 4. Total only thi age $ 4 5 5. Total of ALL CRO -1210 Pages $ ,� (This fine must be on fine 6 of Detailed Summary Page CRO -1100) CRO -1210 NC State Board of Elections April 2007 Amendment In -Kind Contributions Fit of ❑ ties ® No _ Use this form to report non -monetary contributions, donations, goods or services provided to the committee or fund. Use CRO -1215 if In -Kind Contributions were or will be refunded within 7 days. 1. Committee Full Name (and Rit applicable) Committee to Elect Michele King 2 ID Number CJM24C 3. Contributor Information ❑ Add ❑ Remove . Full Name, Mailing Address & Phone (Include city, state, & a1p) Michele King 802 E. Franklin Street Monme NC 28112 (704) 791-6365 b. Type of Contributor ❑ Individual © Candidate ❑ Party ❑ PAC ❑ Referendum ❑ Other Receipt Source c. Comments d. Flection Son to Date $ 180.00 . Description music for meet and greet f. Date (mmlddlyyyy) & Fair Market Amomt 10/16/2021 $ 180.00 $ $ 3. Contributor Information ❑ Add ❑ Remove . Full Name, )tailing Address & Phone (include city, state. & zip) b. Type of Contributor ❑ Individual ❑ Candidate ❑ Party ❑ PAC ❑ Referendum ❑ Other Receipt Source a Comments d. Election Sum to Date $ . Deeerlpdon t. Date (mmlddlyyyy) g. Fair Market Amomt $ 3. Contributor Information 0 Add ❑ Remove . Full Name, Mailing Address & Phone (include city, State,& alp) Njy 60U b. Type of Contributor [3Individual [3Candidate ❑ Party ❑ PAC ❑ Referendum ❑ other Receipt Source c. Comments 0t49N GE CAMPAIGN FINP. I OCT 2 5 2021 RECEIVED it. Election Sum to Date S •. Description f. Date (mmtddtyyyy) g. Fair Market Amount $ $ S 4. Total only this Page $ 180.00 5. Total of ALL CRO -1510 Pages (This Gne must be on line 17 of Detailed Summary Page CRO -1100) $ 180.00 CRO -1510 NC State Board of Elections December 2007 Debts and Obligations Owed By the Committee P, i a I _pent ® No Use this form to report anv unpaid debts or obligations owed by the conunittee. to include campaign credit card nurchase, 1. Cvanninm Full Name (and Fundapplicable) 2. 10D Num r Committee to Elect Michele King CJM24C 3. Creditor Information Ll Remove . Full Name, Mailing Address & Phone Note; All payments made toward debts should he listed on form CBO - (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 Balnn t d. Total Amount Paid a Told Amount Incurred . Bim [sing Balance R. Incurred Debis (what the committee received this period) t. Purchase Place Full Name, MaRing Address & Phone g2. Dale (mm/ddlyyyy) g3. Amount (include city, state, &zip) Zip Printing & Mailing, Inc. 10/18/2021 $ 4,175.75 1237 5 Lincoln Ave # C Clearwater, FL 33756 g4. Purpose Code _-- g5. Required Remarlo 727-446-3662 www.zi omailin florida.com IB:B printing and mailing of postcard 1. Purchase Place Full Name, Mailing Address & Phone g2. Date (mmlddlyyyy) g3. Annual I include cih, state,& zip) 09/24/2021 $ 186.74 Kraze Custom PrintB4PurposeP9e 2115 W Roosevelt Blvd Code 95 . ed Rewaria; --- - -- Monroe, NC 28110 O tshirts 1. Purchase Place Full Name, Mailing Address & Phone g2. Date (mm/dt1lyyyy) g3. Amo®t ( include city, state., & zip) - - 09/24/2021 $ 15.84 BB&T PO Box 580340 Pwpoft Celle -- -- red Reurks ��R- r - Charlotte, NC 28258-0340 O cc finance charge 1. Purchase Place Fall Name. Mailing Address & Phone g2 Date (mmlddlyyyy) g3. Amount 10/15/2021 (include city, state, & zip) 1 $ 167.03 BB&T PO Box 580340 gI. Purpose Cade g5. Required Remarks Charlotte, NC 28258-0340 O cash advance fee 1. Purchase R)g{(,¢Jl')ji¢{WA#dress &Phone gZ Dale (mto/dd/YYYY) g3. Amount (Include city, slate, & zip) __ -- OCT 2 5 2021 $ g4. Purpose Code. Required Remoda RECEIVED 4. Total only this Page (This should be the sum of all 'g3.' from this page) 4W, $ 4,545.36 5. Total of ALL CRO -1610 Pages (This line must be on line 22 of Detailed Summary Page CRO -1100) $ 4,545.36 Codes (List d ed exoenditure A* •Media B* -Printing C* - Fundraising - To Another Candidate E - Salaries F* - Equipment G - Political Party Postage J - Penalties K* - Office Expenses * Codes require detailed explanation in required remarks field W.) H* - Holding Public Office Expenses O* - Other Nu Niate nuard of Elections February 2011