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Martin,Steve_2022-1st-qtrAmendment Disclosure Report Cover ❑ Yea ® Na 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. to Number Committee to Elect Steve Martin b. Mailing Address (include City, State and Zip Code) d. Date Filed P.O. Box 1593 05/09/2022 Matthews, NC 28106 e. Phone Number 704-254-4789 2. Report Year 3. Period Start Date (mm/dd/yy) ®0/� d End Date 5. Treasurer Full Name ?0]'_ 01/01/2022 04/30/2022 Stephen D. Martin 6. Type of Committee Check One 9. Type of Report check only one type of report om one category) ® Candidate Campaign ❑ Pam Municipal SiateWounty Referendum ❑ Organizational ❑ Organizational ❑ Organizational ❑ PAC ❑ Referendum Independent ❑ Joint Fundraiser ❑ Expenditure ❑ Thirty -Five day Quarterly ❑ Pre -referendum ❑ Legal Expense Fund ❑ ❑ Pre-primary Pre-election ® First ❑ Second ❑ Final ❑ Supplemental Final 7. Type of Fund (tfappticabk, check ore) ❑ "Booster Fund" ❑ Building Fund ❑ Pre-mnoff ❑ Third ❑ Annual Semi-annual ❑ Fourth ❑ Special ❑ Mid Year Semi-annual ❑ Other: ❑ Year End ❑ Mid Year 10. Special Report Name ❑ ❑ Final Special ❑ Year End ❑ Final ❑ Special 8. Number of Fundraisers this Report 11. Account Information 11. Account Information'"` a. Financial Institution Full Name a. Financial Institution Full Name Wells Faro Bank, NA IL Purpose c. Account Code Is. Puritans c. Account Code all campaign Ad�� expenses MAY 0 9 2 222 d. Period Begin Balance d. Period Begin Balance S 94.12 $ Union Co. Elections CERTIFICATION 1 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 prohib' d of r non is osed funds. I further certify that this report is complete, true and correct and that 1 have been trained by the NC le ti s. of Stephen D. Martin 0/09/2022 Printed Name of Signer tgnature of App Treasurer Date FOR OFFICE USE ONLY Date Received: "I �11P� A4ethod Mail Employee:�[_]Normal Date Postmarked: Dale Scanned: Employee: gistered Mail Hand Delivered Electronically Filed Employee: ❑ Signer has not received Date Data Entered: mandatory training Employee: 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 20us Amendment Detailed Summary ❑ Yes ® No 1 Ise this form to summarize all disclosure renortine forms and to total monetary information. 1. Committee Full Name and Fund if app e of Report 3. ID Number' Committee to Elect Steve Martin Organizational Start of Election Cycle: January 1, 2019 Total this Reporting Period Total this Election Cycle 4) Cash on Hand at Start $ 94.12 $ 0.00 RFaW 5) 6) 7) 8) 9) 10) 11) Aggregated Contributions from Individuals Contributions from Individuals Contributions from Political Party Committees Contributions from Other Political Committees Loan Proceeds Refunds/Reimbursements To the Committee Other Receipt Sources Ila) Interest on Bank Accounts 11 b) Contributions from Not -for -Profit Organizations lie) Outside Sources of Income Ild) Legal Expense Fund — Other Sources 11 e) Exempt Purchase Price Sales (CRO -1205) (CRO -1110) (CRO -1110) (CRO -1130) (CRO -1410) (CRO -1140) (CRO -1250) (CRO -1150) (CRO -1150) (CRO -/170) (CRO -1165) $ 754.32 $ 754.32 $ 2,906.76 $ 3,990.19 $ 50.00 $ 50.00 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 12) 13) 14) 15) 16) 17) TOTAL RECEIPTS (Add lines 5.6. 7.8.9, 10, Ila. iib. IIc. lidand lie) Disbursements 13a) Operating Expenditures (CRO -1310) 13b) Contributions to Candidates/Political Committees (CRO -1310) 13c) Coordinated Party Expenditures (CRO -1310) Aggregated Non -Media Expenditures (CRO -1315) Loan Repayments (CRO -1410) Refunds/Reimbursements From the Committee (CRO -1310) In -Kind Contributions (CRO -1510) $ 3,711.08 $ 4,794.51 $ 749.23 $ 765.11 $ $ $ $ $ 11.60 $ 11.60 $ $ $ $ $ 121.76 $ 1,095.19 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13e, 14. 15. 16 and 17) $ 882.59 $ 1,871.90 19) Cash on Hand at End ( iJJ I111, J and 12 together, then subtract line 18) $ 2,922.61 $ 2,922.61 AMKT10NA�llllNllll 20) 21) 22) 23) 24) 25) 26) 27) 28) Non -Monetary Gifts Given to Other Committees Outstanding Loans (incl. ones from other campaigns) Debts and Obligations owed By the Committee Debts and Obligations owed To the Committee Account Transfers Within the Committee Administrative Support Forgiven Loans 48 -Hour Notice Reports Sum Contributions to be Refunded (CRO -/330) (CRO -1430) (CRO -1610) (CRO -1620) (CRO -1710) (CRO -1710) (CRo-1440) (CRO -2210) (CRO -1115) $ $ $ $ $ $ $ $ $ $ $ $ $ CRO -1100 NC State Board of Elections August 2008 Amendment Aggregated Contributions from Individuals Page I or 2 ❑ Nes ® 'No Optional form used to report NC Contributions From IndiN iduals of $50 or less 1. Committee Full Name and Fund if applicable) 2. ID Number ( rnnmittee to Elect Stece Martin 3. Contributor Information h. Account d. In -Kind e. Date a. Amend Cute c Farm a(Pa)ment Description o/ddt L Amount m ARedd movc A electronic 01/23/2022 $ 50.00 Add A electronic 01/23/2002 $ 25.00 Remove Ada A electronic 01/23/2002 $ 20.22 Remove Add A electronic 01/23/2022 $ 20.22 Remove Ada A electronic 01/29/2002 $ 40.00 Remove Add A electronic 01/29/2002 $ 20.22 Remove Add A electronic 02/02/2022 $ 50.00 El Remove El Add A electronic 02/02/2022 $ 10.00 ❑ Remove ❑ Add A electronic 02/05/2022 $ 50.00 ❑ Remove ❑ Add A electronic 02/05/2002 $ 25.00 Remove EJ Add A electronic 02/07/2002 $ 25.00 Remove Add A electronic 02/25/2022 $ 2.00 Remove Add A electronic 02/27/2022 $ 50.00 Remove Add A electronic 03/06/2022 $ 10.00 Remove Add A electronic 03/18/2022 $ 10.00 Remove Ada A electronic 03/18/2022 $ 50.00 ❑ Remove ❑ Add A electronic 03/19/2022 $ 5.00 ❑ Remove Ada A electronic 03/24/2022 $ 50.00 Remove Add A electronic 03/24/2022 $ 10.00 Remove ❑ Ada A electronic 03/25/2022 $ 2.00 ❑ Remove Ej Aad A electronic 03/27/2022 $ 35.00 Remove Add A electronic 03/28/2022 $ 20.22 ElRemove 4. Total only this Page $ 579.88 5. Total of ALL CRO -1205 Pages (This line must be on One S of Detailed Summiny Page CRO -1100) $ 754.32 CRO -1105 NC State Board of Elections April 2007 \mendment Aggregated Contributions from Individuals Page 2 of 2 ❑ ties ® a Optional form used to report NC Contributions from Individuals of $50 or less 1. Committee Full Name and Fund if applicable) 2. W Number Committee to Elect Sieg (`Martin 3. Contributor Information e. Amend b. Account Code c. Form of Payment d. In -Kind Description e. Date mm/dEV L Amount Add A electronic 03/282022 $ 20.22 Remove Add A electronic 03/29/2022 $ 10.00 Remove Add A electronic 04/012022 $ 20.22 ❑ Remove Add A electronic 04/03/2022 $ 10.00 Remove Add A electronic 04/062022 $ 10.00 Remove Add A electronic 04/192022 $ 5.00 Remove Add A electronic 04/25/2022 $ 2.00 Remove Add A electronic 04/04/2022 $ 50.00 Remove Add A electronic 02/05/2022 $ 35.00 Remove Add A electronic 03/05/2022 $ 6.00 Remove Add A electronic 04/052022 $ 6.00 Remove Add $ Remove Add $ Remove Add $ Remove Add $ Remove Add $ Remove Add $ ❑ Remove Add $ ❑ Remove ❑ Add $ ❑ Remove Add $ ri Remove Add $ Remove Add $ Remove 4. Total only this Page $ 174.44 5. Total of ALL CRO -1205 Pages $ 754.32 (This line most be on fine S of Detailed Somenap• Page CRO -1100) CRO -1205 NC State Board of Elections April 2007 Amendment Contributions from Individuals Pg I or 7 ❑ lea ® No Use this form to report individual contributions Mer Seor ocontributions under $50 if form CRO 1205 is not used 1. Committee Full Name and Fund if applicable) 2. ID Number Committee to Elect Steve Martin 3. Contributor Information ❑ Add ❑ Remove a. Full Name. Mailing %ddress & Phone (include city, state. & zip) b. Job Title/Profesmon d Comments Compliance Officer Taunula Grayson 453 Lyttleton Dr. Charlotte, NC 28212 c. Employer's Name/Specific Field Vaya Health e. Election Sum to Date $ 100.00 L Prior g. Account Code Is. Form of Payment L Io -Kind Description J. Data (mm/dd/yyyy) K Amount ❑ A electronic 01/12/2022 $ 100.00 ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. I oil Name, Mailing Address & Phone (include city, state, & zip) b. Job Tine/Profession d. Comments Not Employed Ina Schuner 6001 Jeanne Dr. Waxhaw, NC 28173 a Employer's Name/Specific Field Not Employed e. Election Sum to Date $ 100.00 f. Prior g. Account Code It. Form of Payment 1. In -Kind Description J. Date (mm/dd/yyyy) L Amount ❑ A electronic 01/23/2002 $ 100.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state. & zip) b. Job Tide/Profession d. Comments Attorney Tracy LeRoy 455 Faust Ln. Houston, TX 77024 c. Employer's NametSpeciac Fkld Yetter Coleman LLP e. Election Sum to Date $ 100.00 E Prior g. Account Code It. Form of Payment L In -Kind Description J. Date (mm/dd/yyyy) L Amount ❑ A electronic 01/23/2002 $ 100.00 ❑ $ ❑ $ 4. Total only this Page $ 300.00 5. Total of ALL CRO -1210 Pages $ 2,906.76 (Phis fine must be on Line d of Detailed Summary Page CRO -1100) CRO -1210 VC State Board or Elections April 2007 Amendment Contributions from Individuals Pg 2 or , ❑ Nes ® 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 applicable 2. ID Number t .,m mittec to Elect Steve Martin 3. Contributor Information ❑ Add ❑ Remove n. Ioll Name, %tailing Address & Phone (include city, state, & zip) h. Job Title/1'rofession d. Comments physician Katie Shaw 9824 Saddle Ave. Waxhaw, NC 28173 e. Employer's Name/Specific Field Valley Emergency Physicians e. Election Sum to Date $ 100.00 E Prior g. Account Code It. Form of Payment I. In -Bind Description I. Date (mm/dd/yyyy) L Amount ❑ A electronic 01/27/2022 $ 100.00 ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Tine/Profession d. Comments Executive Doug Milone 414 Five Leaf Ln. Waxhaw, NC 28173 e. Employer's Name/Specific Field Wells Fargo e. Election Sum to Date $ 100.00 E Prior g. Account Code It. Form of Payment I. In -Kind Description J. Date (mm/dd/yyyy) L Amount ❑ A electronic 01/29/2002 $ 100.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) It. Job Tifle/Profession d. Comments Physician Susan Antle 2034 Belle Grove Dr. Marvin, NC 28173 c. Employer's Name/Specific Field Atrium e. Election Sum to Date $ 100.00 E Prior g. Account Code It. Form of Payment L In -Kind Description j. Date (mm/dd/yyyy) k. Amount ❑ A electronic 02/02/2022 $ 100.00 ❑ $ ❑ $ 4. Total only this Page $ 300.00 5. Total of ALL CRO -1210 Pages $ 2,906.76 (This line must be on line 6 oJDerailed Summary Page CRO -1 100) CRO -1210 VC State Board of Elections April 2007 Amendment Contributions from Individuals Pe 3 of , ❑ les ® So Use this form to report individual contributions over $50 or contributions under S�0 it form CRO 1205 is not used 1. Committee Fall Name and Fund if applicable) 2. In Number �onunittee to Elect Stcve Martin 3 Contributor Information ❑ Add ❑ Remove a. Full Name, Nailing Address & Phone (include city, stare, & zip) b. Job Title/Profession d. Comments Insurance Agent John Testa 3038 Arsdale Rd. Waxhaw, NC 28173 c. Employer's Name/Specifie Field TGI Insurance Agency e. Election Sum to Date $ 150.00 f. Prior g. Account Code h. Form of Payment 1. In -Kind Description j. Date (mm/ddlyyyy) It. Amount ❑ A electronic 02/02/2022 $ 150.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Nailing Address & Phone (include city, sate, & zip) It. Job Title/Profession it. Comments Not Employed Amy Willson 309 Squash Harvest Ct. Weddington, NC 28104 c. Employer's Name/Specific Field Not Employed e. Election Sum to Date $ 100.00 E Prior g. Account Code h. Form of Payment I. In -Kind Description I. Date (mm/dd/yyyy) K Amount ❑ A electronic 02/16/2022 $ 100.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Nailing Address & Phone (include city, sate, & zip) It. Job Title/Profession d. Comments Attorney Senitria Goodman 854 Old Bell Rd. Charlotte, NC 28270 c. Employer's Name/Specific Field Trillium Health Resources e. Election Sum to Date $ 200.00 E Prior g. Account Code Is. Form of Payment 1. In -Kind Description J. Date (mm/dd/yyyy) It. Amount ❑ A electronic 02/24/2022 $ 200.00 n $ 4. Total only this Page S 550.00 5. Total of ALL CRO -1210 Pages $ 2,906.76 (This line must he on fine b of Detailed Summary Page CRO -1100) C'RO_1 210 NCState Board of Elections April 2007 Amendment Contributions from Individuals Pg 4 of 7 ❑ Ies ® No Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used 1. Committee Fall Name and Fund if applicable) 2. iD Number Committee to Elect Steve Martin 3. Contributor Information ❑ Add ❑ Remove a. Full Name. )tailing Address & Phone (include city, state, & zip) b. Joh T isle; Profession d. (-omments Grocer Keith Dailey 2541 Erie Ave. Cincinnati, OH 45208 c. Employer's Name/Specific Field The Kroger Co. e. Election Sum to Date $ 100.00 E Prior g. Account Code h. Form of Payment I. In-Kiad Description j. Date (mm/dd/yyyy) It. Amount ❑ A electronic 02/25/2022 $ 100.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments Physician Sandeep Patel 1205 Thistledown Ct. Matthews, NC 28104 c. Employer's Name/Specific Field Eventus WholeHealth e. Election Sum to Date $ 600.00 E Prior g. Account Code it. Form of Payment i. In -Kind Description j. Date (mm/ddtyyyy) L Amount ❑ A electronic 03/09/2022 $ 50.00 ❑ $ ❑ 3. Contributor lnformatio $ a. Full Name, Sailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments Not Employed Evelyn Maben-Hall 1 176 Woodwinds Dr. Waxhaw, NC 28173 c. Employer's Name/Specific Field Not Employed e. Election Sum to Date $ 85.00 E Prior g. Account Code It. Form of Payment 1. In -Kind Description j. Date (mmldd/yyyy) It. Amount ❑ A electronic 03/18/2022 $ 85.00 ❑ $ ❑ $ 4. Total only this Page $ 235.00 5. Total of ALL CRO -1210 Pages $ 2,906.76 (This line muv bean line 6 of Detailed Summary Page, CRO -1100) CRO -1110 NC State Board of Elections April 2007 Amendment Contributions from Individuals Pg s or 7 ❑ Nes ® Nn Use this form to report individual contributions over $50 or contributions under S50 if form CRO 1205 is not used 1. Committee Full Name and Fund if applicable) 2. ID Number Committee to Elect Stcve Martin 3. Contributor Information ❑ Add ❑ Remove a. Full Name. Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments Attorney Ellen Endrizzi Unit 6060, Box 437 DPO, AE 9870 e. Employer's Name/Specific Field US Dept. of Justice e. Election Sum to Date $ 100.00 E Prior g. Account Code It. Form of Payment i. In -Kind Description j. Date (mm/ddlyyyy) K Amount ❑ A electronic 03/28/2022 $ 100.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. full Name, ]failing Address & Phone (include city, state, At zip) b. Job Title/Profession d. Comments Real Estate Agent Heather Zboch 321 Candella Dr. Wesley Chapel, NC 28104 c. Employer's Name/Specific Field Coldwell Banker e. Election Sum to Date $ 150.00 f. Prior g. Account Code It. Form of Payment 1. In -Kind Description J. Date (mm/dd/yyyy) it. Amount ❑ A electronic 03/28/2022 $ 150.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove A. Full Name, Mailing Address & Phone (include city, state. & zip) b. Job Tine/Profession d. Comments Attorney Elizabeth Elmore 3704 Kerry Blvd. Springfield, IL 62712 e. Employer's Name/Specific Field None e. Election Sum to Date $ 100.00 E Prior g. Account Code It. Form of Payment 1. In -Kind Description j. Date (mm/dd/yyyy) L Amount ❑ A electronic 04/02/2022 $ 100.00 ❑ $ n $ 4. Total only this Page $ 350.00 5. Total of ALL CRO -1210 Pages $ 2,906.76 (This line must be on line 6 of Detailed Summary Page CRO -1100) CRO- 1210 Nl State Board of Elections April 2007 Amendment Contributions from Individuals Pg 6 or 7 ElYes ® 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 applicable) 2. Ib Number Committee to I_Iret "IcNe Martin 3. Contributor Information ❑ Add ❑ Remove - a. Full Name. flailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments Physician Sandeep Patel 1205 Thistledown Ct. Matthews, NC 28104 e. Employer's Name/Specific Field Eventus WholeHealth e. Election Sum to Date $ 600.00 I. Prior g. Account Code It. Form of Payment I. In -Kind Description j. Date (mm/dd/yyyy) K Amount ❑ A electronic 04/03/2022 $ 500.00 ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Nailing Address & Phone (include city, ante, & zip) b. Job Tine/Profession d. Comments Software engineer Matthias Wiselka 518 Pembroke Ln. Waxhaw, NC 28173 e. Employer's Name/Specific Field Stryker Corp. e. Election Sum to Date $ 500.00 f. Prior g. Account Code It. Form of Payment i. In -Kind Description J. Date (mm/dd/yyyy) h. Amount ❑ A electronic 04/05/2022 $ 500.00 ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, ante, & zip) b. Job Title/Profession d. Commend Physician Sandeep Patel 1205 Thistledown Ct. Matthews, NC 28104 c. Employer's Name/Specific Field Eventus WholeHealth e. Election Sum to Date $ 600.00 f. Prior g. Account Code h. Form of Payment 1. In -Kind Description j. Date (mm/dd/yyyy) it. Amount ❑ A electronic 04/09/2022 $ 50.00 ❑ $ ❑ $ 4. Total only this Page $ 1,050.00 5. Total of ALL CRO -1210 Pages $ 2,906.76 (This line must be on Line 6 of Derated Summary Page CRO -1100) CRO- 12 /1) \C State Board of Elections April 2007 Amendment Contributions from Individuals Pg 7 of 7 ❑ Yes ® No Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used 1. Commi " " 11 Name and Fund if applicable) 2. In Number Committee to Elect Steve Martin 3. Contributor Information ❑ Add ❑ Remove a. Full Name. )tailing Address & Phone (include city, state, & zip) b. .lob Title/Profession d. Comments Attorney Stephen D. Martin 405 Alucio Ct. Wesley Chapel, NC 28104 c. Employer's Name/Specific Field Cardinal Innovations Healthcar e. Election Sum to Date $ 1,205.19 f. Prior g. Account Code h. Form of Payment L In -Kind Description j. Date (mm/dd/yyyy) K Amount ❑ see 1510 $ 121.76 3. Contributor Information ❑ Add ❑ Remove a. Full Same. Mailing Address & Phone (include city, state, & rip) h. Job-IitleA'rofession d. ('omments e. Employer's Name/Specific Field e. Election Sum to Date f. Prior g. Account Code h. Form of Payment L In -Kind Description J. Date (mm/dd/yyyy) h. Amount ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state. & zip) b. Job Title/Profession d. Comments c. Employer's Name/Specific Field e. Election Sum to Date L Prior g. Account Code h. Form of Payment 1. In -Kind Description J. Date (mm/dd/yyyy) h. Amount ❑ $ ❑ $ $ 4. Total only this Page $ 121.76 5. Total of ALL CRO -1210 Pages $ 2,906.76 (This line must be on Line 6 of Detailed Summary Page:CRO4100) CRO -1110 NC State Board of Elections April 2007 Amendment Contributions from Political Party Committees Pg 1 of I ❑ Its ® No Use this form to report contributions from a political parte 1. Committee Full Name and Fund ifapplicable) 2. ID Number Committee to Elect Steve Martin 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Comments Union County Democratic Committee P.O. Box 81 Monroe, NC 28111 e. Election Sum to Date $ 50.00 it. Account Code e. Form of Payment E In -Kind Description .Dateh. Amount A check 03/30/2022 $ 50.00 $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, )tailing Address & Phone (include city, state. & zip) b. Comments c. Election Sum to Date d. Account Code e. Form of Payment E Io -Kind Description g. Date mm/dd h. Amount 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Comments t. Election Sum to Date d. Account Code e. Form of Payment E In -Kind Description . Date It. Amount $ 4. Total only this Page $ 50.00 5. Total of ALL CRO -1220 Pages $ 50.00 (This time most be on fine 7 ofOdaded Summary Page CRO -1100) ( RO-1 21) M liar, loard of bl,aions April 2007 Amendment Disbursements Pg 1 of 4 ❑ Yes ® No Use this form to report expenditures from the committee for: operating expenses, contributions to candidate/political committees and coordinated party expenditures. L Committee Full Name and Fund if applicable) 2. ID Number Coinmittee to Elect Steve Martin 3. Type of Disbursement If4ew use separate CRO -1310 fonits for each type o Disbursement. ® operaum I yIen+C. ❑ C.mni hunons lu ( andidoa+ Polmcal (oninimees ❑ Cuordmaled Pani I_spenditures 4. Payee Information Add El Remove a. Full Name, Mailing Address & Phone Include city, slate & zip) b. Coordinated Colo ninee Name it. Comments Gotprint.com 7651 N. San Fernando Rd. Burbank, CA 91505 c. level Registered (specify) ❑ Federal ❑ County: State ❑ Municipality: e. Election Sum to Date $ 80.55 f. Account Code g. Form of Payment h. Purpose Code L Date (mm/dd/yyyy) J. Amount k. Required Remarks A debit B 01/28/2002 $80.55 car magnets 4. Payee Information Add Remove a. Full Name, Mailing Address & Phone include city, state, &zip) b. Coordinated Committee Name d Comments Uprinting 8000 Haskell Ave. Van Nuys, CA 91406 a level Registered (Specify) ❑ Federal ❑ County: ❑ slate ❑ Municipality: e. Election Sum to Date $ 289.83 L Account Code g. Form of Payment h. Purpose Code L Date (mm/dd/yyyy) J. Amount k. Required Remarks A debit B 02/22/2022 $289.83 bumper stickers $ 4. Payee Information rl Add $atnovt5 a. Full Name, Mailing Address & Phone include city, stil & Zip) b. Coordinated Committee Name it. Comments Union County Board of Election 316-B East Windsor St. Monroe, NC 28112 c. level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date $ 48.00 r. Account Code g. Form of Payment h. Purpose Code L Date (mm/dd/yyyy) J. Amount k. Required Remarks A debit O 02/25/2022 $48.00 Filing fee Pae 5. Total only this $ 418.38 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 136 of Detailed Summary Page CRO -1100 if Contrib to Candidates/Polideal Comm) $ 749.23 (This line goes in line lac of Detailed Summon• Page CR49-I100 if Coordinated Parlr Expenditures) 7. Purpose Codes(List detailed expenditure code in h. above A* - Media B* - Printing C* - Fundraising D - 1 o 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 Sate Board of Elections December 2009 Amendment Disbursements Pg 2 of 1 ❑ 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 Stece Martin 3. Type of Disbursement lease use separate CRO -1310 form for each type of Disbursement ® Operannu I sPenseN ❑ Contributions to Candid:ne, Political lbn nwlee. ❑ Coordinated Pane 1_\pendoures 4. Payee Information rl Add Remove a. Full Name, Mailing Address & Phone include city, state & zip) b. Coordinated Committee Name d. Comments Overnightprints.com 7582 Las Vegas Blvd. Suite 487 Las Vegas, NV 89123 e. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date $ 148.82 L Account Code g. Form of Payment h. Purpose Code L Date (mmldd/yyyy) j. Amount k. Required Remarks A debit B 04/26/2022 $148,82 Campaign cards 4. Payee Information F1 Add Remove a. Full Name, Mailing Address & Phone Include city, state & b. Coordinated Committee Name d. Comments Qr-Code Generator e. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date $ 119.88 L Account Code g. Form of Payment h. Purpose Code i. Date (mm/ddlyyyy) j. Amount L Required Remarks A debit B 04/26/2022 $119,88 QR code for fundraisin 4. Payee Information F1 Add El Remove a. Full Name, Mailing Address & Phone include city, sm & ti b. Coordinated Committee Name d. Comments ActBlue, LLC 366 Summer St. Somerville, MA 02114 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: c. Election Sum to Date $ 44.21 f. Account Code g. Form of Payment h. Purpose Code L Date (mm/ddlyyyy) J. Amount k. Required Remarks A debit C 02/25/2022 $0.91 fees 5. Total only this Pae $ 269.55 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Summon, Page CRO -1100 if Operating Expenses) $ 749'23 (This line goes in line lab of Detailed Summary Page CRO -1100 if Contrib to CandidateslPolitical Comm) (This line goes in line He of Detailed Summay Page CRO -1100 if Coordinated Party Expenditures) 7. Pu 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 J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* - Other * Codes require detailed explanation in required remarks Geld k CRO -1310 NC State Board of Elections December 2009 Amendment Disbursements Pg 3 of 4 ❑ ves ® No Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political committees and coordinated party expenditures. 1 ffi Fu6 Name and Fund if applicable) 2. ID Number Committee to Elect Steve Martin 3. Type of Disbursement lease use separate CRO -1310 krw for each type of Disbursefnent ® Upcmtin@ I`Npen,xes ❑ L ownhutiun, to C:mdidates. Pulibnd l lnnmineci ❑ Coordinated PamI'Vpenditures 4. Payee Information Add 13 Remove a. Full Name, Mailing Address & Phone Include tity, state ,& ZI b. Coordinated Committee Name d. Comments ActBlue. LLC 366 Summer St. Somerville, MA 02114 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Som to Date $ 44.21 f. Account Code g. Form of Payment h. Purpose Code L Date (mmldd/yyyy) J. Amount It. Required Remarks A debit B 02/03/2022 $10.16 fees $ 4. Payee Information Add Remove a. Full Name, Mailing Address & Phone include ci , state, & a b. Coordinated Committee Name d. Comments ActBlue, LLC 366 Summer St. Somerville, MA 02114 a Levet Registered (specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date $ 44.21 E Account Code g. Form of Payment h. Purpose Code L Date (mm/ddlyyyy) j. Amount k Required Remarks A debit B 03/03/2022 $13.47 fees 4. Payee Information Add El Remove a. Full Name,Mailing Address & Phone include city, state & zip) b. Coordinated Committee Name d. Comments ActBlue, LLC 366 Summer St. Somerville, MA 02114 c. Les el Registered (specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date $ 44.21 E Account Code g. Form of Payment It. Purpose Code i. Date (mm/dd/yyyy) j. Amount L Required Remarks A debit C 04/04/2022 $9.23 fees 5. Total only this Pae 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Sunuuan' Page CRO -1100 if 0peraling Expenses) $ 749.23 (This line goes in line 136 of Detailed Summary Page CRO.1100 if Conlrib to Candidates/Polideal Comm) (This line goes in line 13c of Detailed Summam Page CR0-1100 if Coordinated Par(' 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 Part.' H* - Holding Public Office Expenses 1 - 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 `j .ae Board of ' Ir eons December 2009 Amendment Disbursements Pg 4 of 4 ❑ 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 Steve Martin 3. Type of Disbursement lease use separate CRO -1310 forna for each type of Disbursement ® operating I spen,e, l o inhution, to C'andidale, PoInical ('omnutice. ❑ (oordmaled PamExpenditure, 4. Payee Information rl Add El Remove a. Full Name, Mailing Address & Phone include city, state & zip) b. Coordinated Committee Nome d. Comments Vantiv, LLC 8500 Governors Hill Dr Symmes Township, OH 45249 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sam to Date $ 28.44 f. Account Code g. Form of Payment h. Purpose Code L Date (mm/dd/yyyy) J. Ameast Is. Required Remarks A debit B 03/09/2022 $8.76 CC fees 4. Payee Information Add Remove a. Full Name, Mailing Address & Phone include city. state & a It. Coordinated Committee Name d. Comments Vantiv, LLC 38500 Governors HII Dr. Symmes Township, OH 45249 a Level Registered (Specify) ❑ Federal ❑ County: State ❑ Municipality: e. Election Sum to Date $ 28.44 E Account Code g. Form of Payment It. Purpose Code L Date (mm/dd/yyyy) j. Amount h. Required Remarks A debit B 04/11/2022 $19.68 CC fees $ 4. Payee Information Kernave a. Full Name. Mailing .address & Phone include city, state, & ri b. Coordinated Committee Name d. Comments a Level Registered (Specify) ❑ Federal ❑ Count}': ❑ 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 $ 5. Total only this Pae S 28.44 6. Total of ALL CRO -1310 Pages (This line goes in line Hoof Detailed Sunmrnrr Page CRO -1100 if Operating Expemes) $ 749.23 (This line goes in line 13b of Detailed Summary Page CRO -1100 if Comrib to Candidates/Polirical Comm) (This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Para, Expenditures) 7. Purpose Codes(List detailed expenditure code in h. above A* - Media B* - Printing C* - Fundraising D - I o Another Candidate E - Salaries F* - Equipment G - Political Pam 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 1 1 Amendment Aggregated Non -Media Expenditures Page of O Yes p No Optional form used to report NC Non -Media Expenditures of $50 or less. 1. Committee FUH Name applicable) Number Committee to Elect Steve Martin 3. Payee Information a. Amend It. Account Code c. Form or Payment d. Purpose Code e. Date (mm/dd/yyyy) f. Amount g. Required Remarks ❑ Add A debit K 03/04/2022 $ 11.60 postage stamps ❑ Remove Add $ ❑ Remove Add $ ❑ Remove Add $ ❑ Remove Add $ ❑ Remove $ ovc $ ove $ove $oveovc [Remove $ove $oveove $ Add $ ❑ Remove add $ ❑ Removc Add $ ❑ Remove Lj Add $ ❑ Remove Add $ ❑ Remove Add $ Q Remove Add $ ❑ Remove 4. Total only this Pae $11.60 5. Total of ALL CRO -1315 Pages $11.60 i This line nmst be an line 14 of Detailed Summan Pae CRO -1100) 6. 'ur ose Codes (List detailed exoenditure code in (d) above) B* - Printing C* - Fundraising D - Io Anollici Candidate P - .Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses I - Postage 1 - Penalties K* - Office Expenses Q* - Donations to Legal Expense Fund O* - Other * Codes require detailed ex lanation in required remarks field CRO -1315 NC State Board of Elections txcemm tun :Amendment In -Kind Contributions Pg _ of _ ❑ Aes ® No Use this form to report non -monetary contributions, donations, goods or services provided to the committee or fund. C1Se I.KU- IL I7 If Ill -Kano Lontrinturons w'erC or will nC rCILII]LIVU vvinllll / UAVs. 1. Committee Full Name and Fund if applicable) 2.1D Number Committee to Flect Steve Martin a. Full Name, Mailing Address & Phone (include city, state, & sip) Stephen D. Martin 405 Alucio Ct. Wesley Chapel, NC 28104 a uewnpoon Google Domains - website hosting Google Domains - website hosting Google Domains - website hosting a. Full Name, )tailing Address & Phone (include city, state, & rip) Stephen D. Martin 405 Alucio Ct. Wesley Chapel, NC 28104 e. uescnpuoo Google Domains - website hosting Campaign shirts a. Full Name, Mailing .Address & Phone (include city, state, & rip) wa 4. Total only this Page 5. Total of ALL CRO -1510 Pages (This Ane Mutt be on fine 17 of Detailed CRO -1510 Remove ❑ b. Type of Contributor ❑ Individual ® Candidate ❑ Parry ❑ PAC ❑ Referendum ❑ Other Receipt Source E Date (mm/dd/yyy,. 01/26/2022 02/27/2022 03/27/2022 b. I ype of Contributor ❑ Individual ® Candidate ❑ Pare,' ❑ PAC ❑ Referendum ❑ Other Receipt Source E Date (mm/dd/yyy. 04/27/2022 04/13/2022 b. Type of Contributor ❑ Individual ❑ Candidate ❑ Parry ❑ PAC ❑ Referendum ❑ Other Receipt Source L Date (mm/dl NC State Board of Elections c. Comments d. Election Sam to Date $ 1,205.19 g. Fair Market Amount $ 6.00 $ 6.00 $ 6.00 c. Comments d. Election Sum to Date $ 1,205.19 g. Fair Market Amount $ 6.00 $ 96.76 c ('omments d. Election Sum to Date $ g. Fair Market Amount $ $ $ 121.76 $ 121.76 December 2001