Morey, Pedro_2019-1-Pre-electionDisclosure Report Cover 'AOeyes1e"t
No I
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. Ful ame
c, ID Number
FuD
j i'fri 5/J�
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
gool jr cxm1 -
Ina
e, Phone Nmnber
,E
WAx,7rjI
1018
100 _410-501
2. Report Year
3. Period Start Date 'an/ddl )- 4. Period Endate
✓da )
15.Treasurer Full Name
as 1 4
6. Type of Committee Check One
9. Type of Report
(check only one type of re ortfroni one category)
iff Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑Referendum
❑ Organizational
❑ Organizational
❑ Organizational
❑ Independent Expenditure ❑ Joint Fundmiser
❑ Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pre-primary
IDPre-election
❑ Pre -runoff
Semi-annual
❑ First
❑ Second
❑ Third
❑ Fourth
❑ Final
❑ Supplemental Final
❑ Annual
❑ Special
7. Type ofIT,und (if aiplicnble,check one)
❑ Booster Fund
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year End
❑ Mid Year
10. Special Report Namer
❑ Other:
❑ Final
❑ Special
❑ Year End
❑ Final
❑ Special
8. Number 4FFundraisers this Report
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
S13 69N,e
RECENED
b, Purpose
c. Account Code
b. Purpose -
c. Account Code
Nam&G
l9?o8
Union Co. Board of EleClionS
d,Pe od Begin
d. Period Begin Balances
Balance
. of1
$
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 ZPAI true andcorrectand that I have been trained the NC Stat Boar Elections. p
lIq
Printed Ngner Signatureof Appointeti reasoner Date
FOR OFFICE USE ONLY
Date Received: ILOAdIq Employee:.
Delivery Method
❑ Normal Mail
Date Postmarked: Employee:K47
[I Registered Mail
❑ Hand Delivered
Date Scanned: Employee:
❑ Electronically Filed
Date Data Entered? Employee:
, [3 Signer has not received
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-210OA-E) to make committee changes.
CRO -1000 NC Slate Board of Elections August 2008
Amendment. .... _�
Detailed Summary i❑ Yes o No
Use this form to summarize all disclosure reporthm forms and to total monetary information
1. C mittee Full Name (and Fund if a p i able)
2. Type of Report
13. ID Number
Start of Election Cycle: January 1, c;;2elTotal
this
Re orting Period
Total this
Election Cycle
4) Cash on Hand at Start
I$
1q, a
$
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
ll) Other Receipt SourcesIrc'rea
Ila) Interest on Bank Accounts
I lb) Contributions from Not -For -Profit Organizations
Ile) Outside Sources of Income
lld) Legal Expense Fund - Other Sources
lle) Exempt Purchase Price Sales
(CRO -1205)
(CR04210)
(CRO -1220)
(CRO -1230)
(CRO -tato)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$
$
$ 17. 0 ,�
$
$
$
$
$
$ la o
$ Aft 9-22
$
$
x t2 tiseyu,
spa+ . x
a i t s.
"Ilrft,
$
$
$
$
$
$
$
$
$
$
12)TOTAL RECEIPTS (Add lines 5, 6, 7,8, 9,10,11a,l lb,l lc,l Id and l le)
$
/-Q
$7�rQ�
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)
(Cao -1420)
(CRO -1320)
(CR0-1510)
$4
$
$
$
$
$
$
$
$
$
$
$ 7 , 2
$ 117. 0.-
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$
jjr . ,j
$
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$
$
ADDITIONAL INFORMATION
20) Non -Monetary Gifts Given to Other Committees (CRO -1330)
21) Outstanding Loans (incl. ones from other campaigns) (CRO -1430)
22) Debts and Obligations owed by the Committee (CRO -1610)
23) Debts and Obligations owed to the Committee (CRO -1620)
24) Account Transfers Within th�q�d ,un,n,til( �• fV (CR04720)
25) Administrative Support 11. L...�� 1 - -ED (CRO -1710)
26) Forgiven Loans OCT 2 8 2.0.19 (CRo-1440)
27) 48 -Hour Notice Reports Sum (CRO -2220)
$
W9,90. /)o
-
$
$
$
$
$
$
$
$
$
28) Contributions to be Refunde fllOn ),
(CRO -1215)
$
$
CRO -1100 NC State Board of Elections August 2008
Amendment
Contributions from Individuals Pg _ of ❑ Yes [I No
Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205is not used
1,'C ' mtittee Full Name and Fund if applicable)
Z. ID Number
3. Contributor Informatio ❑ Add i❑ Remove
a. Full Name, Mailing Address & Phone
.(include city, & ziip)�.
b. Job Title/Profession
d. Continents
flMb
nstate,
' ` . liqzi` J
27 A.ri n�(iFig tl�' Ae.
oW L�2�(!/W��e. _-a6r?�
c, Employer's Name/Specific Field
e; Election Sum to Date
$
F. Prior
g. Account Code
h. Form `.
I. In -Kind Description
j. Date ( dd/ yyy)
k; Amount
❑
N71r1's
�,o(f1Payment
SPS
0 Gu
$
❑
$
❑
$
3. Contributor Information '...❑ Add ',❑ Remove
a. Fall Name, Mailing Address & Phone
(Include city, state, &.zip)
b, Job Title/Profession
d. Comments
a Employer's Name/Specific Field
e, Election Sum to Date
$
f. Prior
g. Account Code
It, Form of Payment
i, In -Kind Description
J. Date (mm/dd/yyyy)
k, Amount'
$
❑
$
❑
$
3. Contributor Information ❑ Add '❑ Remove
a. Full Name, Mailing Address & Phone
.
(include city, state)WIECEIVED
OCT 2 8 2019
Union Co. Board d Elections
b. Job Title/Profession
d. Conmmnts
c. Employer's Name/Specific Field
e. Election Sum to Date
$
f. Prior
g. Account Code
b.. Form of Payment
1. In -Kind Description
J. Date (mm/dd/yyyy)
It. Amount
❑
$
❑
$
❑
$
4. Total only this Page
$ 9
5. Total of ALL CRO -1210 Pages
(This line must be on line 6 of Detailed Summary Page CRO -1100)
$ 1
/ / .
CRO -1210 NC State Board of Elections April 2007
Loan Proceeds
;Amendment �--yy��"' _t
Pg of _ '_,. 13YesWin
Use this form to report proceeds from a loan and loan endorser's information
A loan nrnceeds statement must accomnanv each hum that is from an individual
1. Comarrittee Full Name and Fund if applicable)
2. In Number
ptw 0 � -rolgL
JUMS/4
3. Lender Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, &A zip)
b. Job Title/Profession
d. Comments
/rir�II�LC
/'[o�
�A� Int n / 7
�I
iiroil oi*lAi/ it Q y�
e. Start Date(mm/tld/yyyy)
c, Employer's Name/Specific Field
f. End Dee (m Vdd/yyyy) .
la 4
g. Rate
1h, Security Pledged
It. Account
J. Form of Payment
gCoodee'
c4s
tkAmount O'o fflo
1. Full Name of Lending Institution
Im.LoanNumber
4. Endolsers/Makers (Tie people wbo gtrnrantee the lo(in.)
a. Full Name, Mailing Address & Phone
-- (include city, state, & zip)
b. JobTitie/Profession
c. Employer's Name/Specific Field
d. Percentage
a. Amount
a. Fall Name, Mailing Address & Phone-.. -
(include city, state, & zip)
b. Job. Title/Professlon
c. Employer's Name/SpecifieField
d. Percentage
e. Amount
a. Full Name, Mailing. Address & Phone
(include city, state, & zip)
b. Job Tide/Profession
c. Employer's Name/Specific Field
HEUMED
OCT 2 8 2018
Union Co. Board of Elections
d. Percentage
e. Amount
%
$
a. Fall Name, Mailing Address & Phone
(include city, state, &zip)
b. Job Tltle/Profcssion
c. Employer's Name/Specific Field
d. Percentage:
e. Amount
5. Total of ALL CRO -1410 Pages
(This line nmstbe on line 9 of Detailed Sunuoury Page CR01100)
a�
CRO -1410 NC State Board of Elections April 2007
Amendment
Disbursements Pg ' of j ❑ Yes WNo
Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated varty expenditures
1.'tf itt-ee Full Native and7F�und it' applica le) -
2.11) Number
�bw Vft e"i 11(1411ffluYrl�
3. Type of Disbursement (Mase separate CRO -1310 forms for each type ofDishursement.
Operating ExpensesU 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 None
d. Comments
�&
ui.if1'� k •1
,; 7ti 5- w�, YMAM �
�`
�(%XlI.iNJr�r [J'
c. Level Registered (Specify)
Federal �7�C"oonly:
❑ Stale wmunicipality:
e. Election Sum. to Date
$ 513
.Account Code Ig.rorniorpayment
Ili, Purpose Code
It. Date{ m/ddlyyyy) J. Amount
k. Required Remarks-
��
0 as
.53
I
I —f
Is
1
4. Payee Ittformation ❑ Add ,❑ Remove
a. Full Name, Mailing Address & Phone
(includecity, state, & zip)
It. Coordinated Committee Name
d. Comments
f�'%�
""J �OA— '�
c Level Registered (Specify)
Federal 11 County:
❑State Municipality:
e. Election Sum. to Date.
$ ?3.
f. Account Code
gor of Payment.
.
h. Purpose Code
i. Dat (nm t` dlyyyy)
J. Amoouunt
k. Required Remarks
4 73ti
)Fm
l- /&
to ot-1
$ 33A
4. Payee Information 0 Add El Remove
a. Full Name, Mailing Address & Phone
(include city, state,&(zipp)) ,/
b. Coordinated Committee None
d. Comments
C RECEIVED -
,v `e ' r tJt e—r' J
OCT 2 8 2019
Union Co. Board of Elections
e. Level Registered. (Specify).
Federal County:
❑ Stale Municipality:
e, Election Sum to Date
s 02 X
C. Account Code
g. Form of Payment
It. Purpose Code
I. Date nndd yyyy)
j. Anmunt
$
k, Required Remarks
1
p
jo tyl)01
Is
1
5, Total only this Page
$
6. Total of ALL CRO -1310 Pages
(This line goes in line l3a of Detailed Summary Page CRO -1100 if Operating Expenses)
(This line goes in line lab of Detailed Summary Page CRO -1100 if ConMh to CandidalestPoliacal Conun)
(This line goes in line 13c of Detailed Summary 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 ex lanation ince ui eed remarks field k
CRU -1310 NC State Board of Elections December 2009
IAnrendment
Disbursements Pg I of I❑ Yes Awa
Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated Dartv expenditures
1. mmittee Full Name (and Fund if applicable) 12.
ID Number
MW /1 Loft ae mpg
IWIV4
3. Type of Disbursement t (Please use separate CRO -1310 forms for each tvve ofDisbarseinent.)
Operating Expenses LJ Contributions to Candidates/Political Committees Coordinated Party Expenditures
4, Payee Information Add 0 Remove
a, Full Name, Mailing Address & Phone
(inclurig city, state, & zip)
b. Coordinated Committee Name
it. Comments
�
`� 3
c. Level Registered (Specify)
Federal 11 County:
❑ State ❑ Municipality:
e: Election Sum to Date
$ g. 00
f. Account Cade
1g. Form of Payment
Ili. Purpose Code 11. Date n/ yyyy)
Ij, Amount
Ik. Requirrepd�Ryemarks
0 /..
$ / O
CNt e
�/ //UX
4. Payee Information 0 Add Remove
a. Full Name, Mailing Address & Phone
(include. city, state, & zip) -
b. Coordinated Committee Name
it. Comments
C. Level Registered (Specify)
Federal County:
❑ State ❑ Municipality:
c. Elution Smn to Date
$
E Account Code
g.. Form of Payment
1h. Purpose Code
11. Date (mmldd/yyyy)
1j, Amount
1k. Required Remarks
$
$
4. Payee Information Add Remove
a. Full Name, Mailing Address & Phone
(include clftrfstp
VEZZOOVED
OCT 2 8 2019
Union Co. Board of Elections
b. Coordinated Committee Name
d. Comments
c, Level Registered (Specify)
Federal 0 County:
13State ❑ Municipality:
e,. Election Sum Date
$
C. Account Code
g. Foran of Payment
It. Purpose Code
I. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
$
$
5. Total only this Page
$ of
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses)
(Thu line goes in line 13b of Detailed Summary Page CRO -1100 if Contrib to CandidateslPolitical Comm)
(This lime goes in line Be of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures)
�0
$ O
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 d - Penalties Ke - Office Expenses Q* - Donation to Legal Expense Fund
O* Other
* Codes re uire detailed ex lavation in reunited remarks field W
CRO -1310 NC State Board of Elections December 2009
Amendment -
In -Kind Contributions Pg _ of _ ;❑ Yes ❑ 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. Comonittee Full Name (and Fund if applicable) 12.
ID Number
6R 1110a- rok6e YrsM10*LIKA
/ "1 &
3. Contributor Informa ion Add El Remove
a. Full Name, Mailing Address & Phone
(In Jude city, state, &�zip)
b. Type of Contributor
c. Comments
Individual
aCandidate
1:1 Party
[3 PAC
[3Referendum
El Other Receipt Source
j(
2 /,AUGC —t
�I�7y
0W1 (DC7 qqq p�Q1
l 1 n 17-7
Ale
( I, ` (7
d. Election Sum to Dale
$
e. Description
S'16A19 --
f. Date (rn dd/y, yy)
dy
g. Fair Market Amount
$ 117, vA
$
$
3, Contributor Information ❑ Add ❑ . Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Type of Contributor
c. Comments
jr1ndrvidual
❑ Candidate
❑ Party
❑ PAC
❑ Referendum
❑ Other Receipt Source
d. Election Sum to Date
$
e. Description
f, Date (innddd/yyyy)
g. Fair Market Amount
$
$
$
3. Contributor Information ❑ Add ❑ .Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Type of Contributor
c. Comments
U Individual
Party ate
❑❑ Party
❑ PAC
❑ Referendum
13 Other Receipt Source
RECEIVED
OCT 2 8 2019
Union Co. Board of Elections
d. Election Stan to Date
$
e. Description
f. Date (rmrddd/yyyy)
g. Fair Market Amount
$
$
$
4. Total only this Page
$ ( '
5. Total of ALL CRO -1510 Pages
(This line must he on line 17 of Detailed Summary Page CRO -1100)
$ /1
CRO -1510 NC State Board of elections December 2007
v® NORTH CAROLINA
STATE BOARD OF ELECTIONS
Loan Proceeds Statement
This Statement is used to report detailed information about a new loan and is required to accompany the
Loan Proceeds Form in the report for which the loan is initially disclosed. If the loan is from an individual,
the lender's signature is required on this form.
This Statement is to be filed with the Election Board where the
thecommitreportss reports are filed.
5''s�(,
AgeV W1 NS 0t1
• Name of committee to receive loan: i6v12- f
n
• Person or committee to make loa 14 t
/4Y
• Date of loan to committee: /db� l7
• ame of lending institution and account number (source):
• Amount of loan: 11AP0100
• Description (if in-kind loan):
• of all parties responsible for payment of loan (guarantors):
�Names
e7 i NN�f�-1
• Period of loan:
• Rate of interest of loan:
• Security pledged for loan:
I, �'�lW e &0-14t , acknowledge that all of the information
lending
(Person money td committee)
prove ed is complete, true, and accurate. I further understand I may not forgive a loan
that balance to any source.
In ou�taMUM
e l
V,fiW /e
Sig t re o Lenik Signed
RECEIVED /v7
Signature of Tr asure Committee OCT 2 8 2019 ate Signed
Union Co. Board of Elections
CRO -6/00 Loan Proceeds Statement