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Palandri,Gina_2021-Year-endAmeadmeot� Disclosure Report Cover ❑Yes Nn 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 . Full Name c. ID Number . Mailing Address (include Clty, State and Zip Code) d. Date F 11W lam es t` e�*a Carr -e- 119-6 iZZzz 5 /r & a elv l e. Phone Number I Z 296 5 35� 2. Report Year 3. Period Start Date (mm/dd/yy) 4. Period End Date (mmlddlyy) 5. Treasurer Full Name 26 Z2 bI 0 / Z020 {a12/;�->I IZO2 I GIf�{> )"4&A ^jP9- 6. T e of Committee Check One 9. Type of Report (check only one type of report from one category)_ Candidate Campaign ❑ Party Municipal State/County Referendum PAC ❑ Referendum ❑ Organisational ❑ Organisational ❑ Organisational ❑ Independent Expenditure ❑ Joint Fundraiser ❑ Thirty-five da, Quarterly ❑ Pre -referendum ❑ Legal Expense Fund ❑ Pre-primary ❑ First ❑ Final ❑ Pre-election ❑ Pre -runoff Semi-annual ❑ Second ❑ Third ❑ Fourth ❑ Supplemental Final ❑ Annual ❑ Special 7. Type of Fund (if applicable, check one) ❑ Booster Fund ❑ Building Fund ❑ Mid Year Semi-annual Year End ❑ Mid Year 10. Special Report Name ❑ Other: Final ❑ special ❑ Year End ❑ Final 8. Number of Fundraisers this Report ❑ Special 11. Account Information 11. Account Information . Financial institution Full Name a. Financial Institution Full Name W, fi . Purpose c. Account Code b. Purpose c. Account Code CPpr�twid GCS kc -e-1 I�� d. Period Begin Balance d. Period Begin Balance - $ t7��,6 / - $ 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 is complete, true and correct and that I have been trained by the NC State Board of lections. Printed Name of Signer Signature of Appointed Treasurer Date OR OFFICE USE ONLY I t� /n� Date Received: (/ .611 ery Method ❑ Normal Mail Date Postmarked: Employee. istered Mail d Delivered Date Scanned: l as Employee: ❑ Electronically Filed Date Data Entered: Employee: ❑ Signer has not received mandato training Please Note: This form cannot be used to amend committee information such as the committwlm S,asurer. assistant treasurer, custodian of books information, or account informati&i %IPAIGN N,, You must amend the Statement of Organization (CRO -2100A -E) to make committee CRO -1000 NC State Board of Elections August 2008 RECEIVED - - Amendment Detailed Summary ❑ ves ® No Use this form to summarize all disclosure reporting forms and to total monetary information. 1. Committee Full Name and Fund if applicable) 2. Type of Report 3. ID Number Gina For Stallings End of year 9JM 19T Start of Election Cycle: January 1, 2020 Total this Reporting Period Total this Election Cycle 4) Cash on Hand at Start $ 575.07 $ 1975.00 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 11b) Contributions from Not -for -Profit Organizations Ile) Outside Sources of Income 11d) Legal Expense Fund — Other Sources 11 e) Exempt Purchase Price Sales (CRO -1203) (CRO -1110) (CRO -1220) (CRO -1230) (CRO -7410) (CRO -1140) (CRO -1150) (CRO -1250) (CRO -1250) (CRO -1270) (CRO -1265) $ 175.00 $ 795.00 $ $ 750.00 $ $ 100.00 $ $ $ $ 330.00 $ $ $ $ $ $ $ $ $ $ $ $ 12) 13) 14) 15) 16) 17) TOTAL RECEIPTS (Add lines 5, 6. 7, 8, 9,10, Ila, llb. (Ic, lidand Ile) URES' Disbursements 13a) Operating Expenditures (CRO -1370) 13b) Contributions to Candidates/Political Committees (CRO -1370) 13c) Coordinated Party Expenditures (CRO -1310) Aggregated Non -Media Expenditures (CRO -1315) Loan Repayments (CRO -1420) Refunds/Reimbursements From the Committee (CRO -1310) In -Kind Contributions (CRO -1510) $ $ 750.07 419.49 $ $ 1975.00 $ $ $ $ $ $ $ 330.00 $ $ $ $ $ 18) TOTAL EXPENDITURES (Add lines 13a, 13b. 13c. 14, 15. 16 and 17) $ 749.49 $ 19) ADDITIONAL 20) 21) 22) 23) 24) 25) 26) 27) 28) Cash on Hand at End (,Idllorrs 4and 11 together, thensabtract fitte 18) INFORMATI Non -Monetary Gifts Given to Other Committees (CRO -1330) Outstanding Loans (incl. ones from other campaigns) (CRO -1430) Debts and Obligations owed By the Committee (CRO -1610) Debts and Obligations owed To the Committee (CRO -1620) Account Transfers Within the Committee (CRO -1720) Administrative Support (CRO -1710) Forgiven Loans (CRO -1440) 48 -Hour Notice Reports Sum (CRO -2110) Contributions to be Refunded (CRO -1215) $ $ $ $ $ .58 $ $ $ $ $ IgION COUNTY $ $ $ CRO -1100 NC State Board of Elections I` 2108 Amendment Aggregated Contributions from Individuals Page I of I ❑ Yes ® No Optional form used to report NC Contributions From Individuals of $50 or less 1. Committee Full Name (and Fund ifapplicable) 2. ID Number Gina For Stallings 9J M 19T 3. Contributor Information a. Amend b. Account Code c Form of Payment d. In -Kind Description e. Date mm/dd/ E Amount ❑ Add GPAB Card 10/28/2021 $ 25.00 ❑ Remove ❑ Add GPAB Card 10/21/2021 $ 25.00 F-1 Remove ❑ Add GPAB Card 10/19/2021 $ 25.00 ❑ Remove ❑ Add GPAB Card 10/19/2021 $ 25.00 ❑ Remove ❑ GPAB Card 11/18/2021 $ 25.00 Remove ❑ Remove ❑ Add GPCH Check 11/2/2021 $ 50.00 ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ E] Remove ❑ Add $ F1 Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ Remove Total only this Page $ iFn3.00 r5Total of ALL CRO -1205 Pages $ 175.00 This fine must be on line S ojDetailed Summary Page CRO.1100) CRO -1205 NC State Board of Elections-%pril'_u07 Amendment Disbursements Pg i of + ❑ ves ® 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 Gina For Stallings 9JM18T 3. Type of Disbursement Please use separate CRO -1310 forms for each nwe of Disbursement ® Operating Expenses ❑ Coninbutions to Candidates/Political C'onuniltees ❑ Coordinated Party Expenditures 4. Payee Information Lj Add Lj Remove a. Full Name, Mailing .Address & Phone include city, state, & a b. Coordinated Committee Name d. Comments Online Donation Fee For campaign Act Blue 366 Summer Street Somerville, MA 02144 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ® Municipality: e. Election Sum to Date $ 23.30 L Account Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) I. Amount IL Required Remarks GPEX Card O 11/1/2021 $18.03 Charges online donation GPEX Card O 12/012021 $,38 Charges online donation 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments Website For Campaign e. Election Sum to Date $ 125.00 Wix 40 Namal Tel Aviv Israel c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ® Municipality: E Account Code g. Form of Payment Is. Purpose Code i. Date (mm/dd/yyyy) j. Amount IL Required Remarks GPEX Card O 11/012021 $25.00 Website for Campaign GPEX Card O 12/0 1 /22021 $25.00 Website for Campaign 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city, state, & a b. Coordinated Committee Name d. Comments Email for Campaign Website e. Election Sum to Date $ 30.00 Wix 40 Namal Tel Aviv Israel e. Level Registered (specify) ❑ Federal ❑ County: ❑ State ® Municipality: L Account Code g. Form of Payment h. Purpose Code L Date (mm/ddlyyyy) I. Amount k. Required Remarks GPEX Card O 11/012021 $6.00 Email fee for campaign GPEX Card O 12/012021 $6.00 Email fee for campaign 5. Total only this Pae $ 80.41 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Sumunmy Page CRO -1100 if Operating E)rpenses) (This line goes in line Iib of Detailed Summan• Page CRO -1100 ifComrib to Candidales/PoRRcal Comm) (Thu line goes in line Be of Detailed Summon• Page CRO.1100 if Coordinated Pao kilhuiii)l1`1 Y $ 419.49 7. Purpose Codes(List detailed expenditure code in (h.) above) A* - Media B* - Printing C* - Fundraising To Another Candidate E - Salaries F* - Equipment G - Political Party I A N i r; 9nl - 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 State Board of Elections December 2009 Amendment Disbursements Pg 1 of 2 ® 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 Gina for Stallings I 9JM 19T 3. Type of Disbursement Please use separate CRO -1310 fonns for each Iplue of Disbursement ® Operating Expenses ❑ Contributions to Cmdidates/Political Committees ❑ Coordinated Parry Expenditures 4. Payee Information LI Add Lj Remove a. Full .Name, Mailing Address & Phone include city, sate, & xi b. Coordinated Committee Name d. Comments Postage Stamps for Camp Thank you cards Postage Stamps USPS 8300 NE Underground Dr Kansas City MO 64144 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ 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 GPEX Card I 10/27/2021 $120,00 Postage Stamps Campaign Thanks GPEX Card 1 10272021 $36.20 Postage Stamps Postcards 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city, state, & ti b. Coordinated Committee Name it. Comments Yardsigns For campaign Alpha Graphics 9129 Monroe Road Charlotte, NC 28270 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ® Municipality: e. Election Sum to Date $ 768.99 L Account Code g. Form of Payment h. Purpose Cade i. Date (mm/dd/yyyy) j. Amount L Required Remarks GPEX Card B 10/19/2021 $182.88 Yardsign for campaign 4. Payee Information ❑ Add ❑ Remove a. Full Same, Mailing Address & Phone include city, sate, & a b. Coordinated Committee Name d. Comments c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date $ L Account Code g. Form of Payment h. Purpose Code E Date (mm/dd/yyyy) j. Amount k. Required Remarks $ 5. Total only this Pae $ 339.08 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses) (This line goin line 13b of Detailed Summar Page CRO -1100 if Coetrib to Candidates/Palideal Comm) es (This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures) $ 419.49 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 explanation in required remarks field (k CRO -1310 NC State Board of Elections December 2009 Loan Repayments Use this form to report payments on an existing loan. Amendment Pg of ❑ Yes ® No 1. Committee Full Name and Fund if applicable) 2. In Number Gina For Stallings 9M 119T 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Comments Loan To Campaign Gina Palandri 1023 Feather Oak Lane Stallings, NC 28104 c. Original Loan Date 8/4/2021 d. Original Loan Amount $ 250.00 e. Remaining Loan Balance E Account Code g. Form of Payment h. Date (mm/dd/yyyy) L Repayment Amount $ 0 GPWF Cash 8/4/2021 $ 250.00 S 0 GPWF Cash 10/06/2021 $ 80.00 3. Lender Information ❑ Add ❑ Remove a. Full Name. Mailing Address & Phone (include city, state, & zip) b. Comments c. Original Loan Date d. Original Loan Amount e. Remaining Loan Balance L Account Code g. Form of Payment h. Date (mm/dd/yyyy) i. Repayment Amount $ $ $ $ 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, sate, & zip) b. Comments c. Original Loan Date d. Original Loan Amount $ e. Remaining Loan Balance L Account Code g. Form of Payment h. Date (mm/dd/yyyy) L Repayment Amount Total is Page $ 330.00 r0*th4. 5. Total of ALCRO-1420 Pages (This One naL uf lx on fine 15 of Derailed Summan, Puge ('RO-1100) S 330.00 CRO -1420 NC State Board of Elections December 2007