Pierce,Rodney_2021-Org-ReportAmendment
Disclosure Report Cover 0 Yes Of No
Use this form for general report and committee information. nmst he signed and submitted along with other detailed fors.
Do not use this form to update inti enation.
1. Committee information
• . Full Name
c. I D [umber
E Aec+ �O0 `e104Y 04 C,01AILA
It. Mailing Address (include Uity, State and Zip Code)
d. Date Filed
rISo3�o�tvc %"Afc-lN MA
/4117 aosi
M A4�5y\ t`1P- fjc a$103
e. Phone Number
704-491- of
. Report Year
3. Period Start Date (mnVdd/y)l 3. Period End Date (mm/dd)yy)
5. Treasurer Full Name
a0a 1
/.09/.70.2-1 !2/17/a0.21
�
JAww�,e L. Et,kl4li 2S
- Type of Committee (Check One)
9. Type of Report (check
on/v one type of report
from one categonl )
Candidate Campaign ❑ Part,
Municipal
State/Couniv
Referendum
PAC ❑ Rclercndum
❑ Organizational
[4 Organizational
❑ Organizational
❑ Independent Expenditure ❑ Joint Fundraiser
❑ Thirty-five day
Quarterly I() . ,DkJ
❑ Pre -referendum
❑ 1 e,_al Expen.e Fund
❑Pre-primary'
❑ Fnt Q�_y,+,ut1
❑Final
❑ Pre-election
❑ Pre -runoff
❑ Second
❑ Third
❑ Supplemental Final
❑ Annual
7. Type of Fund (if applicable, check ane)
❑ Boos ter Fund
Semi-annual
❑ Fourth
❑ Special
❑ Building Fund
❑ Mid Year
Scmi-annual
❑ Year End
❑ Mid Year
10. Special Report Name
❑ Other:
❑ Final
❑ Special
❑ Year End
❑ Final
. Number of Fundraisers this Report
❑ Special
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
Figs+ C:IN} r.e^:s �ietn�
b. Purpose
c. Account Code
Jr. Purpnl pAIGN FINAN(;
c, Account Code
C MV&a n cAcck'%�
'i-
DEC 1 7 2021
d. Period Begin Balance
it. Period Begin Balance
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 1 have been trained by thelate Board of Elec ions.
'T{ Vy N.it I„ • LA.lo ill IIS Ol 7/--)'V 1'
- r
Printed Name ul Signer Si nature of A uinted Treasurer I...
FOR OFFICE USE ONLY /
'
Date Received: /, ., i Employee: Deliverl_Method
I 1 r ❑ Normal Mail
❑ Registered Mail
Date Postmarked: Employee:
Hand Delivered
Date Scanned: Employee: Electronically Filed
Date Data Entered: Employee: 0 Signer has not received
mandatory train
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 -21 OOA-E) to make committee changes.
CRO -1000 NC State Board of Elections August 2008
Amendment
Detailed Summary ❑ lesNn
1 Icy'hi< L,nn to dicrinauv rennrtinv tnrmc and to inml mnnetary inforrnatlnn
1. Committee Full Name (and Fund if applicable)
12. Type of Report
^
oZ! - b.
3. ID Number
GS MQ 3-?
Start of Election Cycle: January 1, OLS
Total [his
Reporting Period
Total this
Flection Cycle
4) Cash on Hand at Start
$
$
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
111 Other Receipt Sources
Ila) Interest on Bank Accounts
llb) Contributions from Not -For -Profit Organizations
llc) Outside Sources of Income
l Id) Legal Expense Fund -Other Sources
1le) Exempt Purchase Price Sales
(CRO -1205)
(CRO -1210)
(CRO4220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$
$
$
$
$
$
$
$
$ I ' I
$
$
$
$
$
$
$
$
$
$
$
$
$
12)TOTAL RECEIPTS (Add lines 5,6,7,8,9,10,1 la,l lb.l lc,l Id and
$
S
I5
IS
EXPENDITURES
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 -1510)
$
$
$
$
$
$$
$
$
$
$
$ SS
$
18) TOTAL EXPENDITURES (Add lines 13a, 13b. 13c, 14, l5, 16 and 17)
$
GI S s
$
S�
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$
3co
S
ADDITIONAL INFORMATION
0) Non -Monetary Gifts Given to Other Committees (CRO -1330)
I) Outstanding Loans (incl. ones from other campaigns) (CRO -1430)
2) Debts and Obligations owed by the Committee (CRO -1610)
23) Debts and Obligations owed to the (ldhilgi eEOUNTY(CROa620)
CAMPAIGN FINANCE
24) Account Transfers Within the Committee (CRO -1720)
25) Administrative Support DEC 17 2021 (CRO -1710)
26, Forgiven Loans RECEIVE( 0-1440)
271 48 -Hour Notice Reports Sum ( 0-2220)
28) Contributions to be Refunded (CRO -1215)
$
$ 75J
$
$
$
$
$
$
$
$
$
$
$
CRO -1100 NC State Bean/ of Elections August 2000
Loan Proceeds
Pg
Use this form to report proceeds from a loan and loan endorser's information
A loan Drocceds statement must accomnanv each loan that is from an individual
Amendment
or � _ ❑ 1'es
1. Committee Full Name (and Fund if applicable)
2. to Number
F � ecA C,\e-(1, A coin
C17S Me 3-9
. Lender Information ❑ Add ❑ Remove
. Full Name.Mailing Address & Phone
(include city, shale, & zip)
b. Job Title/Profession
l'
�%� t�C1C\\j'11Ll�yt
d. Comments
tIAP-- fWL Q IeK'L
'T.'5-03 S03 C AIC-, a�c1A Rd '
1V\AM1sti41�\G NC. "1710 3
JJ
e. Stan Date lmta/dd/yyyy)
/.Z/09,4`20.21
c• Employers NamNeBperifir Field
,SA kiayert. C'4 " C1
I. End Date lm ddd/yyty)
1et1311.2
. Rate
0 `'r
h. Security Pledged
Nome.
i. Account Code
nJ/A
Form of Payment
j"
?� Il(�d
it. Amount
. Full Name of Lending Institution
m Loan Number
N/A
1-
. Endorsers/Makers llfte people u hn guarantee the loan.)
. Full Name, )tailing Address & Phone
(include city, state, & zip)
It. Job Title/Profession
A)C rn Ag I s+lu4k
c. Employer's Name/Specific Field
SJ A.k Qy N
Rc� rley kjA p, ane
n903 O\Nva
d. Percentage
/vto %
e. Amount
$
M P�LShJi \\ e N L 2 3 )0 3
a. Full Name, Mailing Address & Phone
b. Job Title/Profession
c. Employer's Name/Specific Field
(include city, stale, & zip)
d. Percentage
e. Amount
a. Full Name, Mailing Address & Phone
b. Job Title/Profession
c. Employer's Name/Specific Field
(include city, state,& zip)
UNION COUNTY
CAMPAIGN FINANCE
OEC17 2021
1.
d. Percentage
`t
c. Anonmt
$
n. full �:mu. Vailiu A/l ltu
im Imtr , io. ,torr. &-ztp
b. Job Title/Profession
c. Employer's Name/Specific 1'it Id
d. Percentage
c. Amount
5. Total of ALL CRO -1410 Pages
(This line matt be on fine 9 ojDetailed Summary Page C'RO-1100)
$1 SS
CRO -1410 NC Stale Roord of Flections Apri12007
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 committee's reports are filed.
• Name of committee to receive loan: E/BC% Kojy" PiQfCe. Oe" 04 au<L+
• Person or committee to make loan: RO (I ne, UL
• Date of loan to committee: / Z LOd' �oi OS-
T
• Name of lending institution (source):
/✓'1A
• Amount of loan: 4
• Description (if in-kind loan): &144
• Names of all parties responsible for payment of loan (guarantors):
Ito I itxL9—
Period of loan: a Men S
• Rate of interest of loan: d 20
• Security pledged for loan: /UOP4
I, RdilAf:1 AF8 P;CCCA _ acknowledge that all of the information
(Pemo lending money to committee)
provided is complete, true, and accurate. I further understand I may not forgive a loan
that has an outstanding balance to any source.
-- IN /a IJrJ/o?OL 1
Si ature of Lender pgIGN FINANCE ate77Signed
,( Fir- in I
Inature of Treasurer of Committate Signed
DECEIVED
CRO -6100 Loan Proceeds Slatemenl
Amendment
Loan Proceeds Pg a of Qi _ ❑ ,es No
Use this form to report proceeds from a loan and loan endorser's information
A loan oroceeds statement mist acmmnanv aorh ho„ that ;, c.,..., .,..:.,a:.,:a....�
I. Committee Full Narita (and Fttnd if app 'cable)
2. M N;Eer
ttd
I Leer Information
❑ Add Remove
. Full Name, Nailing Address & Phone
b. Job Title/Professio1n—
d. Comments
(include city, state, & zip)
_,Y�t
l•
N Mat],tSA ft k
�Ogvt y F� PtEi'C.,C,
J
e. Start Date
nrr J 1
' 1 0.3 Olive �fl-�'✓tG i'S �d '
(nun/dd/YYYY)
� Employer's NanwJSpecific Field
MAa.SVw1\k NC asio 3
54Ahl. NC,
f. End Date (mmfddlyyyy)
.20Aa,
.RateEhe�Pledged
i. Account Code
. Form ofPayment
k. Amount
D
>ne
h1IA
cheek
$ 300
Full Namfitutlon
m Loan Number
N
e�
(The people who guarantee the loan.)
. FuR Name, Nailing Address & Phone
It. Joh Title/Profession
c. Employer's Name/Specific Field
(include city, state, & zip)
/ IC M A.8 i S+R� .4k
S Y v
Rc)(4 I,e,y kK V\ e,fCp
171903 0\1va Rd.
2310 3
d. Percentage
e. Amount
wv qr
s 30c
. Full Name, Nailing Address & Phone
b. Jab Title/Profession
c. Employer's Name/Specific Field
(include.nity; state, & tip)
;,;AIPAIGN FIP!:=� dC t
OEC 17 2021
RECEIVED
d. Percentage
e. Amount
$
. Full Name. Mailing Address & Phone
b. Job Title/Profession
n Employer's Name/Specific Field
(include city, state, & zip)
it. Percentage
e. Amount
t7a
$
. Full Name, Nailing Address & Phone
b. Job Title/Profession
c. Employer's Name/Specific Field
(include city, state, & zip)
d. Percentage
e. Amount
Total of ALL CRO -1410 Pages
r.(..,.
$
line must be on One 9 of Detailed Summary Page CRO.1100)
1
CRO-IJIO NC Slate Board of Elections ,April >DO - 7
V ^OT E NORTH CAROLINA
70 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 committee's reports are filed.
• Name of committee to receive loan: Eled+ fioj„eti Pierce. �elRk 04 Cou L+
• Person or committee to make loan: RadAP iLk
• Date of loan to committee:
• Name of lending institution (source):
t✓IA
• Amount of loan: 30
• Description (if in-kind loan): N�%J
• Names of all parties responsible for payment of loan (guarantors):
• Period of loan: /07 /)lln4S
• Rate of interest of loan: 610
• pledged for loan: /U04
"S�ec/urity
rj
I, d(SNPs/ U P;CrcA_ acknowledge that all of the information
(Pemoh lending money to committee)
provided is complete, true, and accurate. I further understand I may not forgive a loan
that has an outstanding balance to any source.
Si ature of Lender Tri
aaN� ate Signed
I nature of Treasurer of committeCE ate Signed
CRO -6100 Loan Proceeds Statement
In -Kind Contributions Amendment
Pg � of � ❑Y���CCC
m
es �Nn
Use this forto 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 Fund if applicable)
2. ID Number
Elec,� _�oAhp_ Q-%t4xk C\eRk, o�
L -s, 3�
3. Contributor Information Ad Remove
a. Full Name. )failing Address & Phone
h. 'type of Contributor
c. Comments
(include city, slate, & zip)
❑ Indi, iduUl
YfOC h,e� �Lp PICr,CR�
�Candidat,
1 5_03 011 VCltikvs(.h
PaPartyrr❑
PAC
9
I'A AP3%1st 1 -1? 10 3
❑ Referendum
d. Election Sum to Dale
❑ Other Receipt Source
$ / J
. Description
L Date (mm/dd/yyyy)
g. Fair Market Amount
1.4,16 f
.9021
10 ll Zt card I � riA,
$ a 47
UA llt
fa oEILO2.1
$
. Contributor Information El Add 0 Remove
. Full Name, \failing Address & Phone
to. Type of Contributor
c. Comments
(include city, state. &zip)
❑ Individual
❑ Candidate
UNION COUNTY
❑ Party
,AMPAIGN FINANCE
❑ PAC
n[ �1
'JCC 1 !7 L021
[3 Referendum
❑ Other Receipt Source
d. Election Sum to Date
$
e. Descript�y EC EIVED
-i1 V
L (m
Dale mlddlyy-vy)
g. Fair Markel Amount
$
S
3. Contributor Information Add 0 Remove
a. Full Name, Mailing Address & Phone
h. Type of Contrihutor
c. Comments
(include city. state, & zip)
❑ Individual
❑ Candidate
❑ Party
❑ PAC
❑ Referendum
d. Election Sum to Date
❑ Other Receipt Source
$
. Description
L Date (num'dd/yyyy)
g. Fair Market Amount
S
4. Total only this Page { y s S
5. Total of ALL CRO -1510 Pages $ S
{
(This Rae must be on line 17 of Derailed .Summar• Page CRO -1100)
CRO -1510 NC S1atc Huard of Flection+ December 2007
Amemtmeut
Outstanding Loans Pg --L of ❑ Yes ;X No
Use this form to report any outstanding loans received during a previous reporting period and until the loan is paid in full.
1. Committee Full Name (and Fund if applicable)
2. to Number
I Q L� To�Ytt? ecce CF,
C'S Ih 3
. Lender Information ❑ Add Remove
. Full Name, Mailing Address & Phone
(include city, state. & zip)
b. Job Title/Profession
NG %$Na -Irf..
"�
d. Comments
Ucktmj
- r� �
'75•o3 O 119 L T> AA1 CG`A KM •
n\t►vshtN\\1L NL A-8103
9bq O?41- ot$il
e. start Date Inar✓aalyrrYl
/,� 00'/0 021
c. Employer's Name/Specific Field
Sk.�le cC NL
L End Dale (nuWdd/yyyyI
/,71311.�01Z
. Rateh.
Security Pledged
i. Original Loan Amount
'. Remaining Loan Balance
D
AJOME, Is
1,wi
$ 1
k. Full Name of Lending Institution
I. Loan Number
N/A
I-
3. Lender information Add Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession 1
NC mAbI S�'u ie
d. Cmnments
' lxwtj 4t, QiacG�
t� ��
7J T D 3 0, -1 V*- �0#Adr% Ff]
m4aswok- A1C. -N103
rl 91 - 0 ql5
J
e. Start Date ImMdd/YYYYI
1100101101-1
c. Employer's Name/Specific Field
S >rE NL
L End Date Inudddlyyyy)
l.2 31/.20d A
g. Rale
Security Pledged
I. Original Loan Amount
j. Remaining Loan Balance
1
1b.
A -c
is 300
$ 3oo
k. Full Name of Lending Institution
AJIA
1. Loan Number
A
3. Lender Information ❑ Add 0 Remove
a. Full Name. Mailing Address & Phone
b. Job Tille/Profession
d. Comments
(include city, stale, &zi
UNION C&g lIY
r'.AMPAION FINANCE
e. start Date (mmldd/yyyy)
c. Employer's Name/Specific Field
0EC17 2021
IJ l•
RECEIVED
f. End Dale Imm/dd/yyyy)
g. Rate
Security Pledged
I. Original Loan Amount
j. Remaining Loan Balance
1h.
k. Full Name of Lending Institution
1. Loan Number
4. Total only this Page I SS
5. Total of ALL CRO -1430 Pages �/ t (r
(This lint must be on line 21 of Detailed Summary Page CRO -1100) I I J "
CRO -1430 NC Slay, B,,,dof 8lirlluns December 2007