Pierce,Rodney_2021-Year-endAmendment
Disclosure Report Cover I ❑ Yea No
Use this form for general report and committee information, must be signed and submitted along with other detailed forms.
Iln not lime flik corm to undate information
1. Committee Information
a. Full Name c. 11) Number
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CS mP3'?
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
g5'03
fy\t,aS\nV 1\\P_
e. Phone Number
2. Re t Year
p _......
3. Period Start Date (mm/dd/yy)
4. Period End Date
( mm/dd/
5. Treasurer Full Name
�31P') I
SPtvstwC �u�An�(5
6. Type,of Committee (Check One
9. Type of Report check onk one e of reort rom one category)
Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑ Organizmional
❑ Organizational
❑ Organizational
Independent ❑ Joint Fundraiser
❑ Expenditure
❑ Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pre-primary
1-1First
E] Final
❑ "Booster Fund"
❑ Pre-election
❑ Second
❑ Supplemental Final
❑ Building Fund
❑ Pre -runoff
❑ Third
❑ Annual
Semi-annual
❑ Fourth
❑ Special
❑ Mid Year
Semi-annual
10. Special Rep ortName
❑ Other:
❑ Year End
❑ Mid Year
❑ Final
❑ Special
Year End
Final
❑ Special
8. Number of Fundraisers this Report
Q
11, Account Information 11. Account
Information'
a. Financial Institution Full Name a. Financial Institution Full Name
as3 C" %Zers >7
b. Purpose
c. Account Cod`e1 b. Purpose
a Account Code
it. Period Begin Balance
d. Period Begin Balance
$ 300
$
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 ha a been trained by the State Board of Elections.
ZAtHves\C I. Eu VJt►A 5 0 / Z0 ? L,2 VQ
Printed Name of Signer Signature of Appointed Treasurer 7 'Date
FOR OFFICE USE ONLY
\ ry Method
Date Received: Employee: ❑ Normal Mail
Registered Mail
Date Postmarked: Employee: and Delivered
❑ Electronically Filed
Date Scanned: I �� Employee: ❑ Signer;hasnotreeeived
i4
mandatory, training 'r
Date Data Entered: 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. C E. I V E G
committee ch
You must amend the Statement of Organization (CRO-210OA-E) to make commn s
CRO -1000 NC State Board of Elections Aul 2008
Amendment
Detailed Summary ❑ Yes ® NO
T kc thio fnrm to spmmarize all disclnsnre reporting forms and t0 total monetary information.
1. Committee Full Name and Fund if applicable) 2.
of Re ort`
3. ID Number
G5 M9 3e
E l of j C1e.tlk J CDV*w Gaal `le Pa Era Sera, Aga+
Start of Election Cycle: January 1, a o a
"�
Total this
Reporting Period
Total this
Election Cycle
4) Cash on Hand at Start
$
300
$
0
5) Aggregated Contributions from Individuals
(CRO -1105)
$
$
$
$
6) Contributions from Individuals
(CRO -1210)
$
$
7) Contributions from Political Party Committees
(CRO -1120)
$
$
8) Contributions from Other Political Committees
(CRO -1230)
$
$
9) Loan Proceeds
(CR0.1410)
$
$
H1) Refunds/Reimbursements To the Committee (CRO -1240)
11) Other Receipt Sources
Ila) Interest on Bank Accounts
(CR0.1250)
$
$
$
$
l lb) Contributions from Not -for -Profit Organizations
(CRO -1150)
$
$
Ile) Outside Sources of Income
(CRO-12So)
$
$
lld) Legal Expense Fund — Other Sources
(CRO -1270)
$
$
11 e) Exempt Purchase Price Sales (CRO -1165)
12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10, Ila, Ilb, Ile, Ildmullle)
$
O
$
ll, 175-S
13) Disbursements
13a) Operating Expenditures
(CRO -1310)
$
$
13b) Contributions to Candidates/Political Committees
(CR0.1310)
$
$
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 -1310)
$
$
17) In -Kind Contributions
(CRO -1510)
$
$
�SS
18) TOTAL EXPENDITURES (Addlines 13,z 13b, 13c, 14, 15, 16and17)
$
% S
19) Cash on Hand at End (Addlines4andl2together,thensubtractline 18)
$
,300
A'
20) Non -Monetary Gifts Given to Other Committees
(CRO -1330)
21) Outstanding Loans (incl. ones from other campaigns)
(CRO -1430)
tf75j,5__'
22) Debts and Obligations owed By the Committee
(CRO -1610)
23) Debts and Obligations owed To the Committee
(CRO -1620)24)
Account Transfers Within the Committee
(CRO -1720)
25) Administrative Support
(CRO -1710)
$
UIADN
COUNTY
26) Forgiven Loans
$
2 8 2022
27) 48 -Hour Notice Reports Sum
(CRO -2200)
$
28) Contributions to be Refunded (CRO -1215)
CRO -1100 NC State Board of Elections ^aKa" LWO
Amendment
Outstanding Loans Pg —L of / 13�y Yea b"i 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)
F, 9 -CA *-TCA- �� 9 (�,IAV-t I
2. to Number
CIISM a
3. Lender Information Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, &zip)
l Ock l %�t P�e+cx
f7 1 �
150,3 O I I JC. �jii,#y\GV1 R� •
gtq-a41- o�?�
h. Job Title/Profession _
Nr. i�Q�\S�tla
J
it. Comments
e. Start Date (mtddd/YYYY)
1410 elac 1
e Employer's Name/Specific Field
f. End Date (mm/dd/yyyy)
/z/3 I Po 1-2-
. Rate
O c/n
Ils. Security Pledged
Pome,
1. Original Loan Amount
$ t �S
'. RemainingLoanBalance
$ I +r�
Ful Name of Lending Institution
N/A
I. Loan Number
2
3. Lender Information C3 Add 13 Remove
. Full Name, Mailing Address & Phone
(include city, stale, & zip)
1�/0–¢Ti�hQ� �t QiGf G�
3 t �ti�N�`
?J v 01 YC Y1
Mp¢Slrt�ille A1C d-9 1b3
nog- t9j— oli?�
b. Job Title/Profession 1
tic ry1 S�(L,N'K
d. Comments
e. Start Date (mm/dd/yyyy)
V 08 dog I
c. Employer's Name/Specific Field
s �Q 1J(r
C End Date (mm/dd/yyyy)
)s J31 .20dA
g. Rate
d
1h. Security Pledged
AIOKt
i. Original Loan Amount
is 30o
j. Remaining Loan Balance
$ 3oo
Full Name of fending Institution
A1/A
1. Loan Number
A
Lajidgr Information Add Remove
•Full Name• Mailing Address & Phone
(include city, slate, & zip)
b. Job Title/Profession
d. Comments
e. Start Date (mm/dd/yyyy)
c. Employer's Name/Speesc Field
I. End Date (mm/dd/yyyy)
g. Rateb.
Security Pledged
1. Original Loan Amount
'. Remaining Loan Balance
k. Full Name of Lending Institution
1. Loan Number
4. Total only this Page S SS
5. Total of ALL CRO -1430 Pages $ r�
(This fine must be on line 11 of Decoded Summon Page CRO -1100)
CRO -1430 NC ST -IC Board of Elez i:ocs 'U L 1)",nhL' -
RECEIVED