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JPropst - 2015 YE reportAmendment Disclosure'Report Cover ❑ ves ® No 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. ID Number Janice G. Propst SJMR33 IL Milling Address (include City, State and Zip Code) RECEIVEDd. Date Filed 531 Weddington Rd. Matthews, NC JAN 29 2016 07/0612015 a Phone Number 28104 Union Co. Board of Eleetlf,on 704 849-6759 2. Report Year 3. Period Start Date (mm/dd/yy) 4. Period End Date (mm/ddhv)_ 5. Treasurer Full Name _ 201 10 20'01 I¢nice (�. Prttpst I_ ;I 'Ulz 6. Type of Committee (Check One) 9. Type of Report (check onty one ope o re ort nom one category) ® Candidate Campaign ❑ Party Municipal State/County Referendum ❑ PAC ❑ Referendum ❑ Organizational ❑ Organizational ❑ Organizational Independent ❑ Joint Fundraiser ❑ Expenditure ❑ Thirty-five day Quarterly ❑ Pre -referendum ❑ Legal Expense Fwd ❑ Pre-primary ❑ First ❑ Final ❑ "Booster Fund" ❑ Pre-election ❑ Second ❑ Supplemental Final ❑ Building Fund ❑ Pre-nmoff ❑ 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 withdrew Threshold 08/19 2015 8. Number of Fundraisers this Report 11. Account Information 11. Account Information a. Financial Institution Full Name a. Financial institution Full Name Community One Bank N.A. It. Purpose c. Account Code It. Purpose c. Account Code Campaign Funds JGP d. Period Begin Balance d. Period Begin Balance S 432.90 S CERTIFICATION I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B, & 2213-22M of Chapter 163 of the NC General Statutes and that no funds are commingled with prohibited or other non -disclosed fiords. I further certify that this report is complete, true and correct and that I have been trained by the to BoaKd of Elleplic, Janice G. Propst 01/252016 Printed Name of Signer ignmure of Arillbinted Treasurer Date FOR OFFICE USE ONLY LaM Date Received: `F `✓ Date Postmarked: e1.--- E mpoyee: Emplloyee: I l i t n,(� Delivery Method El Normal Mail Registered Mail Hand Delivered Date Scanned: Employee: ❑ Electronically Filed ❑ Signer has not received Date Data Entered: Employee: 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. Amendment Detailed Summary ❑ f es ❑ No Use this form to summarize all disclosure reporting forms and to total monetary information. I. Committee Full Name and Fund If applicable) 2. Type of Report 3. ID Number Committee to Elect Janice Prospt 2015 semi annual year end Report SJMR33 Start of Election Cycle: lanuanr 1, 2011 Total this Reporting Period I Total this Election Cycle 4) s) 6) 7) 8) 9) 10) 11) Cash on Hand at Start 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 llb) Contributions from Not -for -Profit Organizations 1 lc) Outside Sources of Income I Id) Legal Expense Fund —Other Sources 11 e) Exempt Purchase Price Sales (CRO -1205) (CRO.1210) (CRO -1220) (Ot&1230) (CRO -1410) (CROd240) (CRO -1250) (CRO -1250) (CRO -1250) (CRO -1270) (CRO -1265) $ S 432.90 175.00 S $ 0.00 750.00 $ 300.00 $ 2270.00 S $ S $ S S S $ $ $ $ $ JAN 29 $ $ $ S $ 12) 13) 14) 15) 16) 17) TOTAL RECEIPTS (Add lines 5, 6, 7.8.9. 10. Ila Ilb, 11c, l/dand Ile) 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-13IS) Loan Repayments (CRO -1420) Refunds/Reimbursements From the Committee (CRO -1320) In -Kind Contributions (CRO -1510) S 475.00 $ 3020.00 S 72725 S 2769.35 S S $ $ S S S $ $ $ $ $ 70.00 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14,15, 16 and 17) S 2839.35 19) Cash on [land at End (Addlines4ard 12 together, then subtract line 18) $ 180.65 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 -1330) (CRO -1430) (CRO.1610) (CRO -1630) (CRO -1720) (CRO -1710) (CRO -1440) (CRO -2200) (cR0•1215) t727,25 $ $ S $ S $ S $ C Amendment Aggregated Contributions from Individuals Page i or i ❑ Yes ® No Optional form used to report NC Contributions From Individuals of $50 or less 1. Committee Fall Name and Fund N appBaW 12. M Number Committee To Elect Janice Propst S1MR33 3. Contributor information a. Amend 6. Account Code C. Form of Payment d. In -Kind Description e. Date mm/dd/ f. Amount ❑ Add JGP check 10/28/2015 $ 30.00 ❑ Remove ❑ Add JGP check 10/292015 $ 25.00 Remove ❑ Add JGP check 10/292015 $ 50.00 ❑ Remove ❑ Add $ ® Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove Add Won U. $luara of Llections Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ Remove Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove 4. Total only this Page $ 175.00 5. Total of ALL CRO -1205 Pages (This line must be on line 5 of Detailed Summary Page CRO.1100) $ 750.00 CRO -1205 NC. state Board of Elections April 2007 Amendment Contributions from Individuals Pg I or 1 ❑ ves ® 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 a lieabk 2. ID Number Committee to Elect Janice Propst SJMR33 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments Retired sales Pamela Hadley 1032 James Maddison , Matthews, NC 28104 e. Employees Name/Specific Field Loreal e. Election Sum to Date $ 200.00 E Prior g. Account Code h. Form of Payment 1.ln-10nd Dcseription J. Date (mm/dd/yyyy) L Amount ❑ JGP check 10/21/2015 $ 200.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name,Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments Homemaker Marissa Sullins 8703 Prince Valiant Dr. Waxhaw, NC 28173 e. Employer's Name/Specific Field e. Election Stem to Date $ 100.00 f. Prior g. Account Code Is. Form of Payment i. In -Vied Description J. Date (mm/ddlyyyy) V Amount ❑ JGP check 10/21/2015 $ 100.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Com JAN 2 9 20 c. Employer's Name/Spedfic Field e. ElectionOard of Dan $ E Prior g. Account Code h. Form of Payment i. In -Kind Description J. Date (mmtdd/yyyy) h. Amount ❑ $ ❑ $ 300.00 5. Total of ALL CRO -1210 Pages g 2270.00 (This fine must be on line 6 of Deauff d Sammy Page CR4/100) CRO -1210 NC State Board of Elections April 2007 Amendment Disbursements Pg 2 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 ifapplicable) 2. 1D Number Janice G. Propst SJMR33 3. Type of Disbursement Please use separate CRO -1310 forny for each type of Dlsburseme t ® Operating Ii penses ❑ Contributions to Candidates: Political Committee, L] Coordinated Pans Expenditures 4. Payee Information Lj Add U Remove a. Full Name, Mailing Address & Phone include city, stat & b. Coordinated Committee Name d. Comments United States Post Office 11035 Golf Links Dr. Charlotte, NC 28277 c. level Registered (Specify) ❑ Federal ❑ County: ❑ State ® Municipality: e. Election Sum to Date $ 14.70 E Account Code g. Farm of Payment it. Purpose Code L Date (asm/ddlyyyy) J. Amount K Required Remarks JGP Debit 1 12/172015 $14.70 postage 4. Payee Information Add Remove a. Full Name. Mailing Address & Phone include city, state, & a It. Coordinated Committee Name d. Comments Union Co. Board of Election Louis Phdlipi 2026 Coatsdale Lane Stallings, NC 28104 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ® Municipality: e. Election Sam to Date $ 1218.94 f. Account Code g. Form of Payment It. Purpose Code L Date (mm/ddlyyyy) J. Amount E Required Remarks JGP check B* 10222015 $609.47 Mailer 4. Payee Information ❑ Atm Remove a. Full Name, Mailing Address & Phone include city, state, & ri b. Coordinated Committee Name it. Comments c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sam to Date $ E Account Code g. Form of Payment h. Purpose Code i. Dote (mm/dd/yyyy) j. Amount E Required Remarks 5. Total only fish Pae $ 624.17 6. Total of ALL CRO -1310 Pages 7 2-?. ;L tj (This line goes in line 13a of Detailed SummarPage CRO -1100 if Operating Expenses) $ . 2169.35 (This tine goes in line 136 of Detailed Summary Page CRO -1100 if Contrib to Candidatm/Polifical Conan) (This line goes in line lac of Detailed Summar' Page CRO -1100 if Coordinated Parry Expenditures) 7. Purpose Codes(List detailed expenditure code in .) above) A* - Media B* - Printing C* - Fundraising D - to 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) Amendment Disbursements Pg t of x ❑ 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 Fall Name and Fund if applicable) 2. ID NumbW Committee To Elect Janice Pro st SJMR33 3. Type of Disbursement Please use sawate CRO-1310orwar for each type of Disbursement ® Operating Expenses ❑ Coinnhutions m Candidates/Political Committees ❑ Coordinated Party Expenditures 4. Payee Information U Add Remove a. Full Name. Mailing .Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments Target Wesley Chapel, NC 28173 a Level Registered (specify) ❑ Federal ❑ County: ❑ State ® Municipality t. Election Sum to Date $ 34.46 L Account Code I g. Form of Payment h. Purpose Code I. Date (mm/dd/yyyy) J. Amount L Required Remarks JGP debit K 10/13/2015 $34.46 ink cartridge $ RECE Vr 4. Payee Information 0 Add El Remove a. Full Name, Mailing Address & Phone include city, statq & zip) b. Coordinated Committee Name d. Comments JAN 29 2w Won Co. Board of awt Staples 10850 Providence Road Charlotte, NC 28277 e. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ® Municipality: e. Election Sum to Date $ 53.63 f. Account Code g. Form of Payment Is. Purpose Code 1. Date (mmfdd/yyyy) J. Amount L Required Remarks JGP debit B• 10/232015 $53.63 copies 4. Payee Information Lj Add El Remove a. Full Name. Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments Marshalls 9876 Rea Road Charlotte, NC 28277 a Ltvd Registered (Specify) ❑ Federal ❑ County: ❑ State ® Municipality: e. Election Sum to Date $ 14.99 L Account Code g. Form of Payment It. Purpose Code i. Date (mm/ddlyyyy) J. Amount L Required Remarks JGP debit K* 12/102015 $14.99 stationery $ 5. Total only this Pae $ 103.08 6. Total of ALL CRO -1310 Pages (This line goes in line l3a of Detailed Summan Page CRO -1101) if Operating Otpemsesy (This line goes in line I3h of Detailed Summon Page CRO -1100 if Contrib to CandidalesiPolidcal Comm) (This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Party Erpenditures) �� �S- $ 7. Purpose Codes (List detailed expenditure code in .) above A* - Media B* - Printing C* - Fundraising D - To Another Candidate E - Salaries F* - Equipment G - Political Party H• - Holding Public Office Expenses 1 - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* - Other * f Ori PC rpauirP (IPtAIIPd PYninnnti.n in rPI niI P,i rPmurl,c field rtrI