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JPropst-2015 YE AmendmentA ment liisclosure Report Cover [►fives ❑ 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. m Number Janice G. Propst RECEIVED SJMR33 b. Mailing Address (include City, State and Zip Code) it. tate Filed 531 Weddington Rd. MAR 08 07/06/2015 Matthews, NC e. Phone Number 28104 Union Co. Board of Elections 704 849-6759 2. Report Year 3. Period Start Date (mm/dd/yy) ®v rind End Date 5. Treasurer Full Name Janice G. Propst 2015 10/20/2015 12/31/2015 6. Type of Committee (Check One) 9. Type of Report (check only one type of report om one category) ® Candidate Campaign ❑ Party Municipal State/County Referendum ❑ PAC ❑ Referendum ❑ Organizational ❑ Organizational ❑ Organizational Independent Joint Fundraiser ❑ Expenditure ❑ ❑ Thirty-five d rty- ay Quarterly ❑ Pre -referendum ❑ Legal Expense Fund ❑ ❑ Pre-primary Preclection ❑ First ❑ Second ❑ Final ❑ Supplemental Final 7. Tvoe of Fund (/Io➢➢//-bk, check one) ❑ "Booster Fond" ❑ Building Fund ❑ Pre -runoff ❑ Thud ❑ 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 S. Number of Fundraisers this Report 0 11. Account Information 11. Account Information a. Financial Institution Fall Name a. Financial Institution Full Name Community One Bank N.A. b. Purpose c. Account Code b. Purpose c Account Code Campaign JGP Funds it. Period Begin Balance d. Period Begin Balance $ $ 432.90 CERTIFICATION 1 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 funds. 1 further certify that this report is complete, true and correct and that 1 have been trained by the NC State Board o EI 'ons. Janice G. Propst 03/08/2016 Printed Name of Signer Signature Appointed Tr6swer Date FOR OFFICE USE ONLY Delivery MetDate Received: '3/� Employee: (�Q t MJF M E] Normal Mail Mail Date Postmarked: %E Employee: t❑� Registered Mail >t�d Hand Delivered ❑ Electronically Filed Date Scanned: Employee: ❑ Signer has not received mandatory training 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. You must amend the Statement of Organization (CRO-2100A-E)to make committee changes. CRO -1000 NC State Board of Elections August 2008 Ame meat Detailed Summary Yes p No Use this form to summarize all disclosure reporting forms and to total monetary information. 1. Committee Full Name and Fund if applicable2. of Report 3. m Number Committee to Elect Janice Prospt 2015 semi annual year end Report SJMR33 Start of Election Cycle: January 1, 2011 Total this Reporting Period Total this Election Cycle 4) Cash on Hand at Start $ 432.90 $ 0.00 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 11) Other Receipt Sources Ila) Interest on Bank Accounts 1 I b) Contributions from Not -for -Profit Organizations 1 le) Outside Sources of Income Ild) Legal Expense Fund — Other Sources 11 e) Exempt Purchase Price Sales (CRO -1205) (CRO -7270) (CRO -7220) (CRO -1230) (CRO -1410) (CRO -1240) (CRO -7250) (CRO -1250) (CRO -1250) (CRO -1270) (CRO -1265) $ 105.00 $ 680.00 S 300.00 $ 2270.00 $ $ $ $ $ $ $ $ S $ S $ S $ S $ $ $ 12) TOTAL RECEIPTS (Add lines 5, 6, 7.8.9, 10. /la, 11b. lie, lldwd lie) S 405.00 $ 2950.00 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 (CR&1310) (CR&1310) (CRO -1310) (CRO -1315) (CR&1420) (CRO -1320) (CR0.1S1o) $ 72715 $ 2769.35 S $ $ $ S $ S $ $ $ S $ 70.00 18) TOTAL EXPENDITURES (Add lines l3µ 13b,13c, 14.15, 16 and 17) $ 72725 $ 2839.35 19) Cash on Hand at End (Add lines 4 and 12 togedwr, Eben subtract lire 18) S 110.65 S 110.65 ADDITIONAL INFORMATION 20) Non -Monetary Gifts Given to Other Committees 21) Outstanding Loans (incl. ones from other campaigns) 22) Debts and Obligations owed By the Committee 23) Debts and Obligations owed To the Committee 24) Account Transfers Withi 25) Administrative Support 1�/ED 26) Forgiven Loans MAR U S 20 27) 48 -Hour Notice Reports fbn Go. Board of Elections 28) Contributions to be Refunded (CRO -1330) (CR&1430) (CR&1610) (CR&1620) (CRO -1720) (CRO -1710) (CRO -7440) (CRO -2200) (CRO -1215) $ S S $ S $ $ $ $ S $ $ $ CRO -1100 NC State Roud of Elections August 2008 Ame ment Aggregated Contributions from Individuals Page 1 of I 6Z Yes ❑ No Optional form used to report NC Contributions From Individuals of $50 or less 1. Committee Full Name and Fund if applicable) 2. ID Number Committee To Elect Janice Propst SJMR33 3. Contributor Information a. Amend b. Account Code C. Form of Payment d.In-Kind Description e. Date mm/dd/ Amount ❑ Add JGP check 10/282015 $ 30.00 ❑ Remove Add JGP check 10292015 $ 25'00 ❑ Remove ❑ Add JGP check 10292015 $ 50.00 ❑ Remove ❑ Add $ ® Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ E] Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add $ ❑ Remove ❑ Add RECEIVED $ ❑ Remove ❑ Add MAR 0 8 20 $ ❑I Remove ❑ Add Go. Board of Elections $ F1 Remove ❑ Add $ ❑ Remove 4. Total only this Page $ 105.00 5. Total of ALL CRO -1205 Pages (TM fine must be online 5 ojDadledSunamry Page CRO -7700) $ 680.00 CRO -1105 NC State Board of Elections April 2007 Amendment Contribuhous from Individuals Pg of s ❑ v« ® NO VZA nr rnntrihtrtu ne tinder $50 if form CRO 1205 is not used I. Committee Fall Name and Fund if a iicable D Number Committee to Elect Janice Propst SJMR33 3. Contributor fnformatioo ❑ Add ❑ Remove a. Fail Name, MaWog Addros & Pboae (include city, state, & rip) b. Job TideMrakasioa d. Comments Retired sales Pamela Hadley 1032 James MaddiSOn , Matthews, NC 28104 c. Employer's NamvSpedtic Field Loreal e. Electioa Sum to Date $ 200.00 L Prior Y• Account Code b. Form of Payment Ola -Kind Description 1• ire (mm/dd/yYYY) a' Amomr ❑ JGP check 10/21/2015 $ 200.00 ❑ $ 3. Contributor Information ❑ Add ❑ Remove A. Fall Nam,btatang Address & Phone (include city, state, & nip) b. Job TtklProfessim d. Comments Homemaker Marissa Sullins 8703 Prince Valiant Dr. Waxhaw, NC 28173 Employer's Name/Specific Field e. Election Sum to Date $ 100.00 L Ptior ❑ (y Actonat Code JGP is Form of Payment cheek LI lGed Descriplion j. Date (mm/d ity-M) 10/2112015 It. Amount $ 100.00 ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Panne (laclude city. state. &rip) MAR 0 8 2016 Union Co. Board of Elections b. Job 71de/Prof ssiou d. Comments r^ Employer's Njundspeci8e Field e. Mentha Sam to Date $ E Prior i4 Account Code Is. Form of Payment i. In-Kiud Description j. Dale (m uldd/yyyy) k. Amount ❑ $ ❑ $ 4. Total only this Page $ 300.00 5. Total of ALL CRO -1210 Pages $ 2270.00 (This Bae art# be as @tie 6ojDdded Sitrammy>We CRO -116M Ami12007 CRO -1110 ""'or �. "' — — - Amendment • Disbursements P9 Z of 2 ❑ Yes ® No Use this form to report expenditures from the committee for, operating expenses, conte -barites to candidate/poltncal committees and coordinated = expenditures. 9 m w..®k.as. 1. Committee Fun Name and Fund if a ble " ' SJMR33 SJM Janice G. Propst 3. Type of Disbursement Please ase rate CRO -1310 &= `o Larh amat19tsb etnefo: ® operating Expanses Contributions b Caodidales/Poiibcal Cootmittees Li Coordinated Patty Expenditures 4. Payee Information Add Remove a. Fall Name, Haillag Address & Phone b. Coordinated Committee Name d. Commenta include city. sin & ti United States Post Office 11035 Golf Links Dr. c. Level Rrgistered (specify) Charlotte, NC 28277 Federal ❑ County: State ® Municipality: e. Election Sum to Dare $ 14.70 L Account Code g. Form ofPayment W Purpose Cade L Date (mm/dd/yyyy) j. Amount k Requited Remarks Postage JGP Debit i 12/1712015 $14.70 $ 4. Payee Information Add Remove a. Full Name, Matting Address & Phone b. Coordimted Committee Nam d. Commmb (include cl , state. & v Louis Phillipi a I-cvd Registered (Specify) 2026 Coatsdale Lane ❑ Federal County Stallings, NC 28104 ❑ State ® Mtmitipdity: e. Uection Som to Date $ 1218.94 L Account Code g- Form of Payment h- Purpose Code 1. Date (mm/d&vyyy) 1- Amotre[ t ea Remarks Maileriler JGP check B° 10/22/2015 $609.47 $ 4. Payee Information Add Remove a. Full Name, Maitittg Address & Phone b. Coordinated Committee Name d. Comments Include city, statet & rl RECEIVED c. Level Registered (Specify) ° Fes' State ❑ ❑ C ounty: Mmrlcipality. 0 82016 MAR LV al e. Election Sem to Date $ Union Co. Board of Elections L Account Cate ll. Form of Payment h. Purpose Code L Date (mm/dd/yyyy) j. Amoaat a. Required Remaris $ $ 624.17 5. Total only this Page 6 Total of ALL CRO -1310 Pages (This Bae goes in Bae 13a ojDeralld Summary Page CRO -1100 ifOperaft Etpensrs) $ 2769.35 (7htr' amgva in one 136 oJDeadld Sanmary Page CRO- IIMYComr7b to CmrdldetedPoWcd Coa * (This fim goes is nae 13c oJDwaild Stammy Page C2?0.1100 tremduwd Parr Etp es) 7. PurpW Codes(List detailedexpenditme code in (h.) above AQ - Media B° - Printing C° - Fundraising D - To Another Candidate E - Salaries Fe - Equipment G - Political Party H' - Holding Public Office Expenses I - Postage J - Penalties Ke - Office Expenses Qt - Donation to Legal Expense Fund Oe - Other i " Codes require detailed eaptanatiou in required remarks field Cal Ameadmmt DisbRTSemenIR Pg i of ❑ Yes ® No Use this farm to report expenditures from the committee for operating expenses, contributions to candidatelpohhcal committees and coordinated Party expenditures. TD T1 Ilei 1. Commihee Fou Name and Fnod if a liable cotrunittee To Elect Janice Prost °m S]MR33 3. T of Dlsbntsement 1 opemhng Fxpmxs 4. Payee Information a. Full Name, Malft Address & Phone ruses CRO -331 a h Drs trsmre+at Comdbmions to Cmdidmes/P00tical Committees Coordinated Pony EapendfiUm Add Remove b. Coordinated Committee Name d. Comments Include city, state, & AP-) Target Wesley Chapel, NC 28173 t. Level Regisiered (Specify) Federal cmuyt ❑ g ® Municipality, e. Election Sum to Date $ 34.46 f, Account Code JGP g. Form of Paymmt debit K h. Purpose CodeEred m/dd/yyyy) 015 1• Amount $34.46 k Required Remark ink cartridge $ 4. Payee Information a Fun Nnmq itaaing Address Pan ❑ Remove Committee Name ui. Comments (include city. state. & vee Staples 10850 Providence Road a Level Registered (Speeify) ❑ Federal ❑ saw ® Com* Municipality Charlotte, NC 28277 e. Election Sum to Date $ 53.63 L Account Code g. Form of Payment It. Purpose Cork L Date (mmldd/yyyy) 1. Amount k acquired Remarks JGP debit B' 10/232015 $53.63 copies $ 4. Payee Information s. Full Name, Maitiog Address & Phone ❑ Add Remove b. Coordinated Committee Name d. Comments include ci , state, & zip) Marshalls c. Level Registered (Specify) 9876 Rea Road Charlotte, NC 28277 ❑ Federal ❑ County: ❑ Stene ® Municipality: e. Eked" Sum to Date $ 14.99 f. Account Code & Form of Payment h. Purpose Code L Date (mm/dd/yyYY) J. Amount k Required Remarks JGP debit K' 12/102015 $14.99 stationery $ 5. Total only this Page $ 103.08 6. Total of ALL CRO -1310 Pages (This 1laegoes to nae 13a ojDedled Sanamrp Page CRO -1100 if Operedog Eaprmes) $ 276935 (This fine gam Io Hm 136 of De Pied Smoamry Page CRO -1100 ifC0naib m Canddwes/Pollrinat C0"V (This line goes in line lac of DaaUtdSUjmwYPage CRO -1100 if Coordnared Parr; '=rpen"i ) 7. Purpose Codes (List detailed expendift= A" - Media B. - Printing E - Salaries F* - Equipment I - Postage J - Penalties code in .) above) C8 - Fundraising G - Political Patty =C" - Office Expenses MAR n er Candidate a= - of mg Public Office Expenses 0 8 °nation to Legal Expense Fund O" - Other I o C dm r Aulre detalled mnlanatMn to rmissrsat remnran acus r a Vnton Co. Board of Elections