Richards, Mark_2021-Pre-ElectionReportAmendment
Disclosure Report Cover I ❑ ves ® No
Use this forth 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. Comma formation
a. Full Name
c. ID Number
Mark A Richards I I+f CC" -4" i TT4£ -rV Afxcr
ICH Ati
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
6129 Creft Circle
07-12-2021
Indian Trail, NC 28079
e. Phone Number
303-204-8949
2. Report Year
3. Period Start Date (mm/dd/yy)
4. Period End Date
5. Treasurer Full Name
mm/dd/
Mark A Richards
2021 07/12/2021
10182012
6. Type of Committee Check One
9. Type of Report
check only one tyDe of re
rt om one cat o ,/
® Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ Organizational
❑ Organizational
❑ Organizational
❑ PAC ❑ Referendum
Independent ❑ Joint Fundraiser
❑ Expenditure
❑ Thirty-five day
Quarterly
❑ Pre -referendum
Legal Expense Fund
❑ Pre-primary
® Preelection
❑ First
❑ Second
❑ Final
❑ Supplemental Final
7. Type of Fund (ifopplienble, check oneJ -
❑ "13a)ster Fund"
❑ Building Fund
❑ Pre -runoff
❑ 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
8. Number of Fundraisers this Report
Nu
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
Truist Bank
Truist Bank
b. Purpose
c. Account Code
b. Pur GO U::
c. Account Code
i
0 C T 19 2021
it. Period Begin Balance
it. Period Begin Balance
$ 0
$ 0
RECEIVED
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 no inclosed funds. I further certify that this report
is complete, true and correct and that I have been trained by the NC St. a of tions
Mark A Richards
&
10/18/2021
Printed Name of Signer Signature of Appointed Treasurer
Date
FOR OFFICE USE ONLY
Deliver' Method
Date Received: O a Employee:44F
❑ Normal Mail
Registered Mail
Date Postmarked: Employee:
Hand Delivered
Date Scanned:�� a Employee:
Electronically Filed
❑ 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
Detailed Summar Andment
Summary me ❑ Yes ❑ No
Use this form to summarize all disclosure re orcin forms and to total ivionetary information
1. Committee FullName (and Fund if applicable) _____F2.
Tt-r cc-44o%-me:-rD Etic-- hlAa,, 2tc4t4eo5
Type of Report
I cc£cno-)
3.1D Number
Start of Election Cycle: January 1, ZpZdQ
Reporting
Total this
Period
Total this
Election ('vele
4) Cash on Hand at Start
$
t7
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
(CRO -1205)
(CRO -1210)
(CRO -1220)
(CRO.1230)
(CRO -1410)
(CRO -1140)
$
$ I X37 (o3
$
$
$
$
$
$
$
$
$
1) Other Receipt Sources
I la) Interest on Bank Accounts
11 b) Contributions from Not -For -Profit Organizations
(CRO -1250)
(CRO -1250)
$
$
$
$
l lc) Outside Sources of Income
11d) Legal Expense Fund - Other Sources
Ile) Exempt Purchase Price Sales —
(CRO -1150)
(CRO -1270)
(CRO -1265)
$
$
$
$
$
$
12)TOTAL RECEIPTS(Add lines 5,6,7,8,9,10,1 NJ lb,l lc,lld and l le)
$
12516
$
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (CRO -1310)
13b) Contributions to Candidates/Political Committees (CRO -1310)
$
$
$
$
13c) Coordinated Party Expenditures
14) Aggregated Non -Media Expenditures
15) Loan Repayments
16) Refunds/Reimbursements from the Committee
17) In -Rind Contributions
(CRO -1310)
(CRO -1315)
(CRO -1420)
(CRO -1320)
(CRO -1510)
$
$
$
$
$
$
$
$
$ (t yj7 , la �j
$
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$ 7713
-7, 1.0,3
$
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$
$
ADDITIONAL INFORMATION
0) Non -Monetary Gifts Given to Other Committees (CRO -13.00)
1) Outstanding Loans (incl. ones from other campaigns) (CRO -1430)
2) Debts and Obligations owed by the Committee "'Cl (cxa1610)
23) Debts and Obligations oNved to the Committee:N F I (CRO -1620)
24) Account Transfers Within the Committee :jCT 19 20200-1720)
5) Administrative Support no)
$
$
$
$
$
$
$
$
$
6) Forgiven Loans RE6EPE(
7) 48 -Hour Notice Reports Sum
8) Contributions to be Refunded
- 440)
(CRO -2220)
(CRO -1215)
$
$
1 $
$
CRO -1l uo NC State Board of Elections August 2008
Amendment
Contributions from Individuals Pg of L [:Yes ® No
Use this form to report individual contributions over $50 of contributions under $50 it loan CRO 1205 is not used
I Committee Full Name, (and Fund if pphcable)
i H£ COV 0,11 TT_f -t-r) F_r-scr ]li-) �k 12rCu l9a ���
2. ID Number
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, slate, & zip)
fIt I4tQ1L R"
(0124 Clt'sr-T C'r!L
b. Job Title/Profession
d. Comments
c. Employer's Name/Specific Field
G
SL�Hr
e. Election Sum to Date
I. Prior
❑
g. Account Code
It, Form of Payment
i. In -Kind Description
j. Date (mmlddlyyyy)
07- IZ'2�21
k Amount
$ So"
❑
V6VA
- sr 15,. t6A.)
8-rU-2cew
$ 33,36
❑
vista
5;v
yzi-xzt
$ 4(�7, 73
3. Contributor Information ❑ Acid ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, slate, & zip)
j4fl'fi e A PIC" 14421)5
4pf2q C&icrCfact_,e
J K)DI IA )i -t-1 (41Lj AX- V!Qw&_P
b. Job l ine/1'rofession
d. Comments
c. Employer's Name/Spect is Field
e. Election Sum to Date
Is 516S. Zai'
C.Prior
❑
g. Account Code
h. Form of Payment
%5A
i. In -Kind Description
5t6NS
j. Date (mmlddlyyyy)
o?14zerj
k Amount
$ y1o.77
❑
VISA
_-�7TACC5
o4/Z,1ZZt
$ 59(70
❑
vKN
5�vsS
Ib(nl zoal
$ ilRt 32-
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, \failing Address & Phone
(include cit), state, & zip) pn _
r 1`lVZW� t=1 Y�'�- l-t�k120S
_ ��A --y�yy',
JN)I141J� "IIu+I'—I k)G o'a"�/
b. Job Title/Profession
or,�T-cn
d. Comments
c. Employer's Name/Specific Field
e. Election Sum to Date
$ qZ, %70
I. Prior
❑
g. Account Code
h. Form of Payment
UISt'V
I. In -Kind Description
J. Date (nun/dd/yyyy)
k Amount
�13 17eZ4
$
❑
$
❑
$
4. Total only this Page_ _
$fi--3-7-
5. Total of ALL . 042 .0 Pages
(This line must be on line 6 of Detailed Summary Page CRO -1100)
$ �3
CRO -1210 NC Swic B,,jrd of F1tatwn, April 2007
Amendment
In -Kind Contributions Pg or I q Yes 13
Use this form to 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 da s.
1. Committee Full Name (and Fund if applicable)
2. ID Number
I It B [,tlrn ;i<« Z' f 4 -r ll)talzr_ A r/ 02 JS
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
MAty- I4 (Ztet rvtevs
b. 7) pe of Contributor
[3Individual
® Candidate
❑ Pay
c. Comments
lv l 29 COW rr C i 2
1 �j't —y� )L 7 OW
y r�-V�s t (j �
❑ PAC
❑ Referendum
[3 Other Receipt Source
it. Election Sum to Date
$ 5O ! I 1�
10
e. Description
f. Date (mrdddlyyyy)
g. Fair Market Amount
$ S OC7
C r
oil iz.lzoz (
£S r s 16 0
09),4 lzom
$ 33,3k'
SI(oA75
Crq1Zi,ZoZi
$ 7107,79'
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, slate, & zip)
b. Type of Contributor
❑ Individual
❑, Candidate
❑ Party
c. Comments
-
ilk'- �Ic Lf142J5
TN l� t t4 0 I—aA 1 1 C��
❑ PAC
❑ Referendum
❑ Other Receipt Source
it. Election Som to Date
$ Z//
e. Description _ _
t. Date (mmlddlyyyy)
g. Fair Market Amount
co,j�jgz l 1 .t
$ ti (0-77
5l IKt�ZJ
C0Z7)zC-i
$ r 70
�71-q1L-v6
to �VI)ZC7Z-)
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
,/1 - K.F'r /� ,f�
01 11'2 tCq Al2_'i%i
Lai Z(? 00r -r (30P
Fq u L r y �
b. Type of Contributor
❑ Individual
Candidate
Party
❑ PAC
❑ Referendum
❑ Other Receipt Source
c. Comments
it. Election Sum to Date
$ q r-
e. Description UNION COUNT`!
S (-A 40r 1PAIG�N FWT` - — —
f. Date(mmlddtyyyy)
g. Fair Markel Amount
' 0G
$ 2i. ro
10113)2,71
R
$
4. Total only this Page
1 $ l 1 37 , L 3
5. Total of ALL CRO -1510 Pages
(This tine must he on line 17 of Detailed Summary Page CRO -1100)
$
I i 13-7.63
CRO -1510 NC State Board of Elections December 2007