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Rowell,JR_2020-Mid-yearAmendment Disclosure Report Cover I ❑ Yes ® 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. to Number The Committee to Elect J.R. Rowell U.C. Clerk of YSY483 Superior Court b. Mailing Address (include City, State and Zip Code) d. Date Filed 2708 Dellwood Dr. 07/31/2020 Monroe, NC 28112 c. oe r v 704- 8957 2. Report Year 3. Period Start Date (mm/ddlyy) 4. Period End Date 5. Treasurer Fu . a. (mm/dd/yy) Jammie Eubanks 2020 01/01/2020 06/30/2020 6. bpe of Committee (Check One) 9. Typie of Report (check only one type of report om one category) ® Candidate Campaign ❑ Parry Municipal State/County Referendum ❑ PAC ❑ Referendum ❑ Organizational ❑ Organizational ❑ Organizational Independent Joint F]Expenditure E]int Fdr ❑ Thirty-five Y five da Quarterly E] Pre -referendum ❑ Legal Expense Fund ❑ Pre-primary ❑ Pre-election ❑ First ❑ Second ❑ Final ❑ Supplemental Final 7. Type of Fund (rdPPlimble, check one) ❑ 'BWster 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 & Number of Fundraisers this Report p 11. Account Information 11. Account Information a. Financial Institution Full Name it. Financial Institution Full Name First Citizens Bank b. Purpose c. Account Code b. Purpose c. Account Code Campaign 2 Checking d. Period Begin Balance d. Period Begin Balance S 150.94 $ CERTIFICATION 1 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. 1 further certify that this report is complete, true and correct and that I have been trained by the State Board of lec ions. Jammie Eubanks 07/31/2020 Printed Name of Signer Signature ofAppointed Treasurer Date FOR OFFICE USE ONLY Delivery Method Date Received: 7/3/ Employee: ❑ Normal Mail Date Postmarked: Employee: ❑ Registered Mail �j 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 GW8 Amendment Detailed Summary ❑ ves ® No Use this form to summarize all disclosure renortim 4 forms and to total monetary information. 1. Committee Full Name and Fund if applicable) 2. Type of Report 3. ID Number The Committee to Elect J.R. Rowell U.C. Clerk of Superior Court 2020 Mid Year Semi Annual Report YSY483 Start of Election Cycle: January 1, 2019 He xnor tal Imtin •Peis Period rote) this Election Cycle 4) Cash on Hand at start S i s094 S 150.94 Aggregated Contributions from Individuals 6) Contributions from Individuals 7) Contributions from Political Party Committees 8) Contributions from Other Political Committ l O O 9) Loan Proceeds = ��� O 10) Refunds/Reimbursements To the Committ �O�ni 11) Other Receipt Sources Ila) Interest on Bank Accounts 11b) Contributions from Not -for -Profit Organizations Ile) Outside Sources of Income lid) Legal Expense Fund — Other Sources 11 e) Exempt Purchase Price Sales (CRO -1205) (CRO4210) (CRO -1120) CRO -1230) 1410) (� 1240) CRO -1150) (CRO -1250) (CRO -1250) (CRO -1270) (CRO -1265) $ 0 S 1A A_ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 300 $ 300 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 12) TOTAL RECEIPTS Mddlines5.6, 7, 8,9, 10, Ila, 11b, Ilc, IldandIle) $ 300 $ 300 EXPENDITURES;'° 13) 14) 15) 16) 17) Disbursements l3a) Operating Expenditures 13b) Contributions to Candidates/Political Committees 13c) Coordinated Party Expenditures Aggregated Non -Media Expenditures Loan Repayments Refunds/Reimbursements From the Committee In -Kind Contributions (CRO -1310) (CRO -1310) (CRO -1310) (CRO -1315) (CRO -1420) (CRO -1320) (CRO -1510) $ 200 $ 200 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ 200 $ 200 19) Cash on Hand at End (Add Imes 4 and 12 togedwr, then sabtractline 18) $ 250.94 $ 250.94 AWITIQNALINFQ 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 -1610) (CRO -1720) (CRO -1710) (CRO -1440) (CRO -2100) (CRO -1215) 0 - $ 5,063 $ 0; $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 $ 0 CRO -1100 NC State Board of Elections August 2009 Amendment Disbursements Pg 1 of I ❑ Yes N 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 if applicable) 2. ID Number The Committee to Elect J.R. Rowell U.C. Clerk of YSY483 3. Type of Disbursement Please use separate CRO -1310 forms for each e of Disbursement N Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures 4. Payee Information Add El Remove a. Full Name, Mailing Address & Phone include city, sate, & ri It. Coordinated Committee Name d. Comments N/A N/A Jammie L. Eubanks, CPA, P.A. PO Box 1066 Monroe, NC 28111-1066 704-238-1679 a Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date N/A $ 200 L Account Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) j. Amount L Required Remarks I Check O 03/02/2020 $200 Campaign Reporting Svcs 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments u. CSN JP�CE\VEO N 3I, Z O h V 9R0 CF E�� c. Level Registered (Specify) E] Federal E] County: ❑ State ❑ Municipality: e. Election Sum to Date $ L Account Code g. Form of Payment h. Purpose Code i. Date (mm/ddlyyyy) j. Amount L Required Remarks S 4. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone include city, state, & zip) b. Coordinated Committee Name d. Comments c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date $ L Account Code g. Form of Payment Is. Purpose Code i. Date (mmlddlyyyy) j. Amount k Required Remarks $ 5. Total only this Pae $ 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses) $ 200 (This line goes in line 13b of Detailed Summary Page CRO -1100 ifCamrib to Candidates/Polirical Camm) (This line goes in line lac of Detailed Summary Page CRO -1100 if Coordinated Party Eapendifures) 7. Purpose Codes (List detailed expenditure code in (h.) 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 * Codes require detailed explanation in required remarks field (k) CRO -1310 NC State Board of Flections December 2009 Loan Proceeds Amendment Pg I of I ❑ Yes ® No Use this form to report proceeds from a loan and loan endorser's information A Innn nrnceeds statement mast accomnanv each loan that is from an individual 1. Committee Full Name and Fund if ap cable) 2. ID Number The Committee to Elect J.R. Rowell U.C. Clerk of Superior Court YSY483 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Tine/Profession d. Comments Union County Clerk of Superior Court Jeffery Rowell 2708 Dellwood Drive Monroe, NC 28112 704-226-8957 e. Start Date (mm/ddlyyyy) a Employers Name/Specific Field 03/02/2020 State of North Carolina E End Date (mm/ddtyyyy) 12/31/2022 g. Rate h. Security Pledged i. Account Code j. Form of Payment L Amount 0 % None 2 Check $ 300 I. Full Name of Lending Institution m. Loan Number N/A 9 4. Endorsers/Makers (The people who guarantee the loan) a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession c. Employer's Name/Specific Field RF O. p O Q EC1��a� d. Percentage e. Amount % $ a. Full Name, Mailing Address & Phone (include city, state, & zip) It. Job Title/Profession c. Employer's Name/Specific Field it. Percentage e. Amount a. Full Name, Mailing Address & Phone (include city, state, & zip) It. Job Tide/Protession c. Employer's Name/Specific Field d. Percentage e. Amount a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession c. Employer's Name/Specific Field d. Percentage e. Amount $ 5. Total of ALL CRO -1410 Pages (This line must be on line 9 ofDetailedSummary Page CRO -1100) $ 300 CRO -1410 NC State Board of Elections Apni 2 Outstanding Loans Amendment Pg 1 of 3 ❑ Yea ® 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. ID Number The Committee to Elect J.R. Rowell U.C. Clerk of Superior Court YSY483 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments Union County Clerk of Superior Court Jeffery Rowell 2708 Dellwood Drive Monroe, NC 28112 704-226-8957 e. Start tate (mm/dd/yyyy) e. Employer's Name/Specific Field 02/31/2006 State of North Carolina f. End Date (mm/dd/yyyy) 12/31/2020 g. Rate h. Security Pledged i. Original Loan Amount j. Remaining Loan Balance 0 aha None S 950 $ 950 IL Full Name of Lending Institution 1. Loan Number N/A 2 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) 1.Union b. Job Titie/Profession d. Comments County Clerk of Superior Court Jeffery Rowell �O v 1), �O 2708 Dellwood Drive Monroe, NC 281 12 "' G 704-226-8957 e3z�10 < 10 14 e. Sart Date (mm/ddlyyyy) e Employer's Name/Specific Field 03/25/2008 State of North Carolina E End Date (mm/ddtyyyy) 12/31/2020 g. Rate h. Security Pledged i. Original Loan Amount J. Remaining Loan Balance 0 "�a None $ 500 $ 500 L Full Name of Lending Institution 1. Loan Number N/A 3 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Tide/Profession d. Comments Union County Clerk of Superior Court Jeffery Rowell 2708 Dellwood Drive Monroe, NC 28112 704-226-8957 e. Sart Date (mm/ddlyyyy) a Employer's Name/Specific Field 02/09/2010 State of North Carolina L End Date (mm/dd/yyyy) 12/31/2020 g. Rate h. Security Pledged i. Original Loan Amount J. Remaining Loan Balance 0 aha None $ 800 $ 800 L Full Name of Lending Institution I. Loan Number N/A 4 4. Total only this Pae S 2,250 5. Total of ALL CRO -1430 Pages $ 5,063 (This line must be on fine 21 ojDelailed Summary Page CRO -1100) CRO -1430 NC State Board of Elections Vecemoer 2UU Outstanding Loans Amendment Pg 2 of 3 ❑ Yea ® 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 jf applicable) 2. ID Number The Committee to Elect J.R. Rowell U.C. Clerk of Superior Court YSY483 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) It. Job Title/Profession d. Comments Union County Clerk of Superior Court Jeffery Rowell 2708 Dellwood Drive Monroe, NC 28112 704-226-8957 e. start Date (mm/dd/yyyy) c. Employer's Name/Specific Field 08/02/2010 State of North Carolina L End Date (mm/dd/yyyy) 12/31/2020 g. Rate h. Security Pledged i. Original Loan Amount J. Remaining Loan Balance 0 % None $ 80 $ 80 k. Fall Name of Leading Institution I. Loan Number N/A 5 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Tide/Profession d. Comments Union County Clerk of Superior Court Jeffery Rowell p ` G 2708 Dellwood Drive r m Monroe, NC 28112 mO _ m Z 704-226-8957 �� m n �A o Ory S e. start Date (mm/dd/yyyy) G Employer's amepecfic Field ElName/Specific 02/18/2014 State of North Carolina L End Date(mm/dd/yyyy) 12/31/2020 g. Rate �h. Pledged i. Original Loan Amount j. Remaining Loan Balance 0 °/a None $ 1,028 $ 1,028 L Full Name of Lending Institution 1. Loan Number N/A 6 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & rip) b. Job Title/Prokssion d. Comments Union County Clerk of Superior Court Jeffery Rowell 2708 Dellwood Drive Monroe, NC 28112 704-226-8957 e. Start Date (mm/dd/yyyy) a Employer's Name/Specific Field 08/28/2014 State of North Carolina E End Date (mm/dd/yyyy) 12/31/20 g. Rate h. Security Pledged i. Original Loan Amount J. Remaining Loan Balance 0 % I None $ 300 $ 300 L Full Name of Lending Institution 1. Loan Number N/A 7 4. Total only this Pae $ 1,408 _ 5. Total of ALL CRO -1430 Pages $ 5,063 (This line must be on fine 2/ of Deltuled Summary• Page CRO -1100) CRO -1430 NC State Board of Elections December 2007 Outstanding Loans Amendment Pg 3 of 3 ❑ yea ® 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) z. ID Number The Committee to Elect J.R. Rowell U.C. YSY483 Clerk of Superior Court 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & tip) b. Job Title/Profession d. Comments Union County Clerk of Superior Court Jeffery Rowell 2708 Dellwood Drive Monroe, NC 28112 704-226-8957 e. Start Date (mmldd/yyyy) c. EmployeesName/Specific Field 02/14/2018 State of North Carolina E End Date (mm/dd/yyyy) 12/31/2022 g. Rate h. Security Pledged 1. Original Loan Amount j. Remaining Loan Balance 0 % None $ 1,105 $ 1,105 L Full Name of lending Institution I. Loan Number N/A 8 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & tip) b. Job Title/Profession d. Comments Union County Clerk of Superior Court Jeffery Rowell�C, C 9 2708 Dellwood Drive Monroe, NC 28112 rr w��� 704-226-8957 _ �C Z 02 p „5r �O S k n e. Start Date (mm/dd/yyyy) c. Employer's Name/Specific Field 03/02/2020 State of North Carolina r. End Date (mn✓aa/yyyy) 12/31/2022 g. Rate h. Security Pledged i. Original Loan Amount J. Remaining Loan Balance 0 a/0 None $ 300 $ 300 L Full Name of Lending Institution 1. Loan Number N/A 9 3. Lender Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job TinetProfession d. Comments Union County Clerk of Superior Court e. Start Date (mm/ddlyyyy) c. Employer's Name/Specific Field L End Date (mmlddlyyyy) g. Rate h. Security Pledged Loan Amount j. Remaining Loan Balance None f0n�gglnsl $ L Full Name of Lending Institution 1. Loan Number N/A 4. Total only this Pae $ 1,405 5. Total of ALL CRO -1430 Pages (This fine must be on One 2l ojDetaded Sumnmry Page CRO -1700) $ 5,063 CRO -1430 NC State Board of Elections December 2007 PTH CAR STATE BOARD ELECTIONS fte 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: The Committee to Elect J.R. Rowell U.C. clerk of superior court • Person or committee to make loan: Jeffery Rowell • Date of loan to committee: 03/02/2020 • Name of lending institution and account number (source): N/A • Amount of loan: $300 • Description (if in-kind loan): N/A • Names of all parties responsible for payment of loan (guarantors): N/A • Period of loan: 03/02/2020 through 12/31/2022 • Rate of interest of loan: 0% • Security pledged for loan: None Jeffery Rowell , acknowledge that all of the information (Person lending money to committee) provided is complete, true, and accurate. I further understand I may not forgive a loan that has an outstanding balance any source. 03/02/2020 Signat nde& Date Signed '"�\ - -_ � c 1) 1. 4- 03/02/2020 Sloature of Treasurer of Committee CRO -6100 Loan Proceeds Statement Date Signed