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Smith,Brandi_2021-PreElectionReportndm DISCIOSure Report Cover `AOmeYes ❑ No Use this form for Lencial report and committee information, must be signed and submitted along with other detailed forms. Do Hot u.c thi, 101111 Io updulr in!brin.Hiou_ L Committee Information a. full Name c. ID.Number i�rCULZL'� It. Mailing Address (include City, State and Zip Code) it. Date Flied _ rj�/00 �C-M - e. Ph rte Num er ffC ;�i-73 1j6Wh67_Z0 2, Report Year 3.'Period Start Date (mm/dd/yy) 4. Perjoij End Pate (mm/dd/yy) 5. Treasure ull Name �0 al L i v 6:aype of Committee juG`heck Ong 4. Type of Report Municipal (check only one type of report State/County front one category) Referendum �'Eandidate Campaign ❑ Party ❑ PAC ❑ Referendum❑ izational ❑ Organizational [3 Organizational [3O Independent Expenditure ❑ Joint Fundraiser -five day Quarterly ❑ Pre -referendum ❑ Legal Expense Fund Ob -primary Pre-election ❑ First ❑ Final ❑ Pre-mnoff ❑ Second ❑ Third ❑ Supplemental Final ❑ Annual 7. Type of Fund (if njip(lrnhfe; ' ❑ Booster Fund Semi-annual ❑ Fourth ❑ Special ❑ Building Fund ❑ Mid Year Semi-annual ❑ Year End ❑ Mid Year 10. Special Report Natkte,', ❑ Otho. ❑ Final ❑ special ❑ Year End ❑ Final 8: Namber of Fundraisers this Report ❑ Special 11. Account Information 11. Account Information a. Financial Institution Full Name a. Financial Institution Full Name It. Purpose c. Account Code h. Purpyg PAIGN FINANI H5 c. Account Code 00 �T 0C I 7 2 5 2021 d. Period Begin Balance it. Period Begin Balance �CCY $ 0D , IL EIVEL) $ CERTIFICATION I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B & 22D -22M of Chapter 167 of the NC General Statutes and that no funds are commingled witl er non-clisclosed limits. father certify that this report is complete, true and correct and that 1 have been trained It C State Board of Elections. r 0 Printed Name of Signer Signat e p d Treas r Date FOR OFFICE USE ONLY Date Received: 1 Employee: Delivery Method ❑ Normal Mail ❑ Registered Mail Date Postmarked: Employee: Hand Delivered Date Scanned: a Employee: Electronically Filed Date Data Entered: Employee: I-] Signer has not received 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 -2100A -E) to make committee changes. CRO -1000 NC State Board of Elections August 2008 Detailed Summar Amendment y ❑ Yes ❑ No Use this form to summarize all disclosure reoortine forms and to total monetary information 1. Committee Full Name (and Fund jftapplicable) _ 6Y (t _Type eport- _ 3. ID Number t015 Start of Election Cycle: January 1, otal this Period Total thisReg2rfig Election Cycle 4) Cash on Hand at Start I$ O $ RECEIPTS 5) Aggregated Contributions from Individuals 6) Contributions from Individuals 7) Contributions from Political Party Committees 8) Contributions from Other Political Committees (CRO -1205) (CRO -1210) (CRO -1220) (CRO -1230) $ $ $ O $ $ $ $ 9) Loan Proceeds _ (CRO -1410) $ $ 10) Refunds/Reimbursements to the Committee Il) Other Receipt Sources lla) Interest on Bank Accounts llb) Contributions from Not -For -Profit Organizations lle) Outside Sources of Income 11d) Legal Expense Fund - Other Sources lle) Exempt Purchase Price Sales (CRO -1240) (CRO -1250) (CRO -1250) (CRO -1250) (CRO -1270) (CRO -1265) $ $ $ $ $ $ $ $ $ $ $ $ 12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10,11 a, I I b, I I c, I I d and I I e) $ D.(n $tpq2i.hs EXPENDITURES 13) Disbursements 13a) Operating Expenditures 13b) Contributions to Candidates/Political Committees (CRO -1310) (CRO -1310) $ $ $ $ 13c) Coordinated Party Expenditures 14) Aggregated Non -Media Expenditures 15) Loan Repayments 16) Refunds/Reimbursements from the Committee 17) In -Kind Contributions (CRO -1310) (CRO -1315) (CRO -1420) (CRO -1320) (CRO -1510) $ $ $ $ $ $ $ $ $ oa i� $ 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ V7i $ G - 19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18 $ M 01) $ 00 ADDITIONAL INFORMATION 0) Non -Monetary Gifts Given to Other Committees (CRO -1330) 1) Outstanding Loans (incl. ones from other campaigns) (CRO -1430) 22) Debts and Obligations owed by the Committee (CRO -1610) 3) Debts and Obligations owed to the Committee Ot((t620) 4) Account Transfers Within the CommitteCAM�N F1 720)FI 720) $ $ $ $ $ 5) Administrative Support 2 5 001710) $ $ 6) Forgiven Leans C $ $ 7) 48 -Hour Notice Reports Sum 8) Contributions to be Refunded 0) (CRO -1215) $ $ $ $ CRO -1100 NC State Board of Elections August 2008 Amendment Contributions from Individuals Pg of ❑ Yes ❑ No Use this form to report individual contributions over $50 or contributions under S50 if form CRO 1205 is not used 1. Committee Full Name (and Fund if applicable) _ 2. ID Number 3. Contributor Information A ❑ Remoye a. Full Name, Mailing Address & Phone ((in�cludde' city, state, & zip) b. Job Titie/Prof n d. Comments / d'r(��y� /' ,,[(, ,�/O ' , ,� n ,, T W M C.Y�-��"�C Mme" (Z" '7 3 c. Employer's Name/Specific Field n ��C , e. Election Sum to Date f. Prior g. Account Code It. Form of Payment i. In -Kind Description j. Date (mmtdd/yyyy) k Amount ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. full Name. Mailing Address & Phone (include city, state, & zip) b. Job TitletProfession d. Comments c. Employer's Name/Specific Field e. Election Stun to Date $ f.Prior g. Accounl Code h. Form of Payment i. In -Kind Description J. Date (mmtddtyyyy) k Amount ❑ $ ❑ $ 3. Contributor Information ❑ Add ` ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip)_ Id COUNTY At RIN E b. Job Title/Profession d. Comments -- c. Employer's Name/Specific Field e. Election Sum to Date $ f.Prior g. Account Code h. Form of Payment I. In -Kind Description J. Date (mmldd/yyyy) k Amount ❑ RECEIVED $ ❑ $ 4. Total only this Page Is ito 5. Total of ALL CRO -1210 Pages (This line must be on line 6 of Detailed Summary Page CRO -1100) $ CRO -1210 NC.St.r_ hoxd of[ lcciiom April 2007 Amendment In -Kind Contributions Pg _ of _ [3Y es ❑ No 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 of will be refunded within 7 days_ 1. Committee Full Name (and Fund if applicable) 2. ED Number 3. Contributor Information A d ❑ Remove . Full Name, Mailing Address & Phone (include city, slate, & zip) &,(,A e4' /y�, y{/�/ 7�- ,Q���� }'� // 70w / L ly'4 _ - ' / ""' � ' ` �0/r/ 2 (M.til LL l b. 'I _N pe of CoutribatW c. Comments -- _-- OA1.1mclual --- ❑ Candidate ❑ Party PAC Ell Referendum ❑Other Receipt Source d. Election Sum to Dale $ Ll D— 1 . Description f. Date (mm/dd/yyyy) g. Fair Market Amount S (� $ ,. vO 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Type of Contributor ❑ Individual - ❑ Candidate ❑ Party ❑ PAC ❑ Referendum ❑ Other Receipt Source c. Comments - d. Flection Sum to Date $ e. Description f. Date (mm/dd/yyyy) 1g. Fair Market Amount $ $ 3. Contributor Information ❑ Add ❑ Remove . Full Name, Mailing Address & Phone (include city, state, & zip) GOUNN UNION FINANGE CAMPAIGN b. Type of Contributor ❑ Individual ❑ Candidate ❑ Party ❑ PAC ❑ Referendum E3 Other Receipt Source c. Comments d. Election Sum to Date $ e. Description OCT f. Date (mm/dd/yyyy) g. Fair Market Amount $ 4. Total only this Page $ d1i 5. Total of ALL CRO -1510 Pages (This line must be on line 17 of Detailed Summary Page CRO -1100) CRO -1110 NC' State Board of Flections December 2007