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Smith,Brandi_2021-Year-endr ind Disclosure Report Cover o Yes °t o 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 Inforrtation a. Full lame c.ID Number . Malting Adderouch de aty, State and zip code) a. Date FOW V SD A olC*4t.e_ tan J i a �- �����11� ffc �V 73 a 7 Number LJ 2. Re rt Year 3. Period Start D to trim/ 4. Period End Date immf 5 Dc�� a 3� 6. T_ of Committee (Check One) 9. Type of Report (check only one a of reporrfrom one category) Candidate Campaign ❑ Party Municipal Statelcounly Referendum ❑ PAC ❑ Referendum ❑ Organimtional ❑ Organizational ❑ Organizational ❑ Independent Expenditure ❑ Joint Fundraiser ❑ Thirty-five day Quarterly ❑ Pre -referendum ❑ Legal Expense Fund ❑ Pre-primary ❑ Fust ❑ Final ❑ Pre-election ❑ Pre -runoff Semi-annual ❑ Second ❑ Third ❑ Fourth ❑ Supplemental Final ❑ Annual ❑ Special . Type of Fund Wapplicable, check one) ❑ Boaster Fund ❑ Building Fund ❑ Mid Year Semi-annual Year End ❑ Mid Year 10. Special Report Name ❑ Other: nal ❑ Special ❑ Year End ❑ Final 8. Number of Fundpisers this Report _—_._. _ — __ ❑ Special 11. Account Information 11. Account Information . Financial Institution FY�Nanim a. Financial Institution Full Name . Purpose e. Account Code It. Purpose c. Account Code d. eri/ Balance daPeriod Begin Balance $ 00 . D _Begin _ Cl 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 w' hibaed or other non -disclosed funds. I further certify that this report complete, truue� and corte�cI andthat 1 have been train the VC tBoard of Elections. tis ^� LI) O Printed Name of Si a Si azure of inted T iter Date FOR OFFICE USE ONLY _ eth Date Received: —}� F�--tzJ-- Emplo ❑ Normal Mail Date Postmarked: Employee: Regi red Mail and Delivered Date Scanned: Employee: Electronically Filed ❑ Signer has not received Date Data Entered: Employee: training Aaaa"""�mandatory Please Note: This form cannot be used to amend committee information such as the committee address, treasufci. assistant treasurer, custodian of books information, or account information. You must amend the Statement of Organization (CRO -2 I OOA-E) to make committee changes. H CRO -1000 NC State Board of Elections August '(1 i� RECEI ..D Amendment Detailed Summary ❑ Yes ❑ No Use this form to summarize all disclosure reoortine fortes and to total monetary information 1. Committee Fall Name (an if le) 2. Type of Report 3. ID umber g t0h Start of Election Cycle: January], Total this Reporfiw Period Total this Election Cycle 4) Cash on Hand at Start I $ 7 $ RECEIPTS 5) Aggregated Contributions from Individuals 6) Contributions from Individuals 7) Contributions from Political Party Cormnittees 8) Contributions from Other Political Committees 9) Loan Proceeds 10) Refunds/Reimbursements to the Committee 11) Other Receipt Sources Ila) Interest on Bank Accounts 11b) Contributions from Not -For -Profit Organizations Ile) Outside Sources of Income 1 Id) Legal Expense Fund - Other Sources Ile) Exempt Purchase Price Sales (CRO -1205) (CRO -1210) (CRO -1220) (CRO -1230) (CRO -1410) (CRO -1240) (CRO -1250) (CRO -1250) (CRO -1250) (CRO -1270) (CRO -7265) $ $ $ �, 3 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9,10,1 la l Ib,l lc,l Id and I le $ 1 261 3 $ 3 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 (CRO -1370) (CRO -1310) (CRO -1310) (CRO -1315) (CRO -1420) (CRO -1320) (CRO-7SI0) $ $ $ $ $ $ $ $ $ $ $ $ $ 1 J $ 18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ 73 $ 19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18 $ $ COO ADDITIONAL INFORMATION 0) Non -Monetary Gifts Given to Other Committees 1) Outstanding Loans (incl. ones from other campaigns) 2) Debts and Obligations owed by the Committee 23) Debts and Obligations owed to the Committee 24) Account Transfers Within the Committee 5) Administrative Support 6) Forgiven Loans 7) 48 -Hour Notice Reports Sum 128) Contributions to be Refunded (CRO -1330) (CRO -1430) (CRO -7610) (CRO -1620) (CRO -1720) (CRO -1710) (CRO -1440) (CRO -2220) (CRO -1215) $ $ . $ OF $ $ $ $ $ $ Unm $ 4,MPAIGN $ $ CRO -1100 NC State Board of Elections -' "' 20M RECEIVED Amendment Contributions from Individuals Pg _ of p_Yes No Use Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used 1. ConmiCiffid " " _ -applicable) 2. ID Number 3. Contributor Information 0 Add ❑ Remove, . Full Name, Mailing Address & Phone (include city, state, & zip) h. Job Title/Profession d. Comments Employe Name/Specific Field e. Election Sum to Date . Prior IL Form of Payment i. In-Kind�D�esccrripti '. Date (mnlddlyyyy) k Amount ^ `n/ 13$ ❑ f $ 3. Contributor Information ❑ Add ❑ Remove . Full Name, Mailing Address & Phone (include city, slate, & zip) b. Job Title/Profession d. Comments c. Employer's Name/Specific Field e. Election Sum to Date $ L Prior 13$ g. Account Code It. Form of Payment i. In -hind Description j. Date (mm/dd/yyyy) k Amoral 13$ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments a Employer's Name/Specific Field e. Election Sum to Date $ . Prior g. Account Code It. Form of Payment i. In -Kind Description j. Date (mmlddlyyyy) k Amount ❑ $ ❑ $ ❑ $ 4. Total only this Page $ qqa, 3 5. Total of ALL CRO -1210 Pages CAMPAIGN FINANCE (Thus Gne must be on Gne 6 of Detailed Summary Page CRO -1100) $ CRO -1210 NC State Board of Elections RECEIVED April 2007 r`J Amendment -- In -Kind Contributions Pg _ of _ ❑ Yes ❑ 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 or will be refunded within 7 dans. 1. Committee Full Name (andd ' applicable) _ _ _ 2. ID Number ILL 3. Contributor Information ❑ A d Remove . Full Name, Mailing Address & Phone (include city, state, & zip) n _�, (� % l' �I641J� •trim`",(_ `�-i�/ �f''�1� I. Type of Contributor ndividual ❑ Candidate ❑ PAY ❑ PAC c. Comments " ' ❑ Referendum d. Election Sum to Date J � Q 1 % 2 r//1lL/th• ` \l Q I [ [3 Other Receipt Source $ e. Description f. Date (mmldd/yyyy) I I g. Fair Market Amount $ it U-7 �. Lo✓r� cr C°� e� r $ 3. Contributor Information ❑ A id ❑ Remove a. Full Name, Mailing Address & Phone (include city, slate, & zip) h. "I vpe of Contributor ❑ Individual a Comments ❑ Candidate ❑ Party ❑ PAC ❑ Referendum d. Election Sum to Date ❑ Other Receipt Source $ e. Description f. Date (m /ddlyyyy) g. Fair Market Amount S 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include -city, -state, & zip) b. Type of Contributor ❑ Individual ❑ Candidate c. Comments ❑ Party ❑ PAC ❑ Referendum d. Election Sinn to Date ❑ Other Receipt Source $ e. Description C Date (mmlddlyyyy) g. Fair Market Amount $ $ $ 4. Total only this Page iAN 21 2022 Is 5. Total of ALL CRO -1510 Pages R (This line must be online 17 of Detailed Summary Page CRO -1700) D $ /U 3 1 1 CRO -1510 NC State Board of Elections December 2007