Loading...
Stone,Tracy_2021-Year-end-amendArnenthava Disclosure Report Cover YY ` 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 Information a. Full Name c. ID Number l C o S{ocr-o� c ( Z3 0 Malliag.wbemi 0wha& ty4`j swe as aP Code) d. Doe Fled Aso L" cX- C� e wS, c, ZB t c){ ( 1 77 Z -z . ,ret e. Ph oe Number %, 2. keport Year 3. Period Start (Date (mmladlyy) 4. Period Date (VOW&Yyy) 1 o ! g S. Treasurer FuoO PWIM -- of Committee(_ e_c ) 9. a[ (check only onet�W of repo one category) Candidate Campaign ❑ Party Municipal state/County Referendum ❑ PAC ❑ Referendum ❑ Organvatiwal ❑ Organirational ❑ Organizational ❑ Independent Expenditure ❑ Joint Fundraiser ❑ Thirty-five day Quarterly ❑ Pre -referendum ❑ Legal Expense Fund ❑ Pre-primary ❑ First ❑ Final [:I Pre-election ❑ Pre-reaoff ❑ Second ❑ Wit] ❑ Supplemental Final ❑ Annual i. Type of Fund (iifapplicable, check one) ❑ Booster Fund Semi-annual ❑ Fourth ❑ Special ❑ Building Fund ❑ Mid Year Semi-annual ® Year End ❑ Mid Year 10. Special Report Name ❑ Other: Final IN special ❑ Year End ❑ Final S. Number Fundraisers this Report ❑ Special 11. Account Information 11. Account Information Financial Institution Fall Name a. Financial Institution Full Name b. Parpaee c Account Code b. Purpose c. Account Code GAnf'� 0I CU q n d. Period Bede B_ alaai e d.. Period Bede ish a err _ - $ �ioo °= $ CERTIFICATION I 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. I further certify that this report is complete, true and correct and that I have been trained by the C S t atd of Elections. L .S -i'7 Printed N of Signer I S' oiuted Treasurer tate OR OFFICE USE ONLY Date Received: Employ e ad [3 Normal Mail Mail Date Postmarked: Employee: sL li liveredDate Scarred: Employee:PElectrcally Filed l] Signer has not received Date Data Entered: Employee: mandato traman Please Note: This form carrot 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 Stare Board of Elections 'v Augu,i'--pus RECEIVED Amendment Detailed Summary ❑ Yes ❑ No Use this form to summarize all disclosure mounting forms and to total monetary information 1. Committee Full Name (and teport 3. ID Number Elnva_ Lr Y G Start f Election Cycle: Janus 1, 90 Total this Reporting Period 'total this Election Cvcic 4) Cash on Hand at Start $ -- $ RECEIPTS 5) Aggregated Contributions from Individuals (CRO -1205) 6) Contributions from Individuals (CRO -1210) 7) Contributions from Political Party Committees (CRO -1220) 8) Contributions from Other Political Committees (CRO -1230) 9) Loan Proceeds (CRO -1410) 10) Refunds/Reimbursements to the Committee (CR04240) 11) Other Receipt Sources 11a) Interest on Bank Accounts (CRO -1250) 11b) Contributions from Not -For -Profit Organizations (CRO -1250) 11c) Outside Sources of Income (CRO -1250) 11d) Legal Expense Fund - Other Sources (CRO -1270) 11e) Exempt Purchase Price Sales (CRO -1265) $ $ $ $ $ $ $ $ ti $ 5 S $ $ $ $ $ $ $ $ $ 12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8,9, 10,1 la,l lb,l lc,l ld and Ile) $q0-6-5:— $ EXPENDITURES 13) Disbursements 13a) Operating Expenditures (CRO -1310) 13b) Contributions to Candidates/Political Committees (CRO -1370) 13c) Coordinated Party Expenditures (CRO -1370) 14) Aggregated Non -Media Expenditures (CR04315) 15) Loan Repayments (CRO -1420) 16) Refunds/Reimbursements from the Committee (CRO -1320) 17) In -Kind Contributions (CRo-1510) $ $ $ $ $ $ $ $ $ ti $ 18) TOTAL EXPENDITURES (Add fines 13a, 13b, 13c, 14, 15, 16 and 17) $ — w 19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18 $ S ADDITIONAL INFORMATION 0) Non -Monetary Gifts Given to Other Committees (CRO -1330) 1) Outstanding Loans (incl. ones from other campaigns) (CRO -1430) 2) Debts and Obligations owed by the Committee (CRO -1610) 3) Debts and Obligations owed to the Committee (CRO -1620) 4) Account Transfers Within the Committee (CRO -1720) 5) Administrative Support (CRO -1710) 16) Forgiven Loans (CRO -1440) 7) 48 -Hour Notice Reports Sum (CRO -2220) 8) Contributions to be Refunded (CRO -1215) $ $ $ $ $ $ $ $ $ $ $ $ $ CHH -11M NC State Board of Elections August 2008 Amendment Contributions from Individuals Pg _ or _ 0 Yes ❑ No Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used 1. Committee Full Name (and Fund if applicable) 2. ID Number 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) 1'�yC �1�1Q�, ��hews NQ_ f a� b. Job TitleJProfession d. Comments e. Empby1er's Namd3pedee Fldd (),f �Jes-� << a Election Sum to Date $ l f.Prier g. Aceomt Code h. Form of Psymeffi L lo -Shod DowwWou J. Date (mm/dd/yyyy) k. Amomt ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove Full Name. )sailing Address & Phone (include city, state, & zip) W 1��Mlk --- r�� r� `j–'�[� 1 ! p � � � k�� M ` 1"ti 011 "^' �� c, NC, 2St � b. Job TitlelProtession alt d. Comments e. Employer's N [`�/•'� wellipedO Field ✓� �-' — ` \Gc� e. Flection Sam to Daft Is I Z� r.mor g. Aoromt Code h. Form ofPsymom L tooWnd Do w"m J. Date (mm/ddlyyyy) k. Amount ❑ $ IW ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name. Mailing Address & Phone (include city, state, & zip) h. Job Title/Profession d. Comments c. Employer's Nana•ISpecific Field e. Election Sum to Date . Prlor g. Aecount Code h. Form otPayment L 1n KhW Deg9ptlm i. Date (mm/dd/yyyy) k. Amaro t ❑ $ ❑ $ 4. Total only this Page $ Z0i3 5. Total of ALL CRO -1210 Pages $ z OO (This line must be online 6 of Detailed Summary Page CRO -1100) CRs) -1210 NC State Board of Elections April 2W7 Amendment Refunds/Reimbursements From the Committee Pg of _ ❑ 1,cs ❑ No Use this form to report refunds/reimbursements, including contributions returned to the contributor. 1. Committee Full Name (and Fund if applicable) 2. ID Number Cry S �cx 1, n M ( <Tt-:3i4,7_z4 0 3. Payee lnfo tion Add ❑ remove . Full Name, Mailing Address & Phone d. Type of Committee h. Original Receipt Date (include city, state, & zip)® Candidate ❑ PAC l� C3. `fi) f \� ❑ Referendum ❑Party e. Level Registered ❑ Federal County: ❑ State ® Municipality: i. Original Receipt Anunurt $ f. Purpose Code J. Election Sum to Date zmc) -.-_$ qac. oc • Job Title/Profession jc. Employer's Name/Specific Field Ig. Comments 1k. Account Code W (31 1. orm of Pay Im. Req ed Remarks n. Date ( d yyy) o. Amount nnll 3. Payee Information ❑ Add ❑ Remove . Full Name, Mailing Address & Phone d. Type of Committee h. Original Receipt Date (include city, state, & zip) ❑ Candidate ❑ PAC ❑ Referendum ❑ Party e. Level Registered i. Original Receipt Amount ❑ Federal —a County: ❑ Slate ❑ Municipality: $ L Purpose Code J. Election Sam to Date $ b. Job Title/Profession c. Employer's Name/Specific Field g. Comments k Account Code I. Form of Payment m. Required Remarks In. Date (mmldd/yyyy)o. Amount $ 3. Payee Information ❑ Add ❑ Remove a. Full Name, Mailing Address At Phone d. Type of Committee h. Original Receipt Date (include city, state, &zip) ❑ Candidate—[3 PAC — ❑ Referendum ❑ Party e. Level Registered i. Original Receipt Amount 13 Federal County: [3State El Municipality: $ f. Purpose Code '. Election Sum to Date $ b. Job Tide/Profession c Employer's Name/Specific Field g. Comments k Account Code I. Form of Payment m. Required Remarks n. Date (nmt/dd/yyyy) o. Amount 4. Total only this Page $ 5. Total of ALL CRO -1320 Pages (This fine must he on line 16 o Detailed Summa Page CRO -1100 ((�� .�, $ C)0 t ,eW 6. Purpose Codes (List detailed disbursement code in (f) above) L - Returned to Contributor M - Overpayment for Service N - Exceeded Contribution Limit P* - Reimbursement of In -Kind O* Other * Codes re uire detailed ex lanation in reandred remarks field m CRO -1320 NC State Board of Elections December 2007 VOTE © NORTH CAROLINA mT� STATE BOARD OF ELECTIONS Certification to Close Committee This Certification is used to express the intent to close the committee after all funds have been properly disbursed. This Certification is filed at the Board of Elections office where the committee's campaign reports are filed. FILED BY: Committee Name: Treasurer Name: Treasurer Address: Treasurer Phone: I certify that the above mentioned Committee intends to close and cease existence. Upon signing this certification, I declare that all funds have been distributed and reported (if required). In addition, no contributions will be accepted or disbursements made after the "Final Report" is filed or this form is signed. If the Committee at any future time intends to accept or spend funds in support or opposition of any candidate or ballot issue, a new political committee must be formed and registered with the Board of Elections before such activities may commence. Committees that have filed under the $1,000 threshold will only be required to sign this Certification. No "Final Report" will be required for committees meeting this criterion. Any Committee that did not file under the $1,000 threshold must submit a "Final Report" with this Certification. This report must have a zero balance with no outstanding loans or debts. Dae Signed CRO -3400 Certification to Close Committee