Stone,Tracy_2021-Year-endDisclosure Report Cover o t ❑ 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. Cottee Information
. Full Name
e. ID Number
I 2- 0
. Mailing Address pnciade Cny, State and Zip Code) Qd.
Filed
8 Lac V4 C�
e. Phbne Number
_Report Year
3. Period Start Dais (®mtaany)
Period Date (®Idayy) S. Treesarer Fall Name
14.17- 1 7-1 O�
of Committee
9. Type of po (check
only one type of repo
category)
c_ tegory)
t �Type
101 Candidate Campaign ❑ Party
Municipal
StateiCooaty
_
Referendum
❑ PAC ❑ 1tefeaendum
❑ organizational
❑ Organintiooal
❑ Organizational
❑ Independent Expenditure ❑ Joint Fundraiser
❑ Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fond
❑ Pre-primary
❑ Fust
❑ Final
❑ Pre-election
❑ Pre -runoff
❑ Second
❑ Third
❑ Supplemental Final
❑ Annual
7. Type of Fund (if applicable, check one)
❑ Booster Fond
Semi-annual
❑ Fourth
❑ Special
❑ Building Fund
❑ Mid Year
Semi-annual
® Year End
❑ Mid Year
10. Special Report Name
❑ other:
❑ Final
❑ Special
❑ Year End
❑ Final
. Number of Fundraisers this Report
1
10 Special
11. Account Information
11. Account Information
Financial Institution Full Name
a. Financial Institution Full Name
b. Purpose
e. Account Code
b. Purpose
c. Account Code
�.1Y1Pd* �i
d. Period Begun Balance _ _
& Period Begin enlance
$
$
CERTIFICATION
I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22D & 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 andcorrectand that I have been trained by the C S t and of Elections.
I %
Printed of Signer I SNmew 417AOpomted Treasurer Date
FOR OFFICE USE ONLY
Date Received: _� Employ e od
❑Normal Mail
Date Postmarked: Employee: stared Mail
Delivered
Date Scanned: Employee: Electronically Filed
❑ Signer has not received
Date Data Entered: Employee: mandato traimn
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.
CRU -1000 NC State Board of Elections J H IV I - 'I)(.! August 2008
RECEIVED
VeWled Summa ABt
❑Y"es ❑ No
Use this form to summarize all disclosure retorting forms and to total monetary information
1. Committee Full Name (and Fund if applibl)
C G � 1
4
2. Ty of Report
SGS
3, ID Number
31�Z3�o
Start of Election Cycle: January 1, Z021
Total this
Period
Total thisReporting
Election Cycle
4) Cash on Hand at Start
$ _
$ _
RECEIPTS
5) Aggregated Contributions from Individuals (CRO -1206)
6) Contributions from Individuals (CRO -7210)
7) Contributions from Political Party Committees (CRO -1220)
8) Contributions from Other Political Committees (CRO -1230)
9) Loan Proceeds (CBO -1470)
10) Refunds/Reimbursements to the Committee (CRO -1240)
11) Other Receipt Sources
Ila) Interest on Bank Accounts (CRO -1250)
11b) Contributions from Not -For -Profit Organizations (CRO -I250)
llc) Outside Sources of Income (CRO -1250)
lld) Legal Expense Fund - Other Sources (CRO -1270)
1le) Exempt Purchase Price Sales (CRO -7265)
$
$ �L
$ Z
$ 1
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9,10,11 a,I lb,11c,1 ld and I le
$
$
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (CR01310)
13b) Contributions to Candidates/Political Committees (CRO -1310)
13c) Coordinated Party Expenditures (CRO -7370)
14) Aggregated Non -Media Expenditures (CRO -1315)
15) Loan Repayments (CRO -1420)
16) Refunds(Reimbursements from the Committee (CRO -1320)
17) In -Kind Contributions (CRO -1570)
$
$
$
$
$
$
$
$
$
$
$
$
$
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$
$
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 -7330)
1) Outstanding Loans (incl. ones from other campaigns) (CRO -1430)
2) Debts and Obligations owed by the Committee (CRO -7610)
3) Debts and Obligations owed to the Committee (CRO -7620)
24) Account Transfers Within the Committee (CRO -7720)
5) Administrative Support (CRO -7710)
6) Forgiven Loans (CRO -7440)
7) 48 -Hour Notice Reports Sum (CRO -2220)
8) Contributions to be Refunded (CRO -1215)
$
$
$
$
$
$ $
$ $
$ $
$ $
CRO -1100 NC State Board of Elections August 2008
Amend
Contributions from Individuals Pg _ of _ p Ya p 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
. Full Name, Mailing Address & Phone
(include city, state, &zip)
� �
b. Job Title/Profession
�"QxRSC>�Ceri�
d. Comments
c Employer's HweI8ped0e FLW
e. Election Sum to Date
.Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
Date (mmlddfyyyy)
t Amount
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
1�. Mlk
9hV;9_
k S WQc 2` 1,�A
b. Job Title/Profession
�
d. Comments
c Employer's Field
S -4z, cf
, \G
& Election SmatoDwe
$ I Z4
f.Prior
g. Account Code
h. Form sf Faymt't
L la -Kind Denc ipWm
J. hale (mmMWyyyy)
t Asmant
❑
Z Z 1�
$ (
W
❑
$
3. Contributor Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
c. Employer's Name/Specific Field
Is. Ekdlae Sum to Date
.Prier
`.Account Code
h.Formof Payment
i. In -Kind Description
J. Date(s®Iddlyyyy)
LAsssunt
p
$
❑
$
❑
$
4. Total only this Page
$ 7_03
5. Total of ALL CRO -1210 Pages
(This line mull be on line 6 of Deoriled Summary Page CRO -1100)
$ 2 OQ
CRO -1210 NC State Board of Elections April 201f7