Teague,Charles_2022-1st-qtr-amended-pagesAmendment
Disclosure Report Cover , . o No
Use this form for general report and committee information, must he signed and submitted along with thci dctallcd ILrnn.
Do not use this Rmn to undutc inlirnnuilon.
1 Committee Information
a.Full Name
c. ID Number
tornmtlt d Eled 1" l,aG Por 1 �ef-k
d U /M l
b. Mailing Address (Include City, State and Zip Code)
it. Date Filed
QU Camera%on
0'7 -/Z-Z?-
�rCdurt
Mon roc i C' 018 112,
e. Phone Number
r7o4-567 014q
2. Report Year
3. Period Start Date (mn✓ddtyy)
4. Period End_Datehmydd yy) 5. TceasurerFull _Name
22
`t Jilie Wiens '&l 14:1
6.: Type of Cmmnittee (Check One)
9. Type of Report '(checkartly
o` pe(ireport
front one category)
Candldatc Cainp'aien ❑ 1'any
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑ Organizational
❑ Organizational
❑ Organizational
❑ Independent Expenditure Q Joint Fundraiser
❑ Thirty-five dayry1
Quarterly
[3r Preferendum
❑ Legal Expense Fund
❑ Pre-primary
L_7 First
[3Final
❑ Pre-election
❑ Pre -runoff
❑ Second
❑ Third
❑ Supplemental Final
❑ Annual
i. Type of Fund ` (if appiirnhle, cheek ,ne)
❑ Booster Fund
Semi-annual
❑ Fourth
❑ Special
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year End
❑ Mid Year
10. Special Report Name
❑ Other
❑ Final
❑ Special
❑ Year End
❑ Final
S. Number of Fundraisers this Report
_..
_01
❑ Special
11. Account Information
11. Account Ltformation'%
a. Financial Institution Full Name
a. Financial Institution Fldl Name
I-Ir5t t e—n5
b. Purpose
C. Account Code
b. Purpose
c. Account Code
oheaA Ing Reeoun t
W6
Pt) r L10 rn m i Ift—j--
d. Period Begin Balance
d. Period Begin Balance
$
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 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 NC State Board of Elections. Rmended-
Tulle 0.B.rinkkw tip - 'a -A6 ;'Z
Printed Name of Signer Signature of Appointed Tneasther Date
FOR OFFICE USE ONLY
Date Received: Employee: Delivery Method
❑ Normal Mail
Date Postmarked: Employee: ❑ Registered Mail
❑ Hand Delivered
Date Scanned: Employee: ❑ Electronically Filed
Date Data Entered: Employee: ❑ 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 snake committee changes.
CRO -1000 NC State Board of Elections August 2008
A�/4,endment
Detailed Summary Q] yes ❑ No
I Ise this form to summarize all disclosure renortine forms and to total monetary information
1. Committee Full Name (and Fund if applicable)
COtAM i fee tiledTea u.-76-6er
2. Type of Report
3. ID Number
D TM 9 (E
Start of Election Cycle: January 1, o I
Total this
Reporting Period
Total this
Election Cycle
4) Cash on Hand at Start
$ 1,
$
RECEIP'T'S
5) Aggregated Contributions from Individuals
6) Contributions from Individuals
7) Contributions from Political Party Committees
8) Contributions from Other Political Committees
9) Loan Proceeds
10) Refunds/Reimbursements to the Comndttee
11) Other Receipt Sources
lla) Interest on Bank Accounts
11b) Contributions from Not -For -Profit Organizations
Ile) Outside Sources of Income
11d) 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 -1265)
$ �p S
$
/ 8 . d 5
$ q 3 d
$
, 5 eo
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
12)TOTAL RECEIPTS (Add lines 5, 6,7, 8, 9,10,1 la,l lb,l lc,l Id and l lel$
438U.05
I $
5414.65
EXPENDITURES
13) Disbursements
13a) Operating Expenditures
13b) Contributions to Candidates/PoUtical Committees
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 -1310)
(CRO -1310)
(CRO -1315)
(CRO -1420)
(CRO -1320)
(CRo-1510)
$
$,
$
$
$
$
$
$
$
ICEIVEr
$
$
$ 3 01.30
$
451A.86
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and 17)
$ 319 I . B0
$
4 5 5J • f3O
19) Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18
$ 34-8 A13
$
,(oJ
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
3) Debts and Obligations owed to the Committee
4) Account Transfers Within the Committee
5) Administrative Support
6) Forgiven Loans
7) 48 -Hour Notice Reports Sum
8) Contributions to be Refunded
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRO -1620)
(CRO -1720)
(CRO -1710)
(CRO -1440)
(CRO -2220)
(CRO -1215)
$
$
$
$
$
$
$
$
$
$
$
$
$
CRO -1100 NC State Board of Elections Auena Sons
C/) � �� 51,q1zdJ
Aggregated Contributions from
ttj ad d1 -OM * W- AAf-V A
PjiLted e td q 13017z,Amendment
Individuals Page _ of _ ® les ❑ No
1. Committee Full Name (and Fund if applicable)
2. ID Number
Comrn& e 16 E est C uekTfa QC -Cr clerk
E
3. Contributor Information
a. Amend
b. Account Code
c. Form oof Payment
d. Io -Kind Description
a Date (mm/dd/yyyy)
L Amount
CI /SIG
(�� �� �Z%i
'7
$ ` 8, oK
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4. Total only this Page
$
5. Total of ALL CRO -1205 Pages
$
(This line must be online S of Detailed Summary Page CRO -1 /00)
CRO -1205 NC State Hoard of Flections March 2003