Thomas,Jonathon_2021-Year-endAmendment
Disclosure Report Cover I ❑ Yes ❑ No
Use'this form for general report and committee information, must be signed and submitted along with other detailed forms.
Flo not use this form to update information
1. Committee Information
a. Full Name
c. ID Number
Thomas for Union County
JRT 72221
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
2001 Belle Forest Court
1/10/2022
Waxhax NC 28173
e. Phone Number
704-771-4940
2. Report Year
3. Period Start Date (mm/dd/yy)
4. Period End Date
5. Treasurer Full Name
mm/dd
Patrick
2021
07/22/2021
12/31/2021
Harrison
6. Type of Committee Check One
9. Type of Report
check on one twe o re ort rom one category)
® Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ Organizational
❑ Organizational
❑ Organizational
❑ PAC ❑ Referendum
Independent ❑ Joint Fundraiser
❑ Thirty-five day
Quarterly
❑ Pre -referendum
❑ Expenditure
❑ Legal Expense Fund
❑ Pre-primary
- ❑ Pre-election
❑ First
❑ Second
❑ Final
❑ Supplemental Final
7. a of Fund (trapplicable, check one)
❑ 'Booster Fond"
❑ Building Fund
❑ Pre -runoff
❑ Third
❑ Annual
Semi-annual
❑ Fourth
❑ Special
❑ Mid Year
Semi-annual
❑ Other:
❑ Year End
❑ Mid Year
10. Special Report Name
❑ Final
❑ Special
® Year End
❑ Final
❑ Special
8. Number of Fundraisers this Report
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
BB&T/T7uist
b. Purpose
c. Account Code
b. Purpose
c. Account Code
Checking
JT22
UNION COUNTY
CAMPAIGN FINANCE
d. Period Begin Balance
d. Period Begin Balance
$ 0
$
JAN 18 2022
CERTIFICATION
�EF j�
I certify that the Committee or Fund is in compliance with all applicable provisions of rc eI2 A, , &
22D -22M of Chapter 163 of
the NC General Statutes and that no funds are commingled with pro
ti ' or o It r non -disclosed funds. I
further certify that this report
is complete, true and correct and that I have been trained by
d f Elections.
Patrick Harrison
e- 01/10/2022
Printed Name of Signer SignaturefAp'
e Treasurer
Date
FOR OFFICE USE ONLY
Delivery Method
Date Received: T Employee:
❑ Normal Mail
❑ rstered Mail
Date Postmarked: Employee:
Hand Delivered
❑ Electronically Filed
Date Scanned: Employee:
❑ Signer has not received
mandatory training
Date Data Entered: Employee:
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
Amendment
Detailed Summary ❑ Yes ❑ No
I lse this form to summarize all disclosure reoortine forms and to total monetary information.
1. Committee Full Name and Fund if applicable)
2. Type
of Report
3. ID Number
Thomas for Union County
Year
End
JRT72221
Start of Election Cycle: January 1, 2021
'total this
Reporting Period
Total
Election Cycle
Cy
4)
Cash on Hand at Start
$
0
$ 0
RECEIPTS -
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 Committee
11) Other Receipt Sources
Ila) Interest on Bank Accounts
llb) Contributions from Not -for -Profit Organizations
lie) Outside Sources of Income
lld) Legal Expense Fund - Other Sources
11 e) Exempt Purchase Price Sales
IRW„
(CRO -1205)
(CRO -1210)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
—
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$
$
$ 100.00
$
$
$
$ 1064.06
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
12)
TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10, Ila, Ilb, Ile, 11dand Ile)
$
1,164.06
$
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 -1310)
(CRO -1310)
(CRO -1310)
(CRO -1315)
-
(CRO -1420)
(CRO -1320)
(CRO -1510)
$
178.54
$
$
$
$
$
$
$
$
$
$
$
$
$
18)
TOTAL EXPENDITURES (Add lines 13a,13b,13c, 14,15,16 and 17)
$
178.54
$
19)
Cash on Hand at End (Add lines 4 and 12 together, then subtract line 18)
$
985.52
$ 985.52
ADDITIONAL INFORMATION
20) Non -Monetary Gifts Given to Other Committees
21) Outstanding Loans (incl. ones from other campaigns)
22) Debts and Obligations owed By the Committee
23) Debts and Obligations owed To the Committee
24) Account Transfers Within the Committee
25) Administrative Support
26) Forgiven Loans
27) 48 -Hour Notice Reports Sum
28) Contributions to be Refunded
(CRO -1330)
(CRO -1430)
(CRO -1610)
(CRO -1620)
(CRO -1720)
(CRO -1710)
(CRO -1440)
(CRO -2220)
(CRO -1215)
$
661
$
$
$
$
$
$
$
C
PAIGN FINANCE
$
$
IAN 1 202?
$
CRO -1100 NC State Board of Elections H C V t v b$nst 2008
Amendment
Contributions from Individuals Pg I or lnri ❑ 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
Thomas for Union County
JRT72221
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
it. Comments
Retired
Elaine K. Stevens
501 Todd Circle
Wingate NC 28174
c. Employer's Name/Specific Field
c. Election Sum to Date
$ 100.00
f. Prior
g. Account Code
h. Form of Payment
i. In-IGnd Description
j. Date (mmldd/yyyy)
k. Amount
❑
Check
11/16/2021
$ 100.00
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Fall Name, Mailing Address & Phone
(include city, state, & zip)
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 (mm/dd/yyyy)
It. Amount
❑
$
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
it. Comments
c. Employer's Name/Specific Field
e. Election Sum to Date
f. Prior
I g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/ddlyyyy)
k. Amount
❑
$
❑
$
❑
$
4. Total only this Page
$ 100.00
5. Total of ALL CRO -1210 Pages
(This line inusf be on line 6 of Detailed Summary Page CRO -1100)
UNION COUNTY 100.00
CAMPAIGN
CRO -1210 NC State Board of Elections JAN 18 April 2007
7.022
RECEIT-77"
Contributions from Other Political Committees Pg
Use this form to report contributions from other candidate, referendum or PAC committees
I Amendment
of 1 I ❑ Yes ❑ No
1. Committee Full Name and Fund if applicable)
2.11) Number
Thomas for Union County
JRT72221
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Type of Committee
d. Comments
® Candidate ❑ PAC
❑ Referendum
Richard Helms
1212 Rosehill Drive
Waxhaw NC 28173
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 1,064.06
f. Account Code
g. Form of Payment
h.In-Kind Description
I. Date (mm/dd/yyyy)
j. Amount
JT22
Check
08/04/2021
$ 1,064.06
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Type of Committee
d. Comments
❑ Candidate ❑ PAC
❑ Referendum
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Election Sum to Date
$
f. Account Code
g. Form of Payment
h. In -Kind Description
i. Date (mmlddlyyyy)
j. Amount
$
$
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Type of Committee
d. Comments
❑ Candidate ❑ PAC
❑ Referendum
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Election Sum to Date
$
f. Account Code
g. Form of Payment
h. In-Kiad Description
i. Date (mm/dd/yyyy)
j. Amount
$
$
U
CAM
ION COUNTY
AIGN FINANCE
$
4. Total only this Page
$ 1,064.06
5. Total of ALL CRO -1230 Pages
(This line must be on line 8 of Demiled Sutnmary Page CRO -1100) RFrFIVFD
$ 1,064.06
CRO -1230 NC State Board of Elections April 2007
1 Amendment
Disbursements Pg of ❑ Yes ❑ No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated ariv ex enditures.
1. Committee Full Name and Fund if applicable)
2. II) Number
Thomas for Union County
JRT72221
3. Type of Disbursement Please use separate CRO -1310 formy for each type
of Disbursement.
® Operating Expenses ❑
Contributions to Candidates/Political Committees
❑
Coordinated Party Expenditures
4. Payee Information
Add ❑
Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
NameTagWizard
Florida
904-396-2291
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 1,136.21
L Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/ddlyyyy)
j. Amount
k. Required Remarks
JT22
Electronic
O
10/28/2021
$27.85
Name Tag
4. Payee Information
❑ Add ❑
Remove
a. Full Name, Mailing Address & Phone
include city, stat & zip)
b. Coordinated Committee Name
d. Comments
Google LLC
1600 Amphitheatre Pkwy
Mountain View Ca. 94043
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 1,134.49
E Account Code
I g. Form of Payment
h. Purpose Code
i. Date (mmldd/yyyy)
j. Amount
k. Required Remarks
JT22
Electronic
O
10/04/2021
$1.72
Subscrition
Domain Name
$
4. Payee Information
Add
Remove
a. Full Name, Mailing Address & Phone
include city, state & zip)
b. Coordinated Committee Name
d. Comments
HostGator
Houston Tx
888-514-2867
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 1,128.49
L Account Code
g. Form of Payment
h. Purpose Code
L Date (mm/dd/yyyy)
j j. Amount
k. Required Remarks
JT22
Electronic
O
10/12/2021
$6.00
Website
Hosting
$
U
�Z
N
5. Total only this Pae
$ 35.57 z
o
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Derailed Summary Page CRO -1100 if Operating Expenses)
(This line goes in line 131, of Detailed Summary Page CRO -1100 if Contrib to Candidates/Politicat Comm)
(Thls line goes 1n line 13c ojDelailed Summary Page CRO -1700 if Coordinated Party Expenditures)
OO z
z (D
$ 178.54 O
Z 5
ao
P-
7. Purpose Codes(List detailed expenditure code in above
A* -Media B* - Printing C* - Fundraising
E - Salaries F* - Equipment G - Political Party
I - Postage J - Penalties K* - Office Expenses
O* - Other
* Codes require detailed explanation in required remarks field k
D - To Another Candidate
H* - Holding Public Office Expenses
Q* - Donation to Legal Expense Fund
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg of ❑ Yes ❑ No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
cnmmittees and coordinated narty expenditures.
1. Committee Full Name and Fund if a licable
2. ED Number
Thomas for Union County
JRT72221
3. Type of Disbursement lease use separate CRO -1310 forms for each type
of Disbursement.
® Operating Expenses ❑
Contributions to Candidates/Political Committees
❑
Coordinated Party Expenditures
4. Payee Information
❑ Add ❑
Remove
a. Full Name, Mailing Address & Phone
include city, state & zip)
b. Coordinated Committee Name
d. Comments
Google LLC
1600 Amphithatre Pkwy
Mountain View Ca. 94043
c. Level Registered (Specify)
❑ Federal ® County:
❑ state ❑ Municipality:
e. Election Sum to Date
$ 1,110.76
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
JT22
Electronic
O
11/02/2021
$13.28
Subscrition
Domain Name
JT22
Electronic
O
11/02/2021
$4.45
Domain Name
4. Payee Information
❑ Add El
Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
HostGator
Houston Tx
888-514-2867
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 1,104.76
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/ddlyyyy)
J. Amount
k. Required Remarks
JT22
Electronic
O
11/12/2021
$6.00
Website
Hosting
4. Payee Information
❑ Add ❑
Remove
a. Full Name, Mailing Address & Phone
include city, state & zip)
b. Coordinated Committee Name
d. Comments
Paper and Inc Printing
740 Stallings Road
Matthews NC 28104
704-821-4500
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 1,010.82
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
I j. Amount
Jr. Required Remarks
JT22
Debit Card
B
11/18/2021
$93.94
Business
Cards
$ 117.67
5. Total only this Pae
6. Total of ALL CRO -1310 Pages
(This lime goes in line 13a ofDelailed Summary Page CRO -1100 if Operating Expenses)
(This line goes in line 13b of Detailed Summary Page CRO-11001fContrib to Candidates/Political Comm)
(This lingoes in line 13c of Detailed Summary Page CRO -11001] CoordinatedPany Expenditures)
z z N
$ 178.54 00
U (Z9
z —
1' 1' ii
W
7. Purpose Codes(List detailed expenditure code in h, above
— ° Q
A* - Media B* - Printing C* - Fundraising
E - Salaries F* - Equipment G - Political Party
I - Postage J - Penalties K* - Office Expenses
O* - Other
* Codes require detailed explanation in required remarks field k
D - To Another Candidate —) <C
H* - Holding Public Office Expen`s4
Q* - Donation to Legal Expense Fund
cc
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg of ❑ Yes ❑ No
.Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated Dartv expenditures.
1. Committee Full Name and Fund if applicable)
2. II) Number
Thomas for Union County
IRT72221
3. Type of Disbursement 6ftm use separate CRO -1310 forms for each
e of Disbursement.
® Operating Expenses ❑
Contributions to Candidates/Political Committees
❑
Coordinated Party Expenditures
4. Payee Information
❑ Add ❑
Remove
a. Full Name, Mailing Address & Phone
include city, state & zip)
b. Coordinated Committee Name
d. Comments
HostGator
Houston Tx
888-514-2867
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 1,004.82
1. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
it. Required Remarks
JT22
Electronic
O
12/13/2021
$6.00
Website
Hosting
$
4. Payee Information
❑ Add ❑
Remove
a. Full Name, Mailing Address & Phone
include city, stat & zip)
b. Coordinated Committee Name
d. Comments
Google LLC
100 Amphitheatre Pkwy
Mountain View Ca. 94043
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 982.52
f. Account Code
g. Form of Payment
It, Purpose Code
i. Date (mmldd/yyyy)
j. Amount
k. Required Remarks
JT22
Electronic
O
12/02/2021
$13.30
Domain Name
JT22
Electronic
O
12/03/2021
$6.00
Domain Name
4. Payee Information
❑ Add ❑
Remove
a. Full Name, Mailing Address & Phone
include city, state & zip)
b. Coordinated Committee Name
d. Comments
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Election Sum to Date
$
f. Account Code
g. Form of Payment
it. Purpose Code
i. Date (mmlddlyyyy)
J. Amount
k. Required Remarks
$
$
w
1J
5. Total only this Pae
$ 15.30 z c.
6. Total of ALL CRO -1310 Pages
(This line goes to line 13a of Detailed Summary Page CRO -1100 if Operating F_Venser)
(This line goes in One 131, ofDemlled Summary Page CRO -1100 ifCorarib to Candidates/PoIldcal Comm)
(This line goes in One 13c of Detniled Summary Page CRO -1100 ifCoordlnated Parry Expenditures)
Z o
$ 178.54 O Z O'D
ZZ
O zz Q
W
V
7. Purpose Codes(List detailed expenditure code in h. above
z
LU
A* - Media B* - Printing C* - Fundraising
E - Salaries F* - Equipment G - Political Party
I - Postage J - Penalties K* - Office Expenses
O* - Other
* Codes require detailed explanation in required remarks Geld k
D - To Another Candidate C�
H* - Holding Public Office Expenses
Q* - Donation to Legal Expense Fund
CRO -1310 NC State Board of Elections December 2009