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Williams,David_2020-2nd-qtrAmendment Disclosure Report Cover I ❑ Vee ® 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 undate information 1. Committee Information' a. Full Name c. ID Number Elect David Williams MJMVR6 b. Mailing Address (include City, State and Zip Code) d. Date Filed P.O. Box 2276 07/01/2020 Indian Trail, NC 28079 e. Phone Number 980-328-4408 2. Report Year 3. Period Start Date (mm/ddlyy) 4. Period End Date mm/dd 5. Treasurer Full Name 2020 02/16/2020 06/30/2020 David H. Williams 6. Type of Committee Check One 9. Type of Report check only one type of report om one category) ® Candidate Campaign ❑ Party Municipal State/County Referendum ❑ Organizational ❑ Organizational ❑ Organizational ❑ PAC ❑ Referendum Independent ❑ Joint Fundraiser ❑ Expenditure ❑ Thirty-five day Quarterly ❑ Pre -referendum Legal Expense Fund ❑ Pre-primary, ❑ Preelection ❑ First ® Second ❑ Final ❑ Supplemental Final 7. T e of Fund (if applicable, check one) ❑ 'Booster Fund" ❑ Building Fund ❑ Pre-rutmff ❑ Third ❑ Annual Semi-annual ❑ Fourth ❑ Special ❑ Mid Year Semi-annual ❑ Other: ❑ Year End ❑ Mid Year 14. Special Report Name ❑ Final ❑ special ❑ Year End ❑ Final ❑ special 8. Number of Fundraisers this Re ort 0 11. Account Information 11. Account Informati, a. Financial Institution Full Name a. Financial Institution Full Name BB&T b. Purpose c. Account Code c. Account Code Campaign Donations Z JUL 0 t 2020 d. Period Begin Balance it. Period Begin Balance and $ 3,391.31 $ Expenditures Union Go. Board of Elections 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 NC to 13oar ofE'� le tions. David H. Williams ��Fu� 07/01/2020 Printed Name of Signer Signature of Appointed Treasurer Date FOR OFFICE USE ONLY Date Received: *_1 oho Employee: Delivery Method ❑ Normal Mail Date Postmarked: Employee: Registered Mail Hand Delivered Date Scanned: Employee: Electronically Filed ❑ Signer has not received Date Data Entered: Employee: 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 -21 OA -E) to make committee changes. rRn-1000 Nr State Roard of Ftrrtinnc Au.mt 90ox VIn t IN lam a ns Detailed Summary ❑ tes ❑ .,, Use this form to summarize all disclosure ieportnw, forms and to total monetary information. 1. Committee Full Name and Fund if applicable) 2. Type of Report 3. ID Number Elect David Williams Second Quarter MJMVR6 Start of Election Cycle: January 1, 2017 Total this Reporting Period Total this Election ('vele 4) Cash on Hand at Start 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 1lb) Contributions from Not -for -Profit Organizations I lc) Outside Sources of Income I ld) Legal Expense Fund — Other Sources 11 e) Exempt Purchase Price Sales (CRO -1205) (CRO -1210) (CRO -1210) (CRO -1230) (CRO -1410) (CRO -1140) (CRO -1250) (CRO -1150) (CRO -1150) (CRO -1270) (CRO -1165) $ $ 3,391.31 $ $ 0.00 $ 100.00 $ 7,477.25 $ $ $ $ 184.34 $ $ $ $ $ $ $ $ $ $ $ $ $ $ 12) TOTAL RECEIPTS (Add lines 5, 6, 7, 8, 9, 10, Ila, 116, Ile, 11d and Ile) $ 100.00 $ 7,661.59 13) 14) 15) 16) 17) Disbursements 13a) Operating Expenditures 13b) Contributions to Candidates/Political Committees 13c) Coordinated Party Expenditures Aggregated Non -Media Expenditures Loan Repayments Refunds/Reimbursements From the Committee In -Kind Contributions (CRO -1310) (CRO -1310) (CRO -1310) (CRO -1315) (CRO -1410) (CRO -1320) (CRO -1510) $ 2,834.36 $ 6,867.79 $ $ $ $ $ $ $ $ $ $ $ $ 136.85 18) TOTAL EXPENDITURES (Addlims 13a, 13b, 13e,, 14, 15, 16and 17) $ 2,834.36 $ 7,004.64 19) Cash on Hand at End (Add lines 4and12 together, then subtract line 18) $ 656.95 $ 656.95 20) 21) 22) 23) 24) 25) 26) 27) 28) Non -Monetary Gifts Given to Other Committees Outstanding Loans (incl. ones from other campaigns) Debts and Obligations owed By the Committee Debts and Obligations owed To the Committee Account Transfers Within tI Administrative Support `N���`1 V E D Forgiven Loans JUL 01 2020 48 -Hour Notice Reports Su inion Co. Board of Elections Contributions to be Refunded (CRO -1330) (CRO -1430) (CRO -1610) (CRO -1620) (CRO -1710) (CRO -1710) (CRO -1440) (CRO -2220) (CRO -1215) $ $ $ $ $ $ $ $ $ $ $ $ $ CRO -1100 NC State Board of Elections August 2008 Amendment Contributions from Individuals Pg 1 of I ❑ 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 Elect David 0. illiams MJMVR6 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession d. Comments Farming Ruth Cox 6002 Cox Rd Monroe, NC 28112 cEmployer's Name/Specific Field Self e. Election Sum to Date $ 100.00 E Prior g. Account Code h. Form of Payment i. In -Kind Description J. Date (mm/ddtyyyy) it. Amount ❑ Z Check 03/02/2020 $ 100.00 3. Contributor Information ❑ Add ❑ Remove a. Full 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 E Prior g. Account Code Is. Form of Payment i. In -Kind Description J. Date (mm/dd/yyyy) k. Amount ❑ $ ❑ $ 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, s REMEIVED JUL O 1 2020 Union Co. Board of Eluctiona 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) k. Amount ❑ $ ❑ $ 4. Total only this Page $ 100.00 5. Total of ALL CRO -1210 Pages $ 100.00 (This line nuw be on am 6 ojDerafled Summary Page CRO -1100) CRO -1110 NC State Board of Elections April 2007 Amendment Disbursements Pg 1 of 2 ❑ Yes ® No Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political committees and coordinated narry expenditures. 1. Committee Full Name and Fund itapplicable) 2. —ID Number Elect David Williams MJMVR6 3. Type of Disbursement Please use separate CRO -1310 formn for each type of Disb rsement Operating Expenses ❑ Contributions to CandidatesiPnlitical Committees ❑ Coordinated Pan) Expenditures 4. Payee Information Add n Remove a. Full Name, Mailing Address & Phone include cill, state & a b. Coordinated Committee Name dtREW EIVED- J U L 01 2020 Union CO. Board of Elections Tractor Supply Company 1010 W. Roosevelt Blvd Monroe, NC 28110 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date $ 122.63 f. Account Code g. Form of Payment h. Purpose Code t. Date (mm/dd/yyyy) j. Amount It. Required Remarks Z electronic O 02/18/2020 $73.64 Sign post supplies 4. Payee Information Fj Add Remove' a. Full Name, Mailing Address & Phone include citv. state & zip) b. Coordinated Committee Name d. Comments Amazon Marketplace 440 Terry Ave N Seattle, WA 98108 c. Level Registered (Specify) ❑ Federal ❑ County ❑ State ElMunicipality: e. Election Sum to Date $ 14.18 f. Account Code g. Form of Payment It. Purpose Code i. Date (mm/dd/yyyy) J. Amount k. Required Remarks Z electronic O 02/18/2020 $14,18 name tag 4. Payee Information Add Remove a. Full Name, Mailing Address & Phone include city, state & zip) b. Coordinated Committee Name d. Comments WIXE 1700 Buena Vista Rd Monroe, NC 28112 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date $ 1,505.00 E Account Code g. Form of Payment It. Purpose Code i. Date (mm/dd/yyyy) j. Amount k. Required Remarks Z electronic A 02/21/2020 $1,505.00 Radio ads S 5. Total only this Pae S 1,592.82 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses) (This line goes in line 13b of Detailed Summary Page CRO -1100 if Contrib to Candidates/Political Comm) (This line goes in line 13e of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures) $ 2,8343.6 7 Purpose Codes List detailed expenditure code in h. above A* - Media B* - Printing C* - Fundraising D - To Another Candidate E - Salaries F* - Equipment C - Political Party H* - Holding Public Office Expenses - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* - Other *':Codes require detailed explanation in required remarks field k !`a/L 11 In Nr Cw,a P—M ,.r rl"" innc Nnou Amendment Disbursements Pg 2 of 1 ❑ 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.ID Number Elect David Williams I MJMVR6 3. Type of Disbursement Please use separate CRO -1310 forms for each type of Disbursement Operating Expenses ❑ Contributions to Candidates.Political Committees ❑ Coordinated Pam, Expenditures 4. Payee Information n Add M Remove a. Full Name, Mailing Address & Phone include city, stat & zip) b. Coordinated Committee Name JUL 01 2020 Won Co. Board of Elections BB&T 200 Indian Trail Rd N Indian Trail, NC 28079 c. Level Registered (Specify) ❑ Federal ❑ County: State ❑ Municipality: e. Election Sum to Date $ 1.25 E Account Code g. Form of Payment Is. Purpose Code i. Date (mm/dd/yyyy) J. Amount k. Required Remarks Z electronic O 02/21/2020 $1.25 bank charge 4. Payee Information Add El Remove a. Full Name, Mailing Address & Phone include city, state & zip) b. Coordinated Committee Name d. Comments Facebook 1601 Willow Rd Menlo Park, CA 94025 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State Municipality: e. Election Sum to Date $ 1,534.00 f. Account Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) J. Amount k. Required Remarks Z electronic A 03/02/2020 $312.02 Facebook ads Z electronic A 03/162020 $659.41 Facebook ads 4. Payee Information Add Remove a. Full Name, Mailing Address & Phone include city, stat & a h. Coordinated Committee Name d. Comments Facebook 1601 Willow Rd Menlo Park, CA 94025 c. Level Registered (Specify) ❑ Federal ❑ County: State ❑ Municipality: e. Election Sum to Date $ 1,534.00 E Account Code g. Form of Payment h. Purpose Code 1. Date (mm/dd/yyyy) J. Amount k. Required Remarks Z electronic A 04/012020 $282.80 Facebook ads Z electronic A 05/20/2020 $- 13.94 Facebook ads credit 5. Total only this Pae S 1,241.54 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Detailed Sumnmry Page CRO -1100 if Operating Expenses) (This line goes in line 13b of Detailed Summary Page CRO -11001f Conrrib to CandidatesiPoliical Comm) $ 2,834.36 (This line goes in line 13c of Detailed Summmg Page CRO -1100 if Coordinated Party Expenditures) 7. Purpose Codes List detailed expenditure code in above A* - Media B* - Printing C* - Fundraising D - To Another Candidate E - Salaries F* - Equipment G - Political Pam H* - Holding Public Office Expenses 1 - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* - Other * Codes require detailed explanation in required remarks field k i1un_ r r rn ur Garr n—n .,r n--h—nnno