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Williams,David_2020-3rd-qtrAmendment Disclosure Report Cover ❑ les ® No tJNe 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 I. Committee Information a. Full Name c- to Number Elect David Williams MJMVR6 b. Mailing Address (include City, State and Zip (ode) d. Date Filed P.O. Box 2276 02/24/2020 Indian Trail. NC 28079 e. Phone Number 980-328-4408 2. Report Year 3. Period Start Date (mm/dd/yy) `I• Period End Date 5. Treasurer Full Name (mm'dd'%c) David H. Williams 2020 07/01/2020 10 17 2020 6. Type of Committee (Check One) 9. Type of Report ('check onl • one f ym 0/ IT ort rom one cote gwl9 ® Candidalc C'aulpaigo ❑ Poll) Municipal State/Counh Referendum ❑ Organizational ❑ Organizational ❑ 0manizslional ❑ PAC ❑ Referendum Indelxndem ❑ Joinl Fundraiser ❑ Thiry -lice day Ouarlerly ❑ Pre -referendum ❑ Eapendilure Legal Fslxnse Fund ❑ ❑ Pre-prawrcEl Preelection First ❑ Second E]Final ❑ Supplemental Final 7. Type of Fund (fopplicable. check one) ❑ "Booster Fund" ❑ Building Fund UNION COUNTY Llpre-nntnff ® Third ElAnnual CAMPAIGN FINANCE Semi-annual ❑ Fourth ❑ Special r) C O 2020 G OCT1. L E] Mid Year Semi -arcual ❑ Olhcr. ❑ Year End ❑ Mid Year 10. S pecial Report Name ❑ Final ❑ special ❑ Year End ❑ Final ❑ Special 8. Number ofFundr s r II 11. Account Information 11. Account Information a. Finmreial Institntion Full Name a. Financial Institution Fail Name BB&T b. PnI pose C. Account Code It. Purpose c. account Code Campaign Z donations & d. Period Begin Balance d. Period Begin Balance expenditures S 656.95 $ 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 fiords 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 ections. /qy Z L (L (/ dob4, David H. Williams V • lo Printed Nmw,d Signer Siglatureof Appointed Tr su r Dale FOR OFFICE USE ONLI Delivery Method Date Received: Employee: ❑ Normal Mail ❑ Registered Mail Date Postmarked: Employee: ® Hand Delivered ❑ Electronically Filed Dale 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-2I00A-E) to make committee changes. rpt)- I nnh NC M.0, 1L.ard of Flriiinnc A la....I 1ImR Amendment Detailed Summary ❑ des El Use this form to suounarize all disclosure reporting forms and to total monetmti information. 1. Committee Full Name (and Fund if applicable) 2. Tvpe of Report 3. ID Number Elect David Williams Third Own ter Plus MJMVR6 Start of Election Cycle: January 1, 2017 Total this Reporting Period Total this Election CN Cie 4) Cash on Hand at Start $ 656.95 $ u.ou RL*( 1�TS amu' ,:r1 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 I la) Interest on Bank Accounts I Ib) Contributions from Not -for -Profit Organizations 1 le) Outside Sources of Income I Id) Legal Expense Fund —Other Sources I I e) Exempt Purchase Price Sales (CRO -1205) (CRO -121) (CRO -1230) (CRO -1230) (CRO -1419) (CRO -124( (CRO -1250) (CRO -1250) (CRO -1250) (CRO -1270) (CRO -1265) 1�tk i:r ft $ 8020 $ 80.20 $ 1900.00 $ 9,377.25 $ $ $ $ 184.34 $ $ $ $ $ $ $ $ $ $ $ $ 12) TOTAL RECEIPTS Ladd lure ?. b. '. 3. 9. 10, Ilu. Ilh. Ile. IIdaed llmt $ 1981110 $ 9,641.'9 EXPENDITURES 13) Disbursements 13a) Operating Expenditures 13b) Contributions to Candidates/Political Committees 13c) Coordinated Party Ex 6Q�gsOUNTY C MPAIGN FINANCE 14) Aggregated Non -Media Expenditures 15) Loan Repayments OCT 2 6 2020 16) Refunds/Reimbursements ntOtllENE9 17) In -Kind Contributions /CRo-Ltlm (CRO -1310) (CRO -1-410) (CRO -1315) (CRO -1420) (CRO -1.120) (CRO -1510) $ 392.69 $ 7,260.48 $ $ $ $ $ $ $ $ $ $ $ $ 136.85 18) TOTAL EXPENDITURES (dddhne.s13u.13h.13e.14.15.16mrd17) $ 392.69 $ 7397.33 19) Cash on Hand at End (.0,11ines 4 and 121ogeiher. Oren .suhlracr /ore 18) $ 2244.46 $ 2244.*, 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) (CR0-1430) (CRO -1610) (CRO -1620) (CRO -1710) (CRO -1710) (CRO -1440) (CRO -2220) (CRO -121.5) $ $ $ $ $ $ $ $ $ $ $ $ CRO -1100 NC State Board of Elections Aucost '_W8 Amendment Aggregated Contributions from Individuals Page i or I ❑ Yes ® No ODtional form used to report NC Contributions From Individuals of $50 or less 1. Committee Full Name and Fund if applicable) 2. ID Number Elect David Williams MJMVR6 3. Contributor Information a. Amend c. Form of Payment d. In -Kind Deseri tion e. DateGAmount mm/dd/Ada lb.Account Electronic 07/16/2020 $ 50.00 RemoveAdd Electronic 07/16/2020 $ 20.20 Remove Add Z Electronic 07/16/2020 $ 10.00 ElRemove Add $ Remove Add $ Remove Add $ Remove Add $ Remove Add $ Remove Add $ Remove Add $ Remove Add $ Remove Add UNION COUNTY CAMPAIGN FINANCE $ Remove Add C 6 T 202U OCTC $ Remove Add RECEIVED $ Remove Add $ Remove Add $ Remove Add $ Remove Add $ Remove Add $ Remove Add $ Remove Add $ Remove Add $ Remove 4. Total only this Page $ 80.20 5. Total of ALL CRO -1205 Pages (This line must be on line 5 of Detailed Summary Page CR0.1100) $ 80.20 CRO -1105 NC State Board of Elections April 2007 Amendment Contributions from Individuals Pg I of 2 ❑ Yes ® No I icr this fnrm to renori 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 Williams MJMVR6 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession it. Comments Not employed (Retired) Elizabeth Williams 6623 Mimosa Lane Dallas, TX 75230 c. Employer's Name/Specific Field N/A e. Election Sum to Date $ 700.00 f. Prior g. Account Code Is. Form of Payment i. to -Kind Description J. Date (mm/dd/yyyy) k. Amount ❑ Z Electronic 07/16/2020 $ 100.00 ❑ Z Electronic 08/16/2020 $ 100.00 ❑ Z Electronic 09/16/2020 $ 100.00 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, & zip) b. Job Title/Profession it. Comments Not employed (Retired) Elizabeth Williams 6623 Mimosa Lane Dallas, TX 75230 e. Employer's Name/Specific Field N/A e. Election Sum to Date $ 800.00 I. Prior g. Account Code h. Form of Payment I. In -Kind Description j. Date (mm/dd/yyyy) k. Amount ❑ Z Electronic 10/16/2020 $ 100.00 ❑ $ ❑ $ 3. Contributor Information ® Add ❑ Remove a. Full Name, Mailing Address & Phone (include city, state, &•rip) b. Job Title/Profession d. Comments Builder Robert Harrell CAMPAIGN FINANCE 5615 Potter Road Matthews, NC 28104 OCT Z 6 2020 RECEIVED c. Employer's Name/Specific Field Self e. Election Sum to Date $ 1000.00 E Prior g. Account Code b. Form of Payment i. In -Kind Description j. Date (mm/dd/yyyy) It. Amount ❑ Z Electronic 10/14/2020 $ 1000.00 4. Total only this Page $ 1400.00 5. Total of ALL CRO -1210 Pages $ 1900.00 (chis line mist be on line 5 of Detailed Summar' Page CRO -1100) CRO -1110 NC Swe Board of Elections April 2007 Amendment Contributions from Individuals Pg 2 of z ❑ les ® No I Ise this form to renort 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 Williams MJMVR6 3. Contributor Information ® Add ❑ Remove a. Full Name, hlailiug :Address & Phone (include cit)', state. & zip) b..lob Title/Profession d. Commenls Accountant Fern Shubert 505 S. Elm Street Marshville, NC 28103 c. Employer's Name/Specific Field Self e. Election Sum to Dote $ 250.00 C Priar g. Account Code It. Form of Payment i. In -Kind Description j. Date Imm/dd/vc})1 k. Amount ❑ Z Check 09/15/2020 $ 1�o lnl 3. Contributor Information ® Add ❑ Remove a. Fall Name, Mailing Address & Phone (include city, state. & zip) h. lob Title/Profession J. Comments Real Estate Wesley McCaskill 4725 John Craig Road Waxhaw. NC 28173 c. Employer's Name/Specific Field Self e. Election Sum to Date $ 250.00 G Prim g. Account Code It. Form of Payment i. In -Kind Description j. Date (mm/dd/)yyy) k. Amount ❑ Z Check 10/13/2020 $ 250.00 3. Contributor Information ❑ Add ❑ Remove a. Full Name, Mailing Address & Phone (include cite, stale. &zip h lob Tine/Profession J. Comments CAMPAIGN FINANCE OCT 2 6 2020 RECEIVED e Employer's Name/Specific Field e. Election Stem to Date $ L Prim g. Account Code It. Form of Payment i. [it -Kind Description j. Date Dum/dd/y}w) k. Amount ❑ $ ❑ $ 4. Total only this Page $ 500.00 5. Total of ALL CRO -1210 Pages $ 1900.00 (This line mist he art fine 6 of Derailed Summary Page CRD -1100) CRO -1210 NC' State Board of Elecoons April 2(9)7 Amendment Disbursements Pg 1 of a ❑ Yes ® No Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political �..a crdinated .,�.n, nvnnndin,rrc ................... ...... _.,.,......_.__ —.. -.. -------- 1. Committee Full Name and Fund if applicable) 2. ID Number Elect David Williams MJMVR6 3. Type of Disbursement Please use separate CRO -1310 forms for each twe of Disbursement. ® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Pany Fxpenditures 4. Payee Information Add Remove a. Full Name, Mailing Address & Phone include city, state & zip) It. Coordinated Committee Name d. Comments Anedot 10821 Rosebud Court Baton Rouge, LA 70815 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date $ 23.83 t. Account Code g. Form of Payment It. Purpose Code I. Date (mm/dd/yyyy) j. Amount it. Required Remarks Z electronic O 07/16/2020 $8,41 processing fee Z electronic O 08/16/2020 $4.30 processing fee 4. Payee Information Add Remove a. Full Name, Mailing Address & Phone include city, state & zip) b. Coordinated Committee Name d. Comments Anedot 10821 Rosebud Court Baton Rouge, LA 70815 c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e. Election Sum to Date $ 68.43 f. Account Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) J. Amount it. Required Remarks Z electronic O 09/16/2020 $4.30 processing fee Z electronic O 10/14/2020 $40.30 processing fee 4. Payee Information -El Add Remove it. Full Name, Mailing Address & Phone include city, statet & zip) b.Coordinated Committee Name d. Comments Anedot CAMPAIGN FINANCE 10821 Rosebud Court Baton Rouge, LA 70815 OCT 2 6 2020 RECEIVED c. Level Registered (Specify) ❑ Federal ❑ County: ❑ State Municipality: e. Election Sum to Date $ 72.73 C Account Code g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) j. Amount it. Required Remarks Z electronic O 10/16/2020 $4.30 processing fee 5. Total only this Pae $ 61.61 6. Total of ALL CRO -1310 Pages (This line goes in line 13a of Delailed Summary Page CRO -1100 if Operating Expenses) (This fine goes in line 136 of Derailed Summary Page CRO -1100 If Contrib to Candidales/Political Comm)'i $ 392.69 (This line goes in fine 13c of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures) 7. Purpose Codes List detailed expenditure code in h. above A* - Media B* - Printing C* - Fundraising D - To Another Candidate E - Salaries F* - Equipment G - Political Pam H* - Holding Public Office Expenses I - Postage 3 - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* - Other * Codes require detailed explanation in required remarks field it /'Rrl_ i ] in Nr C,a,r R—M „r ph—h—, 1-1---h— 'nou Amendment Disbursements Pg 2 of a ❑ ''ec ® No Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political rnmmittrrc and ennrdinated nark, exnenditures. 1. Committee Full Name and Fund if applicable) 2. ID Nmnber Elect David Williams MJMVR6 3. Type of Disbursement Please ase separate CRO -1310 fednits for each type of Disburseluent. Olxrating Expenses ❑ Conn"ibulions to Candidates Political Conuniuecs ❑ C,wrdinated Parc Expendinn"es 4. Payee Information Add Remove a. Full Name, Mailing Address & Phone (include Pitt. state. & zip) b. Coordinated (tanni tlee Name it. Comments Facebook 1601 Willow Road Menlo Park, CA 94025 c Level Registered (Specify) ❑ Federal ❑ county: state Municipality: e. Election Sum to Date $ 1717.02 f. Account Code g. Form of Pavment h. Purpose Code i. Date (nim/dd/yyyy) j. Amount k. Required Remarks Z Elextronic A 10/01/2020 $133,02 Facebook ads Z Electronic A 10/13/2020 $50.00 Facebook ads 4. Payee Information ❑ Add Remove a. Fall Name. klailiug Address & Phone (include cit\', state, & Zip) b. Coordinated Committee Name d. Comments Facebook 1601 Willow Road Menlo Park, CA 94025 c Level Registered (Specify) ❑ Federal ❑ Courtly El State El Municipality: e. Election Stein to Date $ 1742.02 I'. Account Code g. Form or Payment It. Purpose Code i. Date (om/dd/yyyy) j. Amount k. Required Remarks Z Electronic A 10/15/2020 $25.00 Facebook ads 4. Payee Information Add Remove it. Fall Name. Mailing Address & Phone (include cin', state, & zi ) b. Coordinated Committee Name d. (moments 13 Brothers 120 Blythe Drive CAMPAIGN FINANCE Indian Trail, NC 28079 OCT 2 6 2020 RECEIVED c. Level Registered (Specif)) ❑ Federal ❑ County: El state ❑ Municipality e. Election Sum to Date $ 100.00 L Account ('ode g. Form of Payment h. Purpose Code i. Date (mm/dd/yyyy) j. Amount k. Required Remarks Z Electronic O 10%1-4'2020 $100.00 Patriotic rally 5. Total only this Pae $ 308.02 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 Sunumrrr Page CRO -1100 if Contrib to Condidates/Political Conlin) $ 392.69 (This lure goes in line 13c if Detailed Sununnrr Poge CRO -1 /Oil it Coordinated Party Expenditures) 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 A - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* - Other * Codes requirt detailed explanation in required remarks field (k /`Arlt_ 12 /it no` G 11 nmvd of Flrrtinnc n,.r.n.hNr 11114 Amendment Disbursements Pg I of a ❑ yes ® No Use this form to report expenditures from the committee for: operating expenses, contributions to candidate/political enmmittees and ennrdinated nartv exnenditures. 1. Committee Full Name and Fund if applicable) 2. ID Number Elect David Williams MJMVR6 3. Type of Disbursement tRfeae use separate CRO -1310 forms for each troe of DisburvetneftLjl Illxraong Eslxnses ❑ Contributions to (:mdidates Political Coni niuees ❑ Coordinated Parti Expenditures 4. Payee Information Add Remove a. Full Name. Mailing Address & Phone include cilx', stale. & zip) It. ('oordinated Committee Name d. Continents The Patriot Wagon -USA, LLC 3718 Plyler Mill Road Waxhaw, NC 28112 c Level Registered (Specify) ❑ Federal ❑ county: El State Municipality: e. Election Sum In Date $ 23.06 f. .Account Code g. Form of Payment It. Purpose Code i. Date (mm/dd/yyyy) j. Amount Is. Required Remarks z Electronic O 09'11202023 $23,06 Rallv ticket 4. Pavee Information Add Remove a. Fill Name, Nlailing Address & Phone include cit%, slate, & zip) b. Coordinated Committee Name it. Comments e Leel Registered (Speciry) ❑ Federal ❑ County: Stale Municipality: e. Election Sum to Date f. Account Code g. Form or Payment h. Purpose Cade i. Dale (mm/dd/yyyy) J. Amount k. Required Remarks $ 4. Payee Information Add Remove a. Full Name. Mailing Address & Phone include cit%, stale. & ' CAMPAIGN FINANCE ft OCTl• 2 6 2020 RECEIVED b. Coordinated Committee Name d. Com meals c. Le%ei Registered (Specify) ❑ Federal El County: ❑ State ❑ Municipality: e. Election Sum to Date $ f. Account Code I g. Form of Payment h. Purpose Code i. Date (mm/ddA1%%%) j. Amount k. Required Remarks $ $ 5. Total only this Pate $ 23.06 6. Total of ALL CRO -1310 Pages (This line goes in line 13(t o%Delailed Sunnrwrr Page CRO -1100 if Operating Expenses) $ 392.69 (This line goes in line 13b of Detailed Suunuarr Page CRO -1100 ifContrib to Candidares/Poliacal Conrnq (This line goes in line 13e o1'Detuiled Sunnwrr Page CRO -/100 if Courrlintrred P(tre• Fapenr imres) 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 - Polilical Pang H* - Holding Public Office Expenses 1 - Postage .1 - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund O* - Other * Codes require detailed explanation in required remarks field (k) r,nn-I? It) air o,,,. R..*r.i.,f ",... rh•.+mMr lmW