Yanacsek, Robert_2021-35DayReportDisclosure Report Cover Amendment
0 Yes No
Use this form for general report and committee information, must be signed and submitted along with other detailed I'm ms.
nr, ,,.., n., ,h;. fnrm ,,, ,r,d n,v in6,nn.tun
CRO -1000 NC State Board of Elections August 2008
1. Committee Information
• . Full Name
c. to Number
An.Aesr,Ll r-c/t titc..t r
. Mailing Address (include City, State and Zip Code)
d. Date Filed
GG,F,eE TTLc s%
4 2 z
e er [/ Z_
e. Phone Number
Z. Report Year3.
Period Start Date (mmtdd/yy)
d. Period End Date (mmtdd/
5. Treasurer Full Name
2,rZ 1,
I / �ZL' (
'?/21/L (
rsCQ,— flti4uk c_
t jype of Committee (Check One)
`). Type of Report (check
only one hype of report
from one category)
Candidate Campaign ❑Party
Municipal
St de/County
Referendum
❑ PAC ❑ Referendum
[j Organizational
❑ Organizational
❑ Organizational
❑ Independent Expenditure ❑ Joint Fundraiser
Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑ Pre-primary
❑ First
❑ Final
❑ Pre-election
Pre -runoff
Semi-annual
❑ Second
❑ Third
❑ Fourth
❑ Supplemental Final
❑ Annual
❑ Special
7. Type of Fund (fapplimbte. check one)
❑ Booster Fund
❑ Building Fund
❑ Mid Year
Semi-annual
❑ Year End
❑ Mid Year
10. Special Report Name
❑ Other:
❑ 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
Is. Purpose
e. Account Code
It. Pur ANCL
c. Account Code
L'R µ PA ICN
S/0
SEP 2 B 2021
d. Period Begin Balance
d. Period Begin Balance
$
$
ED
CERTIFICATION
I cenify 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 the NC State Board of Elections.
e&99rrjer AA5e�� P e z
Printed Name of Signer signature of A nted Treasurer Date
FOR OFFICE USE ONLY
�J
Date Received: aO a I Employee: Delivery Method
❑t q"? Normal Mail
Date Postmarked: Employee:,Registered Mail
Hand Delivered
Date Scanned: Employee: Electronically Filed
Date Data Entered: Employee: 1] Signer has not received
mandato 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-210OA-E) to make committee changes.
CRO -1000 NC State Board of Elections August 2008
Detailed Summary
$
$
Amendment l
[3 Yes Nn
Use this form to summarize all disclosure renortinm forms and to total monetary information
$
1. Committee Full Name (and Fund if a plicable)
2, pe of Report
3. II) Number
$
$
$
$
$
$
16) Refunds/Reimbursements from the Committee (CRO -1320)
7� tirS�3
Start of Election Cycle: January 1, %O (�
$
Total this
Total this
$
$
Reporting Period
Election Cycle
4) Cash on Hand at Start
$ Or
I $
RECEIPTS
5) Aggregated Contributions from Individuals
(CRO -1205)
$
$
6) Contributions from Individuals
(CRO -1210)
$ G
$
7) Contributions from Political Party Committees
(CRO -1220)
$
$
8) Contributions from Other Political Committees
(CRO -1230)
$
$
9) Loan Proceeds
(CRO -1410)
$
$
0) Refunds/Reimbursements to the Committee
(CRO -1240)
$
$
1) Other Receipt Sources
lla) Interest on Bank Accounts
(CRO -1250)
$
$
11b) Contributions from Not -For -Profit Organizations
(CRO -1250)
$
$
llc) Outside Sources of Income
(CRO -1250)
$
$
lld) Legal Expense Fund - Other Sources
(CRO -1270)
$
$
11e) Exempt Purchase Price Sales
(CR04165)
$
$
12)TOTAL RECEIPTS (Add lines 5,6,7,8,9, 10,1 la, l lb,l lc,l td and l lell
$J,�9%�Qo
3) Disbursements
13a) Operating Expenditures (CRO -1310)
13b) Contributions to Candidates/Potitical Committees (CRO -1310)
13c) Coordinated Party Expenditures (CRO -1310)
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 -1510)
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 19'
$
$
Non -Monetary Gifts Given to Other Committees (CRO -1330) $
Outstanding Loans (incl. ones from other campaigns) (CRO -1430) $
Debts and Obligations owed by the Committee (CRO -1610) $
Debts and Obligations oweE(CRO-1620) $
Account Transfers Within the C umfttee �� (CRO -1720) $
5) Administrative Support SEP L (CRO -1710)
$
$
6) Forgiven Loans'EL0-1440)
$
$
7) 48 -Hour Notice Reports Sum (CRO -2220)
$
$
8) Contributions to be Refunded (CRO -1215)
$
$
CKU-11M NU State Board of elections August 2Wg
Aggregated Contributions from Individuals Page I of ( 13 i,c, . m
Optional form used to report NC Contributions From Individuals of $50 or less
1. Committee Full Name (and Fund if applicable) 12.
Ill Number
7Si�15R 3
��ot3i�/1 srC Fc/� �ti/�o/ ci
. Contributor information
. Amend
b. Account Code
c. Form or Payment
d. In -Kind Description
e. Date (mm/dd/yyyy)
f. Amount
Add
❑ Remove
Add
❑ Remove
Sl -ll
eAS
%vTQI QV rye' 4,
�?
d %JrAe
$ Z!�7
CT Add
13Remove-5,1a
eAeI4
C'Q TYr(132' T1 C 4.
/ f
$ �O
Add
1:1 Remove
.s/
�1
Q/t s rr
C'O �!/31, T/Crti
''T Aa /z-
$ ?,!:7
Add
❑ Remove
„$�
er
CQti7it! 17 B�C.�
/®(ZI
$
Add
Remove
E3QL
S/0
[�
eA. O1i d-4—
[7J
4 �D /r' �
$ C �
Add
❑ Remove
..S�0
e.-�
�Y.t%��/�t/TlCtif.
T /�
$ zo
s/0
C�S
eQ.�..eiil!/!t-Tt l ^
of Awe (
$
FRemove
$10
C 45��
('l Aer/7 rArCr7G
9lmk(
$ 20
.S%0
C'� a
iritj%C a, -T! I,,
Ir/LQ/Z 1
$ lO
Remove
Add
❑ Remove
$
Add
❑ Remove
$
Add
❑ Remove
$
Add
❑ Remove
$
Add
❑ Remove
$
Add
1:1 Remove
$
Add
❑ Remove
$
Add
UNp
GN FINANGt
$
❑ Remove
Add
❑ Remove
Q ^tt'Z�
U LU
$
Add`
' r'
F
$
L1 Remove
1 v `
Add
❑ Remove
$
Add
$
❑ Remove
-l. Total onh this Page
$ /910,6,0
5. Total of ALL CRO -1205 Pages
$
(fhis line must he on line 5 of Detailed .Summary Page CRO4100)
CRO -1205 NC State Board of Elections April 2007
Contributions from Individuals Pg Amendment nr ❑ ,es 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. In Number
. Contributor Information ❑ Add ❑ Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
Jam%
cti�26� tiC z�ie
b. Job Title/Profession
d. Comments
iG
c. Employer's Name/Specilic Field
C.'j.V 17 C)
��>iZpL
e. Election Sum to Date
$ /y/ . a 6
r. Prior
g. Account Code
h. Form of Payment i. In -Kind Description
J. Date (mmlddlyyyy)
k Amount
❑
S/
$
❑
CA
$ ZZ, Q3
13
-5/2,
C
1
$ yz 763
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/Speclfic Field
e. Election Sum to Date
f. Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
I. Date (mm/ddtyyyy)
It. Amount
❑
$
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Add e.5s &Olein
(include clty,state UIQ INANCE
b. Job Ti11eftoression
d. Comments
SEP 2 8 2021
RECEIVED
c. Employer's Name/Specific Field
a. Election Sum to Date
$
I'. I'rirnr
g. Account Cade
h. Form of Payment
I. In -Kind Description
I. Date (mmtddtyyyy)
k Amount
❑
$
❑
$
❑
$
4. Total only this Page
$
5. Total of ALL CRO -1210 Pages
(This line must be on line 6 of Detailed Summary Page CRO -7700)
�(s•�
CRO -1210 NC SCtic Board of Gluaiona April 2007
Amendment
Disbursements Pg L of _L_, I ❑ Yes Nis )
Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political
committees and coordinated oartv expenditures
ommittee Full Name (and Fund if a lira le)
,4 At k C 5 r � /�K �- `rro�� ���
2. ID Number
s-ype
of Disbursement Please use se arate CRO -1310 orms or each e o Disbursement13
f
O ratin.- Es ense., Contributions to Cundidates/PoliticalCommittees Coordinated Party Ex nditures
ayee Information Add Remove
ll Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. comments
�o,Le TIfiE 0IfOA
p 6C 1p6 9 2 3 q
c. Level Registered (Specify)
Federal ounry:
❑State Municipality:
a. Election Sum to Date
. Account Code g. Form of Payment
It. Purpose Code
L Date (rrmtlddlyyyy) J. Amount k. Required Remarks
So D iT
9 / Z ( $sLZ93
$ U ZG •
4. Payee Information Add Remove
. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
it. Comments
V1,CTA tr'/l/T
,7 _ Q 5 $—
foL3
i
'L 7 ej "AAA t� it! `s �
245 l
c. Level Registered (Specify)
Federal(���!s'ounry:
❑Stale Municipality:
e. Election Sam to Dale
$
. Accomt Code
jg.FormofPaymmt
h. Purpose Code
i. Date (mMdd/yyyy)
j. Amount
k Required Remarks
-:5'/D
Ive6.- T
vA. Z (
s ele,g3
FC
$
4. Payee Information 0 Add 0 Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
it. Comments
�i-1 COU
G�i,tlpglCaMFINANGE
SEP 2 8 2 21
c. Level Registered (Specify)
Lj FederalCounty:
❑ State ❑ Municipality:
e.Election Sum to Date
f. Account Cade
g. h. Purpose Code
if. Date (amlddlyyyy) D.Amount 1k. Required Remarks
is
$
5. Total only this Page
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 CandidateslPolaical Comm)
(This line goes in line 13c of Detailed Summary Pae CRO -1 100 if Coordinated Party Expenditures)
. 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 Party He - Holding Public Office Expenses
I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* Other
* Codes reuire detailed explanation in required remarks field W
CRO -1310 NC State Board of Election. December 2009