Disclosure Report Cover Amendment. ~

Transcription

1 isclosure Report Cover Amendment. ~ Use this form for general report and committee information, must be signed and submitted along withothe" detai^fo rms o not use this form to update information. '* ' ' " '" - * "'-'* * '.' :-'-.<"" - * *"" " "-:::- *t;^-:,,'f'\';'a-"!r*-:-.. *'"'.' " * "*. wi ^:-t-*y«><t.* : r^ I (1 "WumKnw Richard tfd&e&l &r ScilC6l Pv.flrrl KAJailiag^Address (inchide City, Statea'ria ZipCode)fe^:-^fr-;----. njlo Kino MHlhur Carl 3hdbu, nc ms^ 0/1 jea^andidate Campaign ^^^^mma^^i^^4^^mbrim^m^mmh Q Party [ PAC Referendum JLJ Independent Expenditure fj Joint Fundraiser LJ Legal Expense Fund 0 Booster Fund 1 Building Fund ^^^ejal^nje^tjpng^n^e^-'^l.';"^ & LJ Organizational Thirty-five day Pre-primary l~t Pre-election FT Pre-runoff G ^Sj2ctJ^^0^ j /r/j^h Ccimpaiqr) jcplnsvs and Semi-annual Mid Year Year End Q Organizational Quarterly Hrst Second Third Fourth Semi-annual Mid Year Year End Final d Special fmm&q&mritffitqj^&on'mi? d I Number ScBMM d.at Filed:V':^:-;. Ji Q Ox Phbhe.Number n i i 1M- 4&1- noih ^^eastire^gglesameg^-^^g^^ Q Organizational LJ Pre-referendum Final f~f Supplemental Final j I Annual Special wmmsmmmmmm ^Ac^unVCo&e j'^^s^^0 b^urpose^vj';-.-^!-:ff^ ^^IS:.";.; C^AccountGodEu-:/-^^,...-^ Oi djjpm^begis-bhlanc^ d. Period B&gin Balance^^i^i \ 00 Joan Proceeds *50O& mmmmmmmmmm Icertify that the Committee orfund is in compliance with all applicable provisions ofarticle22a, 22B &22-22M ofchapter163 ofthe NC General Statutes and that no funds are corhrningled with prohibited or other non-disclosed funds. Ifurther certify that this report is complete, true and correct and that Ihave been trained.by the NC State Board ofelections. i / // / Signatur^-ofA^ppoini&ij Treasurer" JO H Ml I afe ^"-^eliverv Method--i ^C[3.f?orrnai~MaiI -..""" %±CM^<^:e.red Mail :': W ^^^^Md;Ielivered * jelec^iicaliy-filedv"'^ & -"'_ -Sigiier has not received'^ i'^-.:. -mandatoryiraimng ->":;C% Please te: 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

2 etailed Summary Use this form to summarize all disclosure reoortinp form. anrl r0 total monetary information ^^^^^^^^^^^^^^^^^^^^^^^^^g 2n-Type of-report?ns:^-g^s Amendment, Yes jgf \/<icharcjhukr krschavv.-j %5_ an 'RmA,tgC^6&H j _ '-J -- - : ~J I "-.:*^-K"* ^Hrr-:-:--.^-?^ 3MP J.'iX) I>UmeryV=:^ Nnmber^-s=5-?sa-ig-5' Z [Start ofelection Cycle: January 1, r%6 j I ' Total this Reporting Period 4) Cash on Hand at Start KE'(BEBB^^^B^^^^^^^g^^^^^^^^^^^^ 5) Aggregated Contributions from Individuals 6) Contributions from Individuals I 7) Contributions from Political Party Committees 8) Contributions from Other Political Committees 9) Loan Proceeds [10) Refunds/Reimbursements to the Committee ll) Other Receipt Sources 11a) Interest on Bank Accounts lib) Contributions from t-for-progt Organizations (CRO-1250) lie) Outside Sources ofincome lid) Legal Expense Fund - OtherSources lie) Exempt Purchase Price Sales 12) TOTAL RECEIPTS (Add lines5, ,lU.lla,llb,llc,lld and lie) Total this Election Cycle 13) isbursements 13a) Operating Expenditures 13b) Contributions to Candidates/Political Cornmittees (CRO-niO) 13c) Coordinated Party Expenditures 14) Aggregated n-media Expenditures 15) Loan Repayments.6) Refunds/Reimbursements from the Committee 17) In-Kind Contributions 18) TOTAL EXPENITURES (Add lines 13a. 13b, 13c, and 17) jjl9) Cash on Hand at End (Add lines 4and 12 together, then subtract line 18j W) n-monetary Gifts Given to Other Committees 1) Outstanding Loans (incl ones from other campaigns) (CRO-1430) 12) ebts and Obligations owed by the Committee 23) ebts and Obligations owed to the Committee i) Account Transfers Within the Committee 15) Administrative Support 16) Forgiven Loans 11) 48-Hour tice Reports Sum 18) Contributions to be Refunded CRO-1100 NC State Board of Elections August 2008

3 si A Amendment ± of ^ Yes "^ Contributions from Individuals Pg Use this form to report individual contributions over 50 or contributions under 50 ifform CRO 1205 is not used 1. CommitteeFull Name (and Fund ifapplicable) Richard' Hooktr for School Vyo^cri (include dry, state, & zip) 113 ijjlr J)tive ShLlbtj, NC cz&i^o 01 Chuck. Sob hbun-b 5ZA Apr, I Or: ShiAtou. Nc &\SO foo-fwfe"?- om f. Prior g. Account Code b. Form ofpayment Ol Cash Bob bivnh )l Cash P. 01 Cash 4. Total only this Page 5. Total ofall CRO-1210 Pages (T/fto /fug iwm/beonline 6 ofetailed Summary Page CRO-1100) CRO-1210 Add Remove 2. I Number /?l/lflc/ A//A ScSPXiH 'i /\ & * /O o&ihijloii /oo Add Remove Mvjvs'hep Oio OUT Sdf-implied ^> CtC* CB/ii/juH -5";o CO Add Remove duhshop Qionor Sl\F- implolj J. i. In-Kind escription j. ate (mm/dd/yyyy) oa/rt/^oji 0&/12M0U k. Amount t>~ 06 * /do*-*- 5^-» ^too^ Is TO NC State Board ofelections April 2007

4 Contributions from Individuals pg <* of A Use this form to report individual contributions over 50 or contributions under 50 ifform CRO 1205 is not used 1. Committee Full Name (and Fund ifapplicable) fte/ijrd'//wjuf 7zS/- School 3o*r-J 3.Contributor Information Q Add (include city, state,& zip) Remove 2. I Number Amendment Yes SeZR&Citi 4M Z*ss Grow ltd- Shtibq, NC ABiSO f. Prior g. Account Code h. Form of Payment 01 Cash (includecity, state,& zip) tfun Uan hiiehatj Chtnc* /SB Mr&shori- 2>. CharrLjviile., NC t%60 l 01 ChicL /?/7 V/s+j Z> ShdbtjiNC o&i^o 0/ Ch<Lck- 4. Total only this Page 5. Total of ALL CRO-1210 Pages (This line must beon line 6ofetailed Summary Page CRO-1100) CRO-1210 c Employer's Name/SpecificField i. In-Kind escription j. ate (mm/dd/yyyy) Add Remove m/m/mii c. Employer's Name/SpecificField tlf' >T)pi6 IjiLcl SO^ k. Amount / M oo Add Remove crc\ Jl/ffiiA '<&>// /^ H-dducL^ Manacfju~ T)cr\dJjcn Vfj-ero /6>0 #& NC State Board ofelections MJAl/i. ' 611 /M> - s r%? i «5>0 &-5-0 April 2007

5 /(P^v Contributions from Individuals Use this form to report individual contributions over 50 or contributions under 50 ifform CRO 1205 is not used 1. Committee Full Name (and Fund if applicable) 7&cb&JjUookur Ur School JSoarc/ Citrine. U. Cahanhs 8Z4 fhde.richsl ShdbL{, NC #&>Z6 (7M) Of Ch^ck. a. Full Name, MaUingAddress & Phone /jjcillt M v<ws ShtlbL/t NC &&>5t> (76A\4&n-M*6 01 Chexk^ AIM Strict n ShdbLj, MC ABte*- f. Prior g. Account Code b. Form ofpayment 61 &sh 4. Total only this Page 5. Total ofall CRO-1210 Pages (This linemust beonline 6ofetailedSummary Page CRO-1100) ''' - Add Remove pg A of A Amendment Yes j^' 2. I Number Bcmqu /Zhhttj c. Employer'sName/SpecificField HIM ih / 2«- M//6/&II /^-2S. Add Remove /^Lrtrt\d c Employer's Name/Specific Field A/A Med-?CjmUe. Election Sum to ate tfs-*2-09/s7/*ot/ <2?5"**- Add Remove /Zejire-J * /6 < >& J9/&lla >i) /d ac ao 4^_ 6>5C CRO-1210 NC State Board ofelections April 2007

6 A s. Amendment Contributions from Individuals Pg Use this form to report individual contributions over 50 or contributions under 50 ifform CRO 1205 is not used 1. Committee Full Name (and Fund if applicable) /?/clljrc/mtoltr for School 7*)6#rc/ (includecity, state, & zip) /Ma M. U)tlh<i/nson '361 Comb; Sh <ZhdbLjl NC <#3ti>^ (7Q<,\ 3& r ^ 5^ f. Prior g. Account Code h. Form of Payment Of Chock c&m /,&rbdlh dvsljhabh, tic #&ISQ Ci Chejck- Add Remove _J of I Yes V/j (liffnrmrrnnftllmm,,^ /\ 2. I Number ScMQ U \J)anAhon lirerfi 5~ >. 2. Add Remove /zk minmrd rn nc»pal c. Employer's Name/Specific /Snecil Field G/jCJuUctnd CoccHl\ Fi/a*iM>{i s 'bo ~dondbcn \Qarn as 6<lj*?iUoil -7. ^-xo 5\ o Add Remove / t7^ firtd m Mill T^r^-1- f. Prior g. Account Code h. Form of Payment / Chock 4. Total only this Page 5. Total of ALL CRO-1210 Pages (This line must be on line 6ofetailedSummary Page CRO-1100) W-2- MlAU1*611 /oo /V6-50 O''- CRO-1210 NC State Board ofelections April 2007

7 isbursements Po /, A P7 v Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political committees and coordinated party expenditures. 1. Committee Full Name (and Fund if applicable) XicJiJhJ f-fdokdr hr School JZr\Z?rl 3/Type ofisbursement "jy^ Operating Expenses ~~] (include city,state, & zip) 7J//uif 'J ^tkthncj do^i Adair L)n vl rjtf. 3hUbnlN(LA6l'5-0 6gf. Account Code g. Form ofpayment h. Purpose Code (Please use separate CRO-1310 forms for each c. Level Registered(Specify) Federal State i. ate (mm/dd/yyyy) Amendment Pg L of L U Yes County: Municipality: j. Amount Campaian (Cards?A /3(*^ 01 Ch&j^k~ ~e> coa/ailzii *mc& rrt n\gj QtvsincibsCa^ Add LTI Remove (include city,state,& zip) ^o^jjcj. com c. Level Registered(Specify) Federal State County: Municipality: Csimp&qn focfsil h. Purpose Code i. ate (mm/dd/yyyy) j. Amount Ol ChojcK A QBl^JM>'n?. lijtbs.-r-^ X IT (include city,state,& zip) j/ljc/onnttj^ Sporktoia 7- PurPose Codes (List detailed expenditure code in (h.) above) A*- Media B* - Printing C* - Fundraising E - Salaries F* - Equipment G- Political Party I - Postage J - Penalties K* - Office Expenses O* - Other Add C Remove * Codes require detailed explanation in required remarks field (k) CRO-1310 NCState Board of Elections r c. Level Registered (Specify) Federal State County: Municipality: f. AccountCode g. Form of Payment h. Purpose Code i. ate (mm/dd/yyyy) j. Amount 01 Check- A >8>/Mrja >H JOO 5. Total only this Page 6. Total of ALL CRO-1310 Pages " (This Hnegoes inline 13a ofetailedsummary Page CRO-1100 ifoperating Expenses) (This line goes in line 13b ofetailed Summary Page CRO-1100 ifcontrib to Candidates/Political Comm) (This line goes in line 13c ofetailedsummary Page CRO-1100 ifcoordinated Party Expenditures) % oc> (Csmpcuan yzsjlirfe /^>Op mnrld I~.sh»r4s i <to*r. gx G'7 J7&0 - - To Another Candidate H* - Holding Public Office Expenses Q* - onationto Legal Expense Fund J ecember 2009

8 isbursements,-2 <f a A"-* tt *u- r.... pg J2L of _T_ Yes Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political committeesand coordinated party expenditures. 1. Committee Full Name (and Fund ifapplicable) tichairi HMk.<Lr +r\r irhr^j r^^r-a 3/Type ofisbursement (Please use separate CRO-1310 forms for each J2L Operating Expenses Contributions to Candidates/Political Committees rrdflttfonal /ouch 110 Chtrrvjville. ~RcaA X 2. I Number arart^m L Account Code g. Form ofpayment 01 Chtck (include city, state,& zip) (JJisi-morihnd J^/ninn Inc Sht\bL\, NC ABiSoL (704) AbZ-CflC) 01 Ch&ck (include city, state,& zip) USPS 01 Chick, 01 ChicK 5. Total only this Page 6. Total ofall CRO-1310 Pages (This line goes intine 13a ofetailedsummary Page CRO-1100 if Operating Expenses) (This Hnegoes inline 13b ofetailedsummary Page CRO-1100 ifcontrib tocandidates/political Comm) (This Hnegoes inline 13c ofetailedsummary Page CRO-1100 if Coordinated Party Expenditures) 7. Purpose Codes (List detailed expenditure code in (h.) above) A* - Media E - Salaries B*- Printing F* - Equipment C*- Fundraising G - Political Part)' I - Postage J - Penalties K* - Office Expenses O* - Other * Codes require detailed explanation in required remarks field (k) CRO-1310 NC State Board ofelections - To Another Candidate H* - Holding PublicOffice Expenses Q* - onationto Legal Expense Fund ecember 2009

9 isbursements Pg _.r 4 fjt M Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political committees and coordinated party expenditures. 1. Committee Full Name (and Fund if applicable) ^^_ 2. I Number #C-p>Afjh4 j TyPe ofisbursement (Please use separate CRO-1310 forms for each type ofisbursement.) 13x Operating Expenses Contributions to Candidates/Political Committees Q Coordinated Party Expenditures" Add Remove (include city,state, & zip) ZW ffuskuj 01 ChtLc-t h. Purpose Code c c. Level Registered (Specify') Federal State i. ate (mm/dd/yyyy) tfliukoll County: Municipality: j. Amount /0O&- ^^ /^W Cahrmc* /# 2 k. Required Remarks For rtft*jr)c^ru)r r^kiro Vrmi /nc 01 Ch^ h. Purpose Code A Add Remove c. Level Registered (Specify) Federal State i. ate (mm/dd/yyyy) m/m/mi County: Municipality: j. Amount c t<fn Uard S'fs>s /JOf^ curd S"ins '4\ ] (includecity, state,& zip) -Tfii Sbilbtj Ster 7>0- B<&l 49 J/u-lbLj, A)C J&I& (764) 4M Chuck* b. Purpose Code A Add l~~l Remove c. Level Registered (Specify) Federal State County: I I Municipality: i. ate (mm/dd/yyyy) j. Amount 61/zjL/jLoH 5-^ 5. Total only this Page 6. Total ofall CRO-1310 Pages (This Une goesinune 13aofetailedSummary Page CRO-1100 if Operating Expenses) (This Hnegoes inline 13b ofetailedsummary Page CRO-1100 ifcontrib tocandidates/pohtical Comm) (This Hnegoes inune 13cofetailedSummary Page CRO-1100 if Coordinated Party Expenditures) 7.Purpose Codes (List detailed expenditure code in(h.) above) A* - Media E - Salaries I - Postage B* - Printing F* - Equipment J - Penalties C* - Fundraising G - Political Party K* - Office Expenses O* - Other * Codes require detailed explanation in required remarks field(k) CRO-1310 NC StateBoard ofelections Af i 3^ i5«vur\{ /Id /*?<?u, q^r un 78C> - To Another Candidate H* - Holding PublicOffice Expenses Q* - onationto Legal Expense Fund ecember2009

10 jt yt Amendment isbursements Pg nf_ of _L Yes Usethisform to reportexpenditures fromthe committee for; operating expenses, contributions to candidate/political committees and coordinated party expenditures. 1. Committee Full Name (and Fund ifapplicable) 2. I Number SC&BCfM 7?*>chard f/00ktr /z>r Jchool ~P>6Ard 3. Type ofisbursement (Please use separate CRO-1310 forms for each ie ofisbursement.] *fc3l Operating Expenses I Contributions to Candidates/Political Committees I I Coordinated Party Expenditures Add Remove (includecity,state, & zip) UUdST-moribnd Vrinhss /no A0&0 tten Bivfc/. (7cYt) 42> h. Purpose Code c. Level Registered (Specify) Federal State County: I Municipality: i. ate (mm/dd/yyyy) j. Amount 01 Chick. 3. oi/^i/aqh 53* fjtthjrbilad 5*> **??*** K Fr-ZprttS/SCrVa /Tc/p&sQjtoncj UtiLrcl^rifii' Inc- (104) 8(*s~/C l 61 Chock.. h. Purpose Code f Add l~~l Remove c Level Registered (Specify) Federal State County: I Municipality: i. ate (mm/dd/yyyy) j. Amount (ftl*tril<zoil s.3 Sn5^ Add Remove SJands tor SicjnS /7^5- ^ <*3 c. Level Registered (Specify) PI Federal Q County: I State l~] Municipality: h. Purpose Code i. ate (mm/dd/yyyy) j. Amount 5. Total only this Page 6. Total ofall CRO-1310 Pages (This Hnegoes in Une13a ofetailedsummary Page CRO-1100 ifoperatingexpenses) (ThisHnegoes in Une13b ofetailedsummarypage CRO-1100ifContrib to Candidates/Political Comm) (This Unegoes in line 13c ofetailedsummary Page CRO-1100ifCoordinatedPartyExpenditures) 7. Purpose Codes (List detailed expenditure code in (h.) 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) 1 42s1< >\ d.nzo un - To Another Candidate H* - Holding Public Office Expenses Q* - onation to Legal Expense Fund CRO-1310 NC State Board ofelections ecember2009

11 /P^N jjpn, Loan Proceeds Pg / Use this form to report proceeds from a loan and loan endorser's information A loan proceeds statement must accompany each loan that is from an individual 1. Committee Full Name (and Fund ifapplicable) Richard /-/ookiur for School hoard 3. Lender Information 'Richard f-foohtr Jr. f5~ 0 KinCi jdruhor CbOrr ShtibLj, NC J&IZ^ g. Rate h. Security Pledged 0 % h^m I. Full Name oflending Institution Al/A 4. Endorsers/Makers (Thepeople who guarantee the loan.) A//A Add irccilor 7)LLUopmxnr- Cxintvtr Amendment of _L_ Yes ^f 2. I Number Sck&cu Remove i. Account Code j. Form ofpayment k. Amount einj loan e. Start ate (mra/dd/yyyy) 0Q\bt\M>\ f. End ate (mm/dd/yyyy) 01 /ranspt-r s^odo^ aj/a d. Percentage m. Loan Number AJ/A e. Amount AtM d. Percentage e. Amount d. Percentage e. Amount d. Percentage e. Amount % 5. Total ofall CRO-1410 Pages (Thislinemustbe onune 9 ofetailedsummarypage CRO-1100) CRO-1410 NC State Board ofelections! d^oo April 2007

12 j00\ Loan Proceeds Statement The individual making a loan to the committee must provide the following information. Failure to provide all of the information requested could be a violation of campaign reporting disclosure laws. Name of committee to receive loan: /\,chard AAfinkur Person lending money to committee (Lender): & 7/chjr,W McOokjLr J>. ate ofloan to committee: -Ar, Uon/.ft/Mrs/ 9 /B/eZ/)// Name of lending institution and account number (source): Afh'a Amount of loan: #ol_ 500 CO Names of all parties responsible for payment of loan (guarantors): Af/A Period of loan: Af/A Rate of interest of loan: / Security pledged for loan: /V/A I, /[/fihard /-//)/>Jc*r (Jr. (Person lending money to committee)., acknowledge that all of the information provided is complete, true, and accurate. I further understand I may not forgive a loan that has an outstanding balance to any source. Signature of Lender yyj^ iature of Treasurer of Committee This form must be submitted with the disclosure report for which the loan is initially disclosed. CRO-6100 Loan Proceeds Statement July 2007

13 Refunds/Reimbursements To the Committee p8 j/ Qt J ^2^* Use this form to report refunds received by the committee orreimbursements for aprevious expenditure. UCommittee Full Name (and Fund ifapplicable) %,ehar<f fvadzr fir,?r.hoof r\aarj ShLlbL/, NC JAISO 744) 4SA-4S*?9 2. I Number P IACM&ti Contributor Informfltinnvv ,....,. ^^^i\l^mt\i.addyv Q Remove \t<.m<vt» ' d.type ofcommittee g. Comments LJ Candidate PAC U Referendum Q party e. Level Registered(Specify) /^l^trtj.accountcode LFonnofPayment 01 Chtck 1 :. Fun Name, Mailing Address & Phone (Include dty, state, & zip) Federal I"! State LJ County: LJ Municipality: h. Original Expenditure ate tft/falaiml I. Original Expenditure Ami 35-M c Employer's Name/Specific Field f. Purpose j. Election Sum to ate A//A %/35-2 m In-Kind escription ihnn ' n. n Tkat» ate (mm/dd/yyyy) frrrmlaa Shilbd Shf AJ \q^ia3im U Add Remove d.type ofcommittee Candidate Q PAC Referendum f~ Party e. Level Registered (Specify) Federal LJ County: Q State Municipality: o. Amount g. Comments ft*^ h. Original Expenditure ate L Original Expenditure Arat bujob Title/Profession c Employer's Name/Specific Field f. Purpose. Election Sam to ate k. AccountCode L Form ofpayment m. In-Kind escription n. ate (mm/dd/yyyy) o. Amount 3.\Contributor Information Full Name, Mailing Address & Phone (Indade dty, state, & zip) Add-^ Remove d.type ofcommittee LJ Candidate Q PAC Referendum f" Party e. Level Registered(Specify) Federal State Lj County: LJ Municipality: g. Comments h. Original Expenditure ate i. Original Expenditure Amt Eh Job Title/Profession c Employer's Name/Specific Field f. Purpose J. Election Snm to ate k. Account Code L Form ofpayment m. In-Kind escription n. ate (mm/dd/yyyy) o. Amount 4%Tbtal only this Page v Scrotal ofallcro-1240 Pagesi;~ %(ThuUnemwibltohU^ CRO-1240 ^>##?. NC State Board ofelections. Full Name, Mailing Address & Phone (Includecity, state, & zip) ~/3>6tLr/ /. Mi/ltr- JJS-3' ecember 2007