d ~ and ~elivered \ I '&A Disclosure Report Cover - y=.~. 9 ~9. /&-2s- 13 ~mj- yee.

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~ ~ Amendment Disclosure Report Cover y= ~ 9 ~9 Use this form for general repon: and committee information, ::ust h 2 signed and submitted along with other detarled forms States and &at no funds are,true and conem and that ha funds funha cutify that this Date Received: /&2s 13 ~mj yee Date Postma~ked: Em: yee Date Scanned: ;ye \ '&A Dcliverv Method Normal Mail Regisfered Mail d ~ and ~elivered Eiecaonically Filed C) Signer has not received Date Data Emere& Empoyee sm3dmxyg Please Note: This form cannot be used to amend committee information such as the m&&ee address, treasurer, assistant treasurer, custodian of bcc~ mformatiou, or accwnt information You must amend the Statement of Organq&n [@@21WAE) to make cornmiace changes CRolOoa NC Staa goard o~e!cctiom August 2W8

!,mendmerit Disclosure Report Cover n yes m xo Use this form for general report and committee infoma!io: s si; ::a :?!id sub ;;:tea don: w!th other detailed forms, Mailing Address (include City, State and Zip Code) ~ ~ yo/ //AvE;uCKHsE DZi L'k TTHELci5 t NL ;zb/~)l7' ~ c U Number ~~ d Date Filed Report Yearl3 Period Start Date (mmlddlre, 1 Pen>d 3d 1 ate lnmlddfn) 15 Treasum Full Name ri? ~perir NO ML 11 Aa?oont nformation il Account nformation Finandal nstitution FuU Name f i oeisi inrtiwtion Fsit Name ~ ~ rum nz M /Lri r V D M %aa/~,/~ ~ F Account Code c Account Cade certify that the Committee or Fund is in compli&~ce with 311 a:): il ro\ o ~ ~ : ''4 i?zb c9: 3232213 of Chapter 163 oiths NC General Statutes and that no funds are fzniis! funhzr ceitify chat this repon is complete, me and correct and that have ELL bek~ Prinred Name of Signer >: ;:~re f ripso~arcd Dare FOR OFFCE USE ONLY Date Received: 9216 \ 7) Date Postmarked: km r: ~ Date Scanned: ~mp,, 'r~wsum: Deliveri hlethod Kormal Mail Registered Mail @Hand Delivered Eleclronically Filed ";: _pn:4~ Signer has not received Date Data Entered: Empi : =mandatory training Please Note: This form cannot be used to amend cony 8 : for 7arins slch is the committee address, treasurer assistant treasurer, cusrodian o: boo: lib nau ::: sr ~;COCC: informaiiol~ You must amend the Statement of Orga~zatic CR 2100AE! to mke commiriee changes t CRO1000 NC Stzie E c 2: :<,o:, Aupust 200

~ Detailed Summary Cse this form io summmze all disclosi~ie redoruw forms r 11 J t 4 n;nc;z$ dc rrajsn Cornminee Full Name (and Fund if applicable) : T w of RFF J 3 8 [imtn, 71ee Jb a/ BLL &ti% Start of Election Cycle: January 1, A/ 3 4) Cash on Hand at Start RECEPTS 5) A~meeated Contributions from ndividuals 6) Contributions from ndividuals 7) Contributions from Political Party Committees 8) Contributions from Other Political Cumrnittee? 9) Loan Proceeds 10) RefunddReimbursemcnts to the Committee * L C * * D Number 7 P,d,>/dT "& LC4 7&yC To a1 this Total this Reporting Period, Election Cvcle 1 la) nterest on Bank Accounts llc) Outside Sources of ncome lld) Legal Espense Fund Other Sources llb) Contnbutlons from NotForProfit Orgarnzat r ~ x ~ ~ r e h Price a s Sales e ) TOTAL RECEPTS,Add lines 56 T &, 'Ji::!; i XF'ENDTURES 13) Disbursements ~~~ ~~ 13a) Operating Expenditures 13b) Contributions to CandidatesPolitical Cornmjt ~~ ~ 13c) Coordinated Party Expenditures ~ 14) Aggregated NonMedia Expenditures ~ 15) Loan Repayments ~ ~ 16) RefundslReimbursements from the Committee 117) inkind Contributions 18: TOTAL EXPENDTURES (Ad3 LY:,!>; :3:,! 19) Cash on Hand at End (Add lines 4 a d i? ~w!!::r : ~ 0) NonMonetary Gifts Given to Other Committee? ~ Loans (icl ones from other caulpsi? and Obligations owed by the Committee 3) Debts and Obligations owed to the Committee 4) Account Transfers Within the Committee r~nistrative Support / CRO1100 'CS 3 Xi: fel::~iac:j Aogurl2008,~ E' 6) Forgiven Loans RO #io, ~ ~~ 7) 48Hour Notice Reports Sum 0 : ) Contributions to be Refunded, R O! s : r

Aggregated Contributions from ndivid tls 1 f Optional form used to repon NC Contributions Fro= ~ivl la11 sf Sjb or icss Amendment / yes ~ RNP (This line must be on Zinc 5 of Defniled Svmmory Page CRO'M] CRO1205 YC S~ e

irmendmenr Disbursements i ~f 2 3 yes El KO Use this form to report expenditures from the comminea fc:; n: ig t,3,:nsis cor::ihitions to ca~~didaielpc~litical comrmtteer and coordnated pmy exwn&tures (1 Committee Full Name (and Fund if applifable) J211, Number /os5i\ /=',&?,di ipfirr &d Ly,/apLorre NC 223277 o /; Li3S 77" paprr 5 J&/( P~/&r/fi+ 7 ~ s 0 TALL, G$S PAD in/& TH~uS, /v'c =/&if (inclnde city, sfate, & rip) r'mminared Cornmiti Smai n;isi,n;e '2 :e re1 Xrgislereil (Spe :ify! 70 Ao6L4&& ;C F~:,: ~~:%u?r)~ 5; P#L> fig s"d/&+ (This line goes in line 13a of Dclniled Swnrnnry Pa@ CROl'Oll J?rcr? fib (This line goes in line 13b of Delniled Summnr) Pnge CRO!OO iutni o Ccndidotec/Potilc2i Cornm), J Penalties CRO1310 December ZOO9

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