Disclosure Report Cover GiICOPY Anendmek Use this form for general report and committee informatTon, must be signed and submitted along with other detailed forms. Do not use this form to update information [EID Nomar “Type of Commas haa On IE Canine Corpses EL) Pay 7 i I rac By Referendum [EQ Organizaioaat 1D cvzsniaticnal TD Organization ED teenie gente doin Per IB Tay Sve dy Quanery EE Prenseendom ED Leet Expense Find 1 Pre primary Os Co Fin EE Pression scout 5 Seppe nat (aAype ot Rima app Prete wm ssn ET Booster Fans Samana! Fane ED speci ED boii Fons Mil Yea Semana st (Miser veortns EE rns sje i TnforRaatTOn sition Full Name [= Account Code 7 [= Account Code ¢ [a Period ogni a: Period Begin Balance $ 75,858.76 und isin compliance wih all applicable provisions of Article 224, 22B & 22D-22M of Chapter 163, ofthe NC General Statutes and that ao funds are commingled with rabitited or other non-dislose funds, further oe reports complete, true and correct and that [have been trained by Une NC StateBoatd of Elections Le FF “polyon | Wt g anes FOROFFICE USE-ONLY _ Datvery Method Date Received: ee Employ — 1 Normal Mail Ch Registre Mai Date Posmarked: Employee: Reiter Mal puesamed Reagent 1 ceri that the Committe o tha this Date Data Entered Employee: 1 Signer bas not received This form cannot be used to amend committee information such as the committee address, treasurer, assistant treasurer, custodian of books information, or account informat ust amend the Statement of Organization (CRO-2100A-E) to make coms CRO-TI0 THC Sine Hard of Fesooe aaaDetailed Summary Coma rrret. 7 KOSS STEFHE Use this form to summarize all disclosure reporting forms and to total monetary information, Amendment Ove Gs tart of Election Cycle: January 1, 4) Cash on Hand at Start Total this Toral this Election Cycle '5) Aggregated Contributions from (CR0-1208) 6) Contributions from Individuals (cxo-1210) 7) Contributions from Political Party Committees (co-1220) 8) Contributions from Other Political Committees (€RO.1230) 9) Loan Proceeds «cxo-1510) 10) Refunds/Reimbursements to the Committee (cxo.1240) 11) Other Receipt Sources Ha) Interest on Bank Accounts (cRo-1250 1b) Contributions from Not-For-Profit Organizations (CK0-1250) le) Outside Sources of Income (cR0-1250) ‘Lid) Legal Expense Fund - Other Sources «cxo-1270) exempt Purchase Price Sales (cx0-1268) 12) TOTAL RECEIPTS (Ada ines 5, 6,7. 8, 9,10.11a 116 MetIdand Le] 13a) Operating Expenditures (cx0-1310) 13b) Contributions to Candidates/Political Committees. (CR0-1370) 130) Coordinated Party Expenditures (CR0-1310) 1.4) Aggregated Non-Media Expenditures (cRo.1318) H's) Loan Repayments (cRo-1220 16) Refunds/Reimbursements from the Committee (cxo.1320) (cxo.1s10) [EXPENDITURES (Add ines 130,136, 13,14, 15, 16nd 1) 20) Non-Monetary Gifts Given to Other Committees (CR0-1330) 21) Outstanding Loans (incl. ones from other campaigns) (CRO-130) [22) Debts and Obligations owed by the Committee (cno.1610) 3) Debts and Obligations owed to the Committee (80-162) 4) Account Transfers Within the Committee (cxo-1720 15) Administrative Support (cRo-1710 26) Forgiven Loans (cRo-1400) C80. [25) Contributions to be Refunded (ROL) CRO-1100 ToeAggregated Contributions from Individuals Pave Optional form used to report NC Contributions From Individuals of $50 or less Amendment LZ. 0 ws @ no 1. Committee Full Name (and Fund if applicable) 2.1 Number ‘Committee To Elect Ruas Stephenson 3. Contributor Information z , Account in-kind a. Amend eae «Form of Payment cere co (| Ges: ‘Add Rene | 7 CMEC Ade Renae ‘ade ‘Remove BREECH CAE i Hae ify z Tl Remove | 2 tates : [as 1 CT [Remove I e Eada | FELT Rene | B o_paae o Remove S a ‘Add 3: Remie (hae — Remove | s feta o Remove Z a ‘ aw [ET Remove = s a eT : : 8 er : 1. Total only this Page $_7EO -O> “] 5. Total of ALL CRO-1205 Pages (is tine rst be on tine Sof Detailed Summary Page CRO-1100) CRO-1205 ‘WC Sat Board of Elestions ‘apaz007