Amendment Disclosure Report Cover Ow % Use this form for genera report andl commit information, most be signed and submited along with other detailed form Do nt se this form to update information T. Committe Inform “a Full Name [1D Number ‘Commitee o Eee jan Sell a —| ng ds Ci Ste dip Cal) = ei Fir PO Box 5566 > Greensboro, NC 27435 ae “Pins Name Bae MS4646 Report Year| Pele Sart Datei) | EFELOGER DA [5 tremurer Full Name 2000 | 7.1.09 | 8:25.09 | & Type af Committe (Check One) 3 Type af Report (cheek ony one npe of report om one caegor) a Canine Campaign] Vany ‘Mtanilpal TstaterCoonty Referenda Oo orsc Dl Refremtum ‘Organizational ‘Organizatewal ie) Ocminnoe eree mast st rininier | BQ Tnsmeaw — | Osan OO Premed Bl _beeat Expense Fund | Type of Fund” (applicable checkoney |] Preprimary lo Fist O Fim TL Booster Fund Ds Preelection (ao Second Supplemental Finat Guiting Fund Brent lo Thin inp Semanal Gl Fwnt Ol Spit fo) ates Sens — CO ote ee) Te Speclal Report Namie Ol Fin lO Year End t 8. Number of Fundraisers this Report D1 Special (0 Fina [svat Ti Account Information TT Account information 1: Finan satin Fall Nn 1 inl asin Full ae —= “Trulan Federal Credit Union : : eI Pepe [Act oe Tiare Camapaige account for a receipts & Tiered ai ace expenditures S$ 927.50 ‘CERTIFICATION 1 certify thatthe Committee or Fund isin compliance wit all aplicable provisions of Article 22A. 22B, & 22D-22M of Chapter 163 of the NC General Statutes and that no funds are commingled with prohibited or other non-disclosed funds. [further eerily that this report, is complete vy comes ta een aid ye NC Spee em 04 Pinal Name Seer ‘Skane of Arid Tener Dav FOR OFFICE USE ONLY : . Delivery Method pucresiet — RECEIVED enntes: Paice DnePosinarst: §—_GEP 49999 Employee Fy KResinsre Mal Date Scanned GUILFORD COUNTY, Employee: 8 BOARD of ELECTIONS: snandatory taining Date Data Entered Employee 2 Please Note: Phis form cannot be used to amend committee information such asthe committee address, treasurer, assistant treasurer custodian of books information. oF account information, ‘You must amend the Statement of Organization (CRO-2100A-E) 19 make committee changes. CRO-T000 NC State Sean of Elson coer)Detailed Summary O's Os Use this orm o summarize al disclosure reporting forms and to toa monetary information, 1. Committe Ful Name (and Fund if applicable) | 2 Type of Report Tip Nabe ; = oars] Toa Start of Election Cyele: January 1, me 2OOSEE Enea: ee eee a $_ 92730 [s_—_97730 8) cno-105) | 186.00 S__ 18600 6 ‘cao-n1y [5 60000 Ss 60000 2) Contibutons from Political Party Comiitees (cro 5 4). Contributions from Other Political Committees (cno-n 3 9) Loan Proceeds ‘crosaty s 10) Refunds/Reimbursements To the Conn (cxo.1240) 11) Other Receipt Sources Ma) Interest on Bank Accounts (cro. 230) 1b) Contributions from Not-for-Profit Organizations (CR0-1250) Me) Outside Sources of Income c%0.1250) 11d) Legal Expense Fund ~ Other Sources (cx0.1270) 11.) _ Exempt Purchase Price Sales (cn0.1265) 12)_TOTAL RECEIPTS add ima 47,591 Ita. 10h lia Tide To 13) Disbursements 138) Operating Expenditures (cR0-1810) 13) Contributions to Candidates/Poltical Committees (CRO-07 s 13e) Coordinated Party Expenditures (cx0-1310) § 14) Agaregated Non-Media Expenditures (cxousis s 15) Loan Repayments (cxo-u2y 5 16) Refunds/Reimbursements From the Conamittee (80-1320) § 17)_leckind Contributions ccao.isiy | els 5 640.59 1072.91 18) TOTAL EXPENDITURES (4d ne 1,136 10 1418 tol 7) 19) _ Cash on Hand at End sd ines tnd J2 pei son sac fe 18) ADDINVTGNAD INFOR WON GA mee ene 20) Non-Monetary Gifts Given to Other Committees (cno.1830) 21) Outstanding Loans (inc. ones from other campaigns) (CRO-1420 22) Debts and Oblig: 2) 24) Account Transfers Within the Committee ws owed By the Committee cxo.s010) |S as oved To the Committee cxo.1820) |S 25) Administrative Support 26) Forgiven Loans ccro.1840) cno.2200 [ 27) 48-Hour Notice Reports Sum 28) Contributions to be Refunded CRO-TT00 Teta Beno Fie ETAggregated Contributions from Individuals me lal Oo % Oo Opvional form use to report NC Contributions From Individuals of $80 or ess T, Commitee Full Name (and Fund ifappicable) ZI Nanber Commie to Elect Ryen Shell 3. Contributor Information Amend TB Recowt [Form of Pagment fama eae | ae Online ros |S 2500 3 1 Online rasoo [$2500 tH — 1 Online 72200 | 5 t00 a 1 Online rao | s_3800 1 S$ 25.00 L Online { 1 Online j 8 3100 L Online S$ 20.00 1 Online 8-18-09 S$ 25.00 ame aa com 7a ena Ta [aa Teme a cr at ame ra + co | oI + 1 tem | fa ; fame a fal ro Ta tT T Remove i ie [Aga a 4. Total only this Page e 5. Total of ALL CRO-1205 Pages s Chis ine mst eo int 5 of Deed Summary Page CRO-1100 CRO-1205 NCH Band Es oy rrr | sicoiaciiagdc cl aContributions from Individuals re of D w O % Use this forn to report individual contetbutions over $50 o¢ contributions under $50 ifform CRO 1305 is not used T, Commnlitee Fall Name (and Fund applicable) 2.1D Number =a ‘Commitee to Elect Ryan Shell 3. Contributor Information QO add Remove 1 Fall Name Mating Maren Plane ——~SSS~S*~*~dC df Troon Gicndiy.stnte i) 1 Director of Undergrad Aisa ( eEonplay ars Nome Speci Steve More c 2810 Alderman Ct UNCG Greensboro, NC 27408 at Payment [Pri] g Avcount Code | WF of Calne a | E ee | 3. Contributor Information Dag 0 Fall ee, Nig Ars Pa eo (i ‘ex0) ‘Wholesaler Alisha Wier [Timea emepancrar | 711 Chesnut St Tincoln Financial Group S| Greensboro, NC 27405 i [Fin Seve | les Ehvior |g Aeon Code [he [bate onan Amount o 1 | Ontine 85-09 s 100,00 o 1 — 1 oO i [s 3, Contrbstor Information aa Rene 1 Fall Ne, ig Adres Pane Teh Taco co Aatude city tat, & ip) Wholesaler Alisha Wielfaert 711 Chestnut St Greensboro, NC 27405 [informer Pape FT bae maT) | Online $14.09 50.00 {| __ ~ | | s l is 4. Total only this Page 5 200.00 5. Total of ALL CRO-1210 Pages s 600.00 Tis line must online ef Dnled Summary Page CRO-L100) CRO-T20 NC Sat Boarder Eso orContributions from Individuals Awendnen Pe 2 of 1 O w OQ w Use this form to repor individual contributions over $50 or sontibitions under $50 iF Form CRO 105s wot used 1, Committee Ful Name (and Fand i applicable [2D Number Committee to Elect Ryan Shell Contibutor faformation _o- Th Remove ang ‘Ful ae Maing Addo & Prone Common = ead cy, state & 0) _ Phil Bullington [ Nae 2108 Rolling Re j Continent a Greensboro, NC 27403 | = Bion Sa Dat | $100.00 “Erion [x Account Gade hFormot Payment | i eKind Daan 7 Date 5) Anew of Online | 822-09 s 109.00 ala I I 8 o | i | $ 3. Contributor Information GO Ai_ Remove 2 1 Fal Name Mang Address & Fhowe EConments |__ inte ity tate ip) Eric Haw Engler NomelSpac Fe 7Sualer PL United Heath Group Greensboro, NC 27410 | Eilon Sumo Bae s Prior |g Account Code [ h Form of Payment | Win Nid Dawipion i bn Ganiaainyy Tass ee] all Online | I [Ts 50.00 Qo | s o | | s ‘Fall Na Loretta Calhoun 3812 Madison Ave Greensboro ‘Pilon |g Aveount Code] We Form of Pane of: Cheek | 2 - - Qo I Is 4, Total only this Page Ts 300.00 | 5. Total of ALL CRO-1210 Pages _ 600.00 his tine must be on ie of Detited Summary Page CRO-1100) €RO-1210 NC Sale Brana EksomeContributions from Individuals " «2 Ow » LUse this form to repon individual contributions over $50 or contributions under $50 Tom CRO 1205 ino ned Name (and Fund if applicable) [21D Number 7. Committee Commitee to Elect Ryan Shell 3 Contributor Informati Fall Name Nalin dees & Phone Gata, sat, 2) Bob Lamar 327 Gorrell St. Greensboro, NC 27406 3, Contributor Tformation TAs Renove I 2: Fal Sime alg Aras & Powe [ies Tiron TL Goament ‘ ae | Bonnie Etber f 336 MeAdoo Greensboro, NC 27406 | fos | eBir—[ p aoen Cole [k Fermet apm [bac tamaatiyn [eho Cash ] 8-24-09, | s 100.00 |s - = | DO Add) Remove ‘Fall Nee Mailing Aare & Phove —Thedeb TielPrafeaion Gincadesitstate sip) I 4. Total only this Page s 30000) 3. Total of ALL CRO-1210 Pages (his ine mst be on ie 6 Dette Summary Page CRO-1100) CRO-T210 NC Sure Beano Besar an y 600.00