Kennedy 2012 Year End Report Amendment
Disclosure Report Cover o Yes DU No
Use this form for general report and committee information,must be signed and submitted along with other detailed forms.
Do not use this form to update information.
L Committee Information
a.Full Name e. ID Number
THE COMMITTEE TO ELECT JAN KENNEDY CLERK OF SUPERIOR COURT
b.Mailing Address(include City,State and Zip Code) d.Date Filed
519 SEA CASTLE CT.. 01/13/2013
WILMINGTON,NC 28412
e.Phone Number
2.Report Year 3.Period � ` ate(mm/dd/yy) 5.Treasurer Full Name
ate» � .�� °. �" c',.�:.I`�` f D
2012 07/01/2012 12/31/2012 GEORGE FRANKLIN JONES
6.Type of Committee(Check One) 9. •ms',sR e port (check o nly one ty e of ep e k €a 'g:k`a
,LiT .Cr�.��
® Candidate Campaign ❑ Party Municipal State/County Referendum
❑ Joint Fundraiser ❑ PAC ❑ Organizational ❑ Organizational ❑ Organizational
❑ Referendum ❑ Legal Expense Fund ❑ Thirty-five day Quarterly ❑ Pre-referendum
C ^� M '$ , 8 ' ❑ Pre-primary ❑ First ❑ Final
❑ "Booster Fund" ❑ Pre-election ❑ Second ❑ Supplemental Final
❑ Building Fund ❑ Pre-runoff ❑ Third ❑ Annual
❑ Presidential Election Year Candidates Fund Semi-annual ❑ Fourth ❑ Special
❑ NC Public Campaign Financing Fund ❑ Mid Year Semi-annual
❑ Year End ❑ Mid Year 10.Specialnt Name
❑ Other: ❑ Final Year End
e. s� ..: , e a, o- ❑ Special ❑ Final
0 ❑ Special
3.Account Information 3.Account Information _
a.Financial Institution Full Name a.Financial Institution Full Name
FIRST CITIZENS BANK
b.Purpose c.Account Code b.Purpose c.Account Code
CHECKING 1
d.Period Begin Balance JAN 12 2O!''
d.Period Begin Balance
$
23 . 02 HC Bd of Elections $
CER'H}ICATION
I certify that the Committee or Fund is in compliance with all applicable 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. I further certify that this report is complete,true and correct and that I ha been trained by the NC State Board
C •Frei Kid- ov eS .- I r 01/13/2013
Printed Name of Signer Signature Ap nted Tre r Date
FOR OFFICE USE ONLY
Date Received: Employee: .1
Delivery Method
❑ Normal Mail
Date Postmarked: Employee: ❑ Registered Mail
,g. Hand Delivered
Date Scanned: Employee: ❑ Electronically Filed
Date Data Entered: Employee: ❑ Signer has not received
mandatory 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-2100A-E)to make coirunittee changes.
CR0-1000 NC State Board of Elections December 2007
Amendment
Detailed Summary ❑ Yes ® No
Use this form to summarize all disclosure reporting forms and to total monetary information
1.Committee Full Name(and Fund if applicable) 2.Type of Report _3.ID Number
THE COMMITTEE TO ELECT JAN KENNEDY 2012 Year End Semi-Annual
CLERK OF SUPERIOR COURT
Start of Election Cycle: January 1, 2011 Total this Total this
Reporting Period Election Cycle
4) Cash on Hand at Start $ 7307 $ 1119 . 99
RECEIPTS
5) Aggregated Contributions from Individuals (CRO-1205) $ 0.00 $ 0.00
6) Contributions from Individuals (CRO-1210) $ 0.00 $ 750.00
7) Contributions from Political Party Committees (CRO-1220) $ 0.00 $ 0.00
8) Contributions from Other Political Committees (CRO-1230) $ 0.00 $ 0.00
9) Loan Proceeds (CRO-1410) $ 0.00 $ 0.00
10) Refunds/Reimbursements to the Committee (CRO-1240) $ 0.00 $ 0.00
11) Other Receipt Sources
11a) Interest on Bank Accounts (CRO-1250) $ 0.00 $ 0.00
11 b) Contributions from Not-For-Profit Organizations (CRO-1250) $ 0.00 $ 0.00
11c) Outside Sources of Income (CRO-1250) $ 0.00 $ 0.00
110) Legal Expense Fund-Other Sources (CRO-1270) $ 0.00 $ 0.00
11e) Exempt Purchase Price Sales (CRO-1265) $ 0.00 $ 0.00
12) TOTAL RECEIPTS (Add lines 5,6,7,8,9,10,1 l a,11 b,11 c,11 d and Ile) $ 0.00 $ 750.00
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (CRO-1310) $ 0.00 $ 1,749.97
13b) Contributions to Candidates/Political Committees (CRO-1310) $ 0.00 $ 0.00
13c) Coordinated Party Expenditures (CRO-1310) $ 0.00 $ 0.00
14) Aggregated Non-11�et (CRO-1315) $ 0.00 $ 97.00
15) Loan Repayments JAN 2 2 20S (CRO-1420) $ 0.00 $ 0.00
16) Refunds/Reimbursements from tllg M a (CRO-1320) $ 0.00 $ 0.00
17) In-KindContributiMs (CRO-1510) $ 0.00 $ 0.00
18) TOTAL EXPENDITURES(Add lines 13a, 13b, 13c, 14, 15, 16 and 17) $ 0.00 $ 1,846.97
19) Cash on Hand at End(Add lines 4 and 12 together,then subtract line 18) $ 2 3 . 0 2 $
7� ,,(li
ADDITIONAL INFORMATION
20) Non-Monetary Gifts Given to Other Committees (CRO-1330) $ 0.00
Z1) Outstanding Loans(incl.ones from other campaigns) (CRO-1430) $ 1,500.00
Z2) Debts and Obligations owed by the Committee (CRO-1610) $ 0.00
Z3) Debts and Obligations owed to the Committee (CRO-1620) $ 0.00
Z4) Account Transfers Within the Committee (CRO-1720) $ 0.00
Z5) Administrative Support (CRO-1710) $ 0.00 $ 0.00
Z6) Forgiven Loans (CRO-1440) $ 0.00 $ 0.00
Z7) 48-Hour Notice Reports Sum (CRO-2220) $ 0.00 $ 0.00
28) Contributions to be Refunded (CRO-1215) $ 0.00 $ 0.00
CRO-1100 NC State Board of Elections August 2008
Amendment
Outstanding Loans Pg 1 of 1 ❑ Yes ® No
Use this form to report any outstanding loans received during a previous reporting period and until the loan is paid in full.
1.Committee Fall;Name and Fund ifa;,s icable 2.ID Number
THE COMMITTEE TO ELECT JAN KENNEDY CLERK OF SUPERIOR COURT
moon ❑ Add ❑ Remove .
a.Full Name,Mailing Address&Phone b.Job"Title/Profession d.Comments
(include city,state,&zip) - ASSISTANT CLERK
JAN KENNEDY SUPERIOR COURT
519 SEA CASTLE CT e.Start Date (mm/dd/y■yy)
WILMINGTON,NC 28412 C.Employer's Name/Specific Field 02/04/2010
STATE OF NORTH
CAROLINA f.End Date (mm/dd/yyyy)
g.Rate h.Security Pledged i.Original Loan Amount j.Remaining Loan Balance
$ 1,500.00 $ 1,500.00
k.Full Name of Lending Institution 1.Loan Number
4.Total only this Page $ 1,500.00
5.Total of ALL CRO-1430 Pages $ 1,500.00
(This line must be on line 21 of Detailed Sunznzary Page CRO-1100)
CRO-1430 NC State Board of Elections December 2007
RECEIVED
JAN 2 2 2012
NHC Bd of Elections