Betz 2019 Organizational Report AmendmentDisclosut'e Repoff Cot'et'
LTse this form for eeneral report and conunittee
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irfonrutiorr nust be siened and subffuned alonE rith other detailed forn'rs
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DON BETZ NHC NEW.S}IAL2A.C-065
t. Lhiling sddrees {iaclude Cih:Sare erd 9ip Code) f.{ f- g ; l* E \ / [-; [f {. I}at* f,iled
25I8 PARK AVENUE
WII-MINGTON. NC 28403
NHC Bd. of Elections
06t24t2020
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(910) 619-5939
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20t9 t2t04t20t9 12n3t2019 DONALD HENRY BETZ
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CAMPAIGN
EXPENDITURES
DB-I ELECTRONIC FLINDS
TRANSFER
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d, Period Becin Balerce il" Perio{BqirBdracc
$0.00 $0.00
ERTIIIC..I.TIOH
I certi$'that *re Cooninee or Fr.md is ir compliance rnith all appticable pror.isionr of ,\rtiCe X.$- 2:B & ?fD-f?I\{ of
Chapter 163 of the NC Gmeral Statutes and that no fixrds are conrmhgled xith protrftiited m otbet non-disclosed
fimds I firrther cenifi.' that fhis relaort ic rofif,lptp tme and corrArlt nnd that I have beegr trained br tlre NC State Board
Ff, "r" ^ \l Kl)n:06t24t2020@tffiDeta
R OITIIT USI ONLY
Date Received:
Date Postmarted:
Date Scarured:
Date Data Entered:
li -,LE - Lt)'iJ')Eorplovee
Eoplovee
Earplovee
Enplol'ee
Deliveq'Nlethod
E tlormztngal
E Registered h':ait
fl;UananeUvereaE Eectroaicath'Fited
f, Sigrrer has nst received
Please Note: This form cE Eiot be used to anend cosrmittee infonrarion such as tlre coflriittee ad&ess- treaslrer-
assistant treasurer. custodian of books irfomation- or accorrit ifornration.
Tou must o'nend the Statement of Orsgriization (CRG2I&3A-E] ro make comnrttee chanees.
NC State D*eacr!:r !0$1cRo-l000
Disclssure Repolt CoYer Addendum
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Use *ds fsrfir to ressrt additioaal bank accor.urt inforrration tbat did nst fit sn the Drsclosrse Keport
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ELECTRONIC FTINDS
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CONTzuBUTIONS AND
TRANSFERS
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ERTIflC.{TIT}N
i cediB' rhat the Comnrittee or Fund is in compliance *"ith atl ap$icable provisions of Artide ?aL ?]B & l2D
?2hl of f,hapter 163 of the NC General Statutes and that no fisr& are ca*:ningled wifh prohihited er other
06t24/2020
$,ig!^at6e of Tr;gglg;l'Date
6. ,rr.g11a nmend informgtion such as tbe cof,rriinee name
or ac€ount irfonnrdion.
Ysu ffiugt enend the $tatemsrt of Orsaniatisn (C" O_?IffiA-E] to ruke coosittee changeg'
lease ltote: T!{s csvs sheet
Ilar*o,ber
Detailed Summatl'
.tsrerdmertE l'*" [f tgo
Use this form all dsclosure forms and to to
Comninee Full lirnt {end Fu.nd if emlicahle}3.TpqofBgt{3. ID ltluuber
DON BETZ NHC 2019 Organizational NEW.SllAL2A-C.065
Start of Elsti,or Clcle: January- l, L T*tel this
Rc*ortinaFeriod
Totel this
flmtion Cyclt
4) Cash on Eend rt Strrt t 0.00 5 0.00
RECTIPTS
5) AggrcFted Conffutions fron Indi!{1fs
6) Coutribntions fu hdiriduels
4 Conniau!1ry t:CIn Politieal Per$ Clmlittees
E) Contrihrtirm bom Other Politicd Comsittees
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t tb) Conrri['ntio,ns *- 1go.5uffiS ,.tcnot250tilons :
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t 2,500.00 5 2,5oo.oo
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5 0.00 5 0.00
fJ 0.00 s 0.00
5 0.33 $ 0.33
(0.00 6 0.00
t 0.00 c 0.00
t 0.00 5 0.00
5 0.00 t 0.00
2) TOTAL BICTIPTS {Add lio*s i.6, l. S,9.lG,!ia,t lb,iic"ltrd d tie}I 2,500.33 5 2.500.33
EItrENI}ITLBES
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s) T0TAL E:IFEHDITIJRIS i.4id ]in+s l3q t3b, tlt l1l1-1{:a-l-71 \ . zts.zg E 349.29
9) Cesh on Hfld l rnd (Add lin*s 4 ad 12 tcgethrr, tbeo $$ttet lic lg)5 2.151.04 t z,lsl.o4
illp$r{}li$!fi F-o,E1l{ATrO_N
l0) No,u-l{aneiary Gifts Gjrer to t}ftir Colmrttes r,{?'o1330)
:l) Outstrnding Loens {incl onts ftem other lnglgrsl Fngt4t0l
l:) Il€futE ead O&ligeti,ors o*ed fo'thc Coomi-ttet (t*o-16J0)
13) Ilelts and Otligetials w,td to the Cgmmitttf, {t1O16}81
f{}^dc*+ontTr:ugferslfithirthcCrynittee $not7}01
15) Atuinietrrttue Snpporl fCnolII0J
fcNH440)!6) forgiren Loens
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!8) Contritutions to be Refraded $n#121s)
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3 0.00
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NC State Bosd ffi Arsat 2088
Contribufions from Individuals
Lise *ds fsre to report iniHl'idual contributions ol'er 55* or contdbutions under !5fl if forsr CF.O 1JE5 is not used
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RETIRED
DONALD HENRY BETZ
2518 PARK AVENUE
WILMINGTON, NC 28403
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LOWER CAPE FEAR WATER
AND SEWER AUTHORITY e.flc*tisnSan taDetr
e 2,500.00
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DB-I Check 12t04/2019 s 2,500.00
tr E
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NCSiateE€,{d x*fi1
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Othet'Receipt Sources pg I or I El r'*, E xo
Use this fsrm to report income not reported on anothet form. i.e. interest inaome. not for profit contributions etc
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PAYPAL
24I I NORTH IST STREET
SAN JOSE, CA 95I3I
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5, TotdorlyrlisPlg*s 0.33
6. T*taI $f ALL ffi{LIIS} Pegcs
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5 0.33
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Use this forrr ts report erpenditures frosr rhe committee for operatirg expenses. eontributions to candidate.'politi*al
itrees afid egordiriatc.or]riitree s afi d egordiriate d
1. Cmsiir** InIl Hrmr {rnJ FsJ if didk}2,IBHsukr- -"NEW:S1JAI',)#e:66S
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*.Prrccbftmrtin E Add tr Remove
a. F'uf, Fiame, Mailia-a Address Js Phstre
{fudrd* ritr'. strte,,& zi*}
b, C*riireted Committ*e l{roe d, Comnenta
NEW HANOVER COTINTY BOARD OF ELECT]ONS
230 GOVERNMENT CENTER DRIVE. STE 38
WlLMINGTON, NC 28403
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FILING FEEDB.]Check o t2fi3t2019 5 176.00
*.PlnrlnFmribo El Arld tr Rcaor'*
a- FuE Nafie. h{ar}ing "{ddress & Phone
(+*4#-.e-*.n .sl+lsr.-i :r.-rl ... ..... . *.;::"-.!#r-+e.!
rENprN ALLE' _ "ryF; Uffi\-/tr j_
127 S COLLEGE RD A. KJ
WILMINGTON,NC 28403 .: i, ;: ,a :..i",i:l
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DB-I Check C t2t13/2019 5 173.29 SUPPOPRTERS LTINCH
t
S_T*lfll.y.risfq€5 349.29
E TSI *f .tLL {St}ltl0 Frgee
(This liae gocs ix la.s lia o!Drrrl:ileit Surl,ma4 Pags CRO-I|M i! Opcrv,a4Ery*nray
fllr! Iinr gr*rr ix ti;* Iib olDetaibd Sumrl*ry PaTe tftO-1180 iltaaaib pfian&itlauzlPol*ical Comm|
(1fafu liaa g**s in liar 1 3c o! Drurbd Sulrn^cry' .Pagr t$O-l ffO if toolldizaod Farg' Eq;rnliurez]
5 349.29
t- PEmse Cades Oi*t d*ailcd clr#ifrsr cclic in {hl ab6r.e1
[* - Mdii B* - Printing
E - Sel"ades F* - Equ:ilment[- Postage J-Fenalties
D+ 06er
f,* -FudrdsinC D -To AnotherCsnddate
G - Political Faq' E* - Ealding Fublit t)fice Erpene*s
K* - Oficc Eryrl*es Q* - Ilelrfian ro Ltgel Eryeast Fund
* f'a{s r*snir*dctrik{ erdrnrrisuin tlt*nirr* rruerk kH{k}
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