Betz 2020 Final ReportDisclosure Repor"t Covrr'
Use rhis form for eeneral report and committee informatiorl niust be sisned
.{rn.er.l-tgj1
fl Ycs E Iro
and subnritted aleng *i*r other detailed forms
Do not u form to
l. famnittet Infcmetisn
g, Fall l{ane c, ID Humber
DON BETZ NHC f#ffr**-'"NF,W.SHAL2A-C.065
*-*il*e*#-::-::{kh9-.-c--igrlPF-*rf 6r-c.d:}
25I8 PARK AVENUE
wll.MtNcToN. NC 28403
trFf ].........*.a.9....
lt
..r i ili,r .;. ., l. ,; iil
HfHC Bd" of FJeclions
d, Dgte filed
06124/2020
e" Phone ltumber
(910) 6r9-5939
!.ReeortYc*l. ?eriad Strrt Drt* {uurd{*;tf .{" P+riad F-r,l Drfe {untaa,b:)5" Trcrenrcr Full NrD€
2020 02il612020 06/2412020 STEVF,N DALTON KELLY
6- T-rr af Canifie {Chec! Oue}9.Tyr*af$eenn k'hee* axrl.' ane $'ps pl repwtfr*m ow calegaryi
S &odie"t. C.ampaigrr I P"rty
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tr Fr*griln.a4'
tr Fre-*le*tior,
tr Pr*-nrooff
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tr hfidT*ar
tr }ear Eod
tr Final
tr Sp:eial
5t!teJCouDty Refereldu-
I Orgld.ratisal
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BBildias Fusi
Prairbitial Electir.o Tear C:aEiidate Frmd
NC fiSlic Camgeign Fio.ancins Fr"rC
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t{L S*eid 8r*rt I'ttrnt
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r:.-T-*'r--.g4.bS*.F.-"-:.f il.F:*-"-..
FIRSTNATIONAL BANK
". 6*ji1t hetituticn FuIl Nrme
PAYPAL
h**?rr
CAMPAIGN
EXPENDITURES
e, o{,*aunt Csde b, Pwpo*e r. Aeco-ol Cbde
DB-I ELECTRONIC FL,NDS
TRANSFER
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d. P*riod Begi! Brh-*t d" Period8cgi.uBdrate
$ szo.zo $
ERTIFICATION
I cuti$ that the Committee or Frrid is ir conplience with all applicsble prol'isions of Artirle l}A 238 & 22D-22L{ of
Chaprer 163 of the NC Generel Statutes and that no firnds are conrmhgled *.ith prolu'bited or ofher non-disclosed
Delh'er]'X'{ethsd
E Xgtealhfarl
El RegisteredMailp HandDelivered
E ElectroniccttvFiled
f] Sigrrer has not rectived
ROTTICE USE OmY
Date Recdved:
Date Fostmarte*
Date Scarmed:
Date Data Entered:
i '2.'t'A|.ftt;Enplovee
Esrployee
Fmployee
Enployee
Please Note: Tlris fomr canurot be used to aaend csfirlittee infoniation such as the conmittee address. treastu"er.
assistant treasurer. custodian ofbooks foifornation- or accolult information.
Tou nust enrend the Stateorent of OrEanieation {CRG2l0CA-El to mate commrttee c.hang.es-
tate Bcani cf Ele$ica: Decsnb:* lS0?(RO-1000
Disclosure Repolt Cover Addendum
Use this form to report additional banL account inforuation tlrat did not fit
,{meodmelt
E r"" El u"
e tbrs t'orm to accou:rt mtofluanon fhat alral not tit on the Lhsclosufe ReDort Lovef.
r. A-saitrcf, !-ull fi rac {ltrll n [rlt if rlifltrtr-]3.UlNrrlcr
DON BETZ NHC NEW-S}IAL2A-C.065
l.Actsunrhiomrtim L Accnuntlnformetian
L Finoncid In*titntion Full Hrma t, P6.ogi{ lnrtitutioq Frrll Heue
PAYPAL ACTBLI]E
h, Frrrlose c. Artcu.ui Code b, Pupo*a c. Ac+ou.ut Code
ELECTRONIC FLINDS
TRANSFER
DB-3 ONLINE
CONTRIBUTIONS AND
TRANSFERS
DB-4
t P*riad Begin Ed.rDf,e {, P*riod Begi! Brha*a
$ o.oo $0.00
ERTIFICATIOH
I certi$ tlut the Conmittee or Fund is !r c*mpf,ance *ith all ap$icable provisions of ,{rtide 2}{- lrB & 2?D
2?lvl of Chaptet 163 of the NC General Statutes snd that ns fi-ur& are cornmingled vrith ptrotulbited or oflrer
non-disclosed finds. I fi:rthet certiS'that fis report is complete, true and corect and that I have beetr
06t24/2020
be used to omend cobrittee ifornation such as
Date
the committee aame
You must snend the Statmrent
or accouut iform"dion.
of Organization (CRO-21ttrA-El to m.ake committee chanEes
Prioted Naare of Sig[er
,ease Note: This cover sheet
010 NC StaiE Bc6d af Eleetioas Decesr,b:r ?OS7
fttrCtrIVFtr
"iij,fu .g + Z{tZu
fVHe EO. of Flecfions
Deteiled Summary
Use this form to sunmarize al
A-mendneut
El l'*" El No I
se tlrs to srrnmarue Ell ahsclssure lbrms and
l' Cmuittff FuIl Nrur (end Fund if rypliceble)3" T:*e sf Rcpor{3. ll] fiuilber
DON BETZ NHC 2020 Final NEW-SHAL2A.C-065
Startof Elecfion Cycle: Jannary L, _L Total this
RemrtinsPeriod
Tot{ fhis
Electisn Crclc
4) Cash on Hand rt Strd 5 870.20 g 0.00
RECEIPTS
-
5) fugregrtd Coatributir_n1 tun loiiri-*_ue!
6) Con{tutions fron Indi!{rfs
7) Contrilutions fo'n Polirill Prrtv Committ-ees
E) Contribrtions ft.on Otlel f{iticrt Csnnitte€s
(cR4l205l
(mat21a)
(cnal220)
(c1.a1230)
g)Lo$Procecds Rpng'f i r* Eno.I4Io)
0) Refirnds/Reimburementr ro tl.c*ilniY*f, f Y f li*.or u o,
r) othelReceipi Sonrcrs JUi! * 4 ?AZtl
rre) rn*""ton|lf Ac1,,ftHC Bd. cf gf*g,rifrlll;ljllb) Contributions from Not-For-ProEt O.g.ni
f.f4 Ornsi*e Sourc+s of Inllr @s!.250!
lld) L*gelErytnse Fun*-OtherSonrres &?.o127O)
lle) freupt Purchrse Price Srles (.cno|26t)
*0.00 5 0.00
$ 800.00 5 10,550.00
5 0.00 5 0.00
E 0.00 t 0.00
t 0.00 5 0.00
t 0.00 (0.00
$0.00 5 0.33
$0.00 g 0.00
t 0.00 t 0.00
s 0.00 I 0.00
s 0.00 c 0.00
2) TOTAL RICTIPTS (Add liaes 5, 6. 7. 8. 9,10"i l+l lb,l lc.l ld aod I le)s 800.00 5 10,ss0.33
{eLytaJ
(a.ol3!o!
(rer3:o)
ry!:'::!
(:!0r1:!l
(cna!320)
(cn&tsl0)4 In-Kind Contribntions
s r,6o:.os s ro.s+:.ts
$0.00 E 0.00
3 0.00 s 0.00
$0.00 s 0.00
t 0.00 s 0.00
$ z.rs t '1 .15
s 0.00 t 0.00
t) TOTALIIKPEI{DITURIS (Addlinss 13q l3b, l3c. 14, 15" 16ild l?)S rrznrn $ r o-sso.:r
9) Crsh on Hend at rnd (.{dd lin€s 4 md 12 togetber, tlen eubtret lb l8)$0.00 s 0.00
AI}DITIOHAL INFOR}{ATION
0) Noa-MoneteryGifts Giren to OthcrCommiltees
l) Oufstuding Lorns {incl ones ftom other cemprigns}
;2) Ilelts rnd Obligrtions o*ed \'lte Commitlee
3) Ih$rs rnd Obligetions owed to tbe Conmittee
4) .rd,ccount Trusfer"s lYifhin the Committ*e
5) Administntire Snpport
6) ForgirenLoens
7) 48-Eour Notice Rrports S 'n
{c?tLI330)
{cnoJ#a)
(c".al610)
Fno46!0J
(cn41720)
(cnotTtal
(cnol44a)
tcRo?230)
$0.00
$0.00
$0.00
$0.00
$ l oo.oo
5 0.00 s 0.00
ta 0.00 5 0.00
$0.00 c 0.00
8) Contrilutions to be Refunded (CI.frIUS)$0.00 t 0.00
I NC Steta BoEd of Electioas 2008
Confributions from Individuals
I-lse this forsr to report lrdividual contributions over S50 or contributions under S-i.l if form CRO tLCI5
,{ueadmeot
Pg I of 2 EY"" Elr'
IO ovef ]lu or et 15 not used
DON BETZ NHC
I--,F--He*lnr
NEW-SHAL2A-C-065
!" Csntri5ut*r Iniorulti,en E ,+eA E Rsove
a, full ltrm*, I{liling Addreae & Flone
{iaclude cigi atate, & zip}
b, Job Title,{Fr,ofexi+n { f,srmenta
WIRELESS ENGINE,ER
ANDREW BETZ
902 GLENDALE AVE
DUR}iAM. NC 27709
::.-**nlr:*.$-:*:.15-r-xf.,.--Ti:H
CISCO SYSTEMS
::.-11*-F.-"-*.1..l-*.!g.D-:!-"-.....
5 100.00
DB-4
h, Fonm afPa;imell 1FtrtrtrSrfft i. Date (mm.,'dd.t!1p-)k Auou-ut
Electric Funds Tran 02/2012020 s 100.00
tr ',"'1 I -! 'J;i:'rl
5
tr cnL; Hd. of Ffectjern !
l.Cmffiunorlnbrurtio E eee E Resove
r, F ll g1-*, g.;1* Addeae. dt PL*ac
(include rittr, *tete, & rip)
b. Job Tillr.lhof*ssioa d., Ccm.menfs
RETIRED
DONALD HENRY BETZ
25I8 PARK AVENUE
WILMINGTON. NC 28403
6, [nplo3'crre lteme,iSpe<ifir field
LOWER CAPE FEAR WATER
AND SEWER AUTHORITY ::.-a=9.:-:5.-"--!:.-D-:-':.....
5 6.725.00
F..f.::g-.r"----t,Yd-:
DB-]
h, foro of Prl-meat L In-Kind lloe:yiptian Date {mmJdil*1;p}lr ^tms,rnt
Check 0212612020 3 200.00
tr
tr t
l.Ccaffiutsrhftrurttga tr Add EI Relno*'e
a. Frll Nrme, Lfuiling Addrees & Phune
(iadnde cifi stete, & zip)
b, Job Title,{ftofecsi+r d, Commenfu
ATTORNEY
AULEY CROUCHJ III
3IO N FRONT STREET
WILMINGTON, NC 2840I
-..:..I*p--F-.1-::L'-x:-----:n***--Ti:H....
BLOCK. CROUCH, KEETER.
BEHM. & SAID c, llecti*l Sum lo Date
5 150.00
I Prior g. Aseo-nt Code 5. f-919. 9-L -r:. :l-- -.:31..
Check
t l!-Eird l)*ecriptior Dsie {Eujdd.bnr-)ls A-morrnt
E DB-]02/18t2020 3 150.00
tr S
tr c
l. Total orfu ttis Pege t 4s0.00
i Totel of ALL CR{}l2l0 Pages
fI*a tire mr* D* ot trint 6 $ ItoJlad Snmrua Peg CI.O-I I Wl c 800.00
cR0-1210 nf,April
Corfrihutions froro Indiyiduals
[-ise *ds form to report individual conuibutions over 3j8 or contribution
.{ueadoreat
Pg 2 of 2 EY*, El x"
rm to over 5i8 or contributions under 550 if form CRO 2.fl5 is not used
LCggryrS*,FuIt Itirse (rd Frd if rplidl*)LlllffElcr
DON BETZ NHC NEW-SHAL2A-C.065
3" Csntributcr hfEnnrtia,n El eoc El Rmove
a, Full l9aus, Llailirg Addre*s & Plona
{irdude ritl-, etrle, & zip}
b, Job Title.{Frofegsion d- Ccnnents
IEWELER
MICHAEL KINCOFF
35OI OLEANDERDR
WILMINGTON. NC 28403
::.I---:l:-r-:tl:.Lly-::59:*ff--F-i-*-u...
KINGOFF JEWEI,ERS
e. fk*tion Sum to Dete
s t00.00
DB-I
L. foru of Palm*nl L la-LiDd Ll*sfrirtio!i' Dete tnmrdd.t"o')lL raEerrat
Check 02n9t2020 5 100.00
tr q
tr g
l. Codrfrutarla*rudion El ;la* El Bsove
1, foll N1qeo lfriling.{ddresa & Phone
(inclnde citl', *tetc, & zip)
b, Job Titl*lFmf:gion L Com-maqis
]ONTRACTOR
WALTER PANKOE
970 B]RCH CREEK DR
WILMINGTON. NC 28403
::.-{x-r--k-l-*'-"-*-:=-:S*:**:-.T.i:-H..
SD] CONSTRUCTION
:: PsS-* F::* *.P-l-tl- .
t 250.00
DB.I
h, Fam of Pal'ment L lr-Liffl u€€EfiPtie!i, Daie (-midd;I:'l*-)h Anouat
Check 03/03/2020 g 250.00
tr &I
tr t
L Totalorfo*b Pege 5 350.00
3.?otetr of AII CR{}1210 Pages
fltir tu mrh n li.c 6 g Dadird$lrrrfrlrr&1u Cnstrffi)5 800.00
CRTLl NC State Bo:rd cf Asil 2007
iqEC*f Vr: i;
.'ltir, !r .,' ,,t1iij
ili"ie Bd. of Ele*iarrs
Disbursements Anead.uent
P: I of 2 ffT** Exo
Use this forn to report expenditures fron the committee for operatire expenses- contributions to candidate,'political
com.mittees and coordinatrd rarlt expenditure s
l. C_ qqryflie Fall l{rac gnd Fand if l3rlicrilc}?"IDFiusber
DON BETZ NHC 'TiIEW:SHAI2A-C:065 '
Lrn-.r{P*rr"r-:-"1Eopo"tio:n*p*r*i trC""i.u"i""-t"cr"&at-"gattleatce'*ir** - -'El-'ir"#;;il;-d;;d;;
l, ?ryac Infrrmrtirn B ea* E Rsrove
a. Full Nane, Iv{ading Ad&ers & Phone
(ilclrrde siil', otrte, * zip)
b, Cordimted Conmitte'e Nlmg d, iComm*lla
ACT BLUE
P.O. BOX 44fi46
SOMERVILLE. MA 02I44-OO3 I
c, L*el F.egi*tered tS?e.it')
El r"+*t E G'*ry'
tr...F-*t,*-....................-E..F:ip-:_p.aiir.::e. [le*tion $nn lo Date
5 2.00
.$rs-".**.1.c-*:.
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Draft
L, Furpo+: Cade i Det* {mm{dtr:=t')j, A.maunt k AequirdRemrrl*s
o 03104t2020 s r.50 PROCESSING FEE
DB-4 Drall o 04/0912020 5 o.so PROCESSING FEE
t Ppehfarrudion tr *ee tr Raove
.-: ! ; :.r:i02 I 44-003 I iril-tr: ^. Yi l: u*'vLi{I f,.{tt_. r.yr rTl€CElOr
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d, Coomtntg
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tr..-q*l*-.............,8 $-is*:tig
$
e. flettioa Sum tc Date
s :.zs
I Ae*omr C'ode g Far:m of Peyrnear L. Furyrue Code L Dare (uril,il"11aa'}j. Amou"nt k Reqrrired Red.irkB
DB-4 Dra11 C 03,r0/2020 5 3.7s PROCESSING FEE
5
LPr1e*rnfrrurfin fl Add El Rsove
a. Full Naae. b{aning Address & Pbone
(iaclude citl', *tel*. & 'iF;
b, Cmrdiarird Committce Nrme d. Cmmsata
STEVEN KELLY
5463 EASTWIND RD
WILMINGTON. NC 28402
c, Lsel BegiEtered {$pe<ig}tr rJ.-i tr c;"*: -
El gt.t* f] h{**ioiprtity,Ile*ticn S-- ta Dete
S 34o.oo
$..,}s:**l-9"4:
DB-I
e.F-r.**.:f -P.:r,p.:*t.
Check
b. Farffoee Code i Drte (nm{il!x11.).{.noual k" XlquircdR*ErrLE
K 05/26/2020 5 340.00 COMPUTER RENTAL
3. Tafilar$'ihis Prgc ,5 345.7 5
fi" T{el *f ALL CT0-1310 Pegcs
/lffris hra g'ees ia fias JJa o! Datailad S*nunary PaXr t?<&-|100 ;f Oplrlating Eryan*s)
(This Ew go.ts iA lias 13b af Denibd Snnr.mery PaS'e CftO-110A { Candib nCandidaaglPoliticcl Comnl
{This li;r xo*r ix bine 1 3c oJ Dctarbd Surnmarl Paga CA&1100 il Coardinc*d Par4 lrpendinrag
5 I .663.05
L Pnrpose Codes {List detailed epen($hge code in {h-} abov*}
+,* - Me*i.a B* - Printing C+ - Fundrrising D - To AnotherCandidatei Salaries F* - Eqnip'ment G - Political Pa4' E* - Holdirg Pnblic Officc Erpen*es
. - Postage J - Penalties K*-OfficeErpenses Q*-I)*utiontolegalErpenseFund)* Other* Cales reqdre deteiled esleutio'n in reruir.ed renerts field {h}
0CRO-J NC State Board ef El*dioog
Disburseruerfs
Lise *ris form to report expenditr.rres fron the conurittee for operatine err.penses.
cornmitt e e s and co ordinate d gartv exr enditure s
Pg
Ametdsleol2 sr 2 E t'", El r*o
contributions to eandidate,p oliticalmfluttees and c 5
l,.Sesm#;rf $--Hrss..{*f--Es*.*--rt_*nr-li.r*ld*
DON BETZ NHC
It3e-"t pi*y3;***l Wet&,Afg",F;pag:an {fi.e-t il o f"*,s f"r "d"tt+;Glil;;; "- H I;il;i""' i;d&dJ;";iitUc";;;;-
l-Pelrehforortim E *ea tr R.-"*
a. Full ilame, hfuiling Ad&ess & Phone
(l+sl-'.-d.e..ri*:'. *tr ls* -*..*.*J ... .
MANUAL DIAL COMPANY
1527 SOTJTH COOPER STREET
ARLINGTON. TX 76010
b, Cmrdiaaied Ccmmitlee l{aue & Co'mmenfu
ifs:lS:e**ld$ff*f."1Ll Fe{iedl Ll Corrat_"-,
E $r"t* E :r{*rigrrritr,:;.Eh:tis.*..i.. g*.ts- -9: tr.....5 :s:.:o
Arccoat Code -q.I-9:*.:J.L.r{*....*l
Debit Card
L. Puryoge Code i Drt* (nmJid/11x1')j, Amount k 8+qtrire.l ReErrkB
DB.I C 03/04t2020 5 393.30 DIAL]NG LISTS
t
tPwacInfuu*ilo tr e*s tI *.8"*
:\fJ*n *. , (Li f;d. of f_:leclin.,,
b, Cmrdillted Conmittee NNdc d., Caumente
'r. tercl Regisi*red (Spcci$]
E F€d€@l
El st"t*
trtr f,omg:
Ir{rni,ipfity::r.Lr.gsf:*-.-s..**.1-"--Prl:.....
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DB.I
g:.fggg.gJP*-gr h" Puaoee Code i. Drte (mm{dirrrr:'J i:. **-". ::x1..........$ 23o.oo
k Rasdred Rcnrrls
Check 02/21t2020 TV ADS
DB.1 Check o 02/21/2020 5 zso.oo VIDEO PRODUCTION
llpettbru*on El *ee E Rraove
a. Futr Name- Mading Address & Ph*ne
ft ss-lgd. s.*g:*. *f .r-l*L*..*lp).......
WILMINGTON JOURNAL
412 S 7TH ST
WILMINGTON. NC 2840I
b. Csndiarfid Gamnitle'e lllrm*d, Conoelte
tsel R*giet:*d t5p*cit)tr F"d;i- E[ c...,-.r-,
E 8t.t" E a**i.ip.tity,Election Sum lc Drte
I +++.oo
i...*::-"__"---.1--C.a..:
DB-I
p..tr..s.-"-t.P..:*p.s*l
Debit Card
h.ll***..9.a:
A
*.P-:le".{-'r*fl +...[].?Fl
02/21/2020
,{.uo'nt k Beorrired Reurrka
222.00 AD IN PAPF,R
DB-]Debit Card 02t26/2020 5 222.00 AD IN PAPER
i. Totrl u[r rLi= Prys t r.317.30
f,. Tobl of .{tI, CR0-Ill0 Frge
{This liae goes ia lim 13a al Dttailci! summa4 pag cnoJ r o0 i! opaturiry.Eqernrar/
(This lilr gaas ia tix* 13h e!DafiJled Su*lrr.a4 Page CBo|tM i!tontrib toCanlidc*s.l|o1tic*I Coa*gll ir fixe 3*cs in liae I ix a! Drer.ilad Stmmar3' Page Cfro.l 100 i! Coot-dinaad Par4 1;t4'a1ad;auvg
5 l .663.0s
7. Pnrpose Codes Oisr derailcd eqparditwe code in {h} above}
A* -f,ft{it
f - Sala:ies
I - Postaee
0* Otber
ts+ ^ Printing
F* - fqnipment
J - Penalties
C* -Fundraising
G - Political Pag'
Ii* - OEce F:qenses
E* - Hclding Pullir OEce Erpenses
Q* - Dondion to Lrgd frpense Fuad
* edes rttairedefiild eqhnrtioa in rqtrine{rwtrks fiGli{h}
cRo-l31A Board of Sledioae
Aaneld-ureatRefunds,{Reimbursemetrts Ft'om tle Commiffee pg I or I E l-., E r.o
Use *ds form to report refunds'reimbr:rsements. including ccntnbutions rehrrred to the contributor
l. Csnittee Fctl Nsa (egd Fud if ulis&h)3-IDltuuler
DON BETZ NHC NEW-SHAL2A-C-065
l.Peyechfomrtis tr Add tr Reaove
r. Full Nrme, f,{riling.{ddress & Phone
(include rity, atere, & zip)
& Tlae of Conittee g Cou.menis
tr'c-dd.i;- tr-iAC
E Refereo*s E ParttDONALD HENRY BETZ
25I8 PARK AVENUE
WILMINGTON. NC 28403
e. Lerel Bcgi*emd (Spoci$')h" Origind Scaeipt llrte
tr-f"d.-t - "'-"'H' Cot-ty,
E st"t* El t'{'-ir{p"1ity'
t2/3v2019
l -o- -::H** S$:lf l.$3-"Irllt 25.00
[-r:-.],Ti:l-",f xL:v.i.*
RETIRED
::h----p-F-l:*-{:*:F--r:*-!.:li-"li
LOWER CAPE FEAR WATER AND
SEU'ER AT]THORITY
{, Puraoee Codc i. Llectioo Snm to Drte
LO t 0.00
h.:1*:-1.9d:...
DB. I
l:.-F-t-.:J-P--T=,--*1...
Cash
u. RcqdrcdR*merlg n Ihre (unJdd/rrry)o..{mouat
REFUND OF CONTR]Bt]TION 0st28/2020 5 7.r5
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