Hamerski 2020 First Quarter Report Amd #1 (misc)1. Commi ttee Information
Full Name c. ID Number
CLAYTON HAMERSKI FOR REGISTER OF DEEDS NEW-3HA82V-C-065
Meiling Address (includc , Strtc end Zi Code)Drtc Filcd
02/25/2020
c. Phonc Numbcr
PO BOX 32
WILMINGTON, NC 28402
(et0) 3s2-7991
Year Period Start Date Period FadDate Treasurer Fhll Name
2020 0U0t/2020 02/15/2020 KATHLEEN ORNOWSKI
of one one
Municiprl Statc/County Rcfcrcndum
I foint Fun&aiser
Party
PAC
Legal Expense Fund
Candidate
Referendnn
checkofFhnd ftf
I Pre-referendnn
E rinal
fl Spptemental Final
I Annual
fl Special
Organizational
10.Name
"Booster Fund"
BuildingFund
Presidential Election Year Candidates Frmd
NC Public Campaign FinancingFmd
Other:
Number this
0
Organizational
Thirty-five day
Pre-primary
Pre-election
Pre-nmoff
Semi-annual
Mid Year
Year End
Find
$ecial
Itrtrtrtr
trtrutr
trtrtr
tr
E]trtru
Quarterly
First
Second
Third
Fourth
Semi-annual
Mid Year
Year End
Find
Special
Account 3.Information
. Iinenciel Institution Full Neme e. Finencial Institution Full Neme
FIRST CITIZENS BANK ACTBLUE (VANTIV LLC)
b. Pu c. Account Codc b. Pu4rose c- Account Codc
1 2
d. Pcriod Balance d. Period Balrnce
CAMPAIGN
TRANSACTIONS
1,990.00$
ONLINE CREDIT CARD
PROCESSING
0.00$
I certifr that the Connnittee orFund is in conpliance \ilith all applicable provisions ofArticle 22A,zzB &2Zp;2ZM ofChapter 163 ofthe NC Crneral Statutes and that no funds are connningled with prohibited or other non-disclosedfunds' I further certifi that this report is conplete, true and correct and that I have been trained by the NC State Board
09/24/2020
Printed Narne of Signer
TION
Dateof Appointed Trea$trer
Date Received:
Date Postrmrked:
Date Scanned:
Date Data Entered
Enployee:
Enployee:
Enployee:
Enployee:
Deliverv Method
E NornnlMail
E Reglstered Mail
E Hana Delvered
E Ebctronically Filed
OFTrcELISEONLY
I Signer has not received
train
cannot be used to anpnd corffnittee infonrntion such as the conrnittee address, trcasurer,
assistant treasurer, custodian of books infornation, or account inforrnation
Please Note: This form
rBke co00Anmst anrend of
Disclosure Repofr Cover
Use this form for general report and conanittee infornation, must be signed and submitted along
Do not use this formto infornntion
Amendment 4
X tP. EIo
with other detailed forms
CRGl
)ne)
1. Committee Fhll Name (and Fhnd if apflicaUe)3. ID Number
CLAYTON HAMERSKI FOR REGISTER OF DEEDS 2020 First Quarter NEW-3HA82V-C-065
Start of Election Clcle: January l, _._Y-Totnl this
Reprtine Period
Total this
Eection Cycle
5) Aggregated Contributions from Indivi&rals
6) Contributions from Indivi&rals
7) Contributions from Political Party Committees
E) Contributions from Other Political Committees
9) Iaan Procee*
0) Refun&/Reimbunsernenb to the Committce
1) Other Receipt Sources
1la) Intereston Bank Accounb
llb) Contributions llom Not-For-Profit Organizations GRO-1250)
4) Cash on Ilandat Start 1,980.00 0.00$$
$
$
$
$
$
$
$
$
$
$
$
$l.4l
(CRO,t20s)$
(cRo-l210)$
(cRo-r220)$
(CRo,I230)$
(cRot110)$
(cRo-r210)$
(cRo-r2s0)$
$
(cRo-t2s0)$
(cno-1270)$
(cRGl26s)$
$le)
s45.00
0.00
769.69
0.00
0.00
0.00
1,070.00
0.00
3,581.41
0.00
0.00
s0.00
0.00
14.69
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
I lc) Oubi& Sources of Income
l ld) Legal Erpense ftrnd - Other Sources
1le) kempt Purchase Price Sales
$793.87 793.87$
$0.00 0.00$
$0.00 $0.00
239.89$239.89$
$$0.00
1,192.59$1,192.59$
3) Disbursements
l3a) Opereting kpenditures
I 3b) Contributions to Canddetes/political Committees
l3c) Coordnated Party kpenditures
4) Aggregated Non-lVbdia Dpncltures
5) I,oan Repyrents
(cRo-|310)
GRA|sr0)
(cRo-l3r0)
GRAI31s)
(cRo-1420)
(cRo-r320)
(cRats10)
6) Refrrn&/Reimbursements from the Committee
7) In-Kind Contributions $0.00 1,406.72$
TOTAL D(PE{DITIIRES lines I I(Add 13q J I I I and6 I3b,c,4,7)2,226.35$3,633.07$
(cRGt3j0)
(cRo-r430)
(cRo-r6r0)
GRA|520)
GRAt720)
(cRo-r710)
(cRar110)
(cRo-2220)
0.00
$I $I .34
$
0.00
$
$
hCas on [Iand Endat lines and4 2I(Add then subtract Itogether,line 8)
$
$
$
$
$
$
$
$
$
$
Non-llbnetary Gifo Giren to Other Committees
) Debas and OHigations onod to 1frs esmmittee
Account Trans fers Within the Committce
4E-llour Notice Reporb Sum
Contributions to be Refrrnded
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.000.00
0.00(cRot2ts)
1) Outstanding Lmns (incl. ones from other campigns)
2) Dehs and OHigations oued by the Committee
5) A&ninistratirrc Support
6) trlorgiren laans
Detailed Summary ffi#,-"'ffi,
to total
100
- Tvre ofl :emrt
0.00
if 2.ID Number
CLAYTON HAMERSKI FORREGISTER OF DEEDS NEW-3HA82V-C-065
3. Contributor Infornration
a. Amend b. Account Code c. Form ofPeyment d. In-Kind Description e. Dete (mm/dd/yyyy)f. Amount
f] Add
I Remove
2 Credit Card 01/1512020 25.00$
E Add
f] Remove
2 Credit Card 02/08/2020 5.00$
El Add
I Remove
2 Credit Card 0yt't/2020 25.00$
E Add
fl Remove
I Check 02/0412020 35.00$
E Add
I Remove
2 Credit Card 0U2U2020 25.00$
E Add
f] Remove
2 Credit Card 0t/t6/2020 25.00$
E Add
f] Remove
2 Credit Card 02/03/2020 25.00$
f,l Add
I Remove
2 Credit Card 01114t2020 $50.00
E Add
fl Remove
2 Credit Card 01t09/2020 25.00$
E Add
I Remove
2 Credit Card 01/20t2020 50.00$
EI Add
I Remove
2 Credit Card 0t/17/2020 $25.00
E Add
I Remove
2 Credit Card 0t/14/2020 $50.00
E Add
I Remone
2 Credit Card 0Ut7/2020 10.00$
E Add
f] Remove
2 Credit Card 0t/16/2020 50.00$
E Add
f] Remove
2 Credit Card 0t/10/2020 50.00$
E Add
I Remove
I Check 0t/14t2020 25.00$
E Add
I Remove
I Check 02/04/2020 25.00$
02/10/2020
cRo-r100)
I Cash
$tr
$
$
Total this
20.00
$545.00
$545.00
(This llne must be on line 5 of Daailed Summary
Total of AIIL CRO'1205 Pages
Add
Remove
Aggregated Contributions from Individuals page I or
Amendment 4-trW El no
form used to NC Contributions From Indivitluals of S50 or less
CRG|2O5 Board o
1
l. Committee Full Name (and Fhnd if applicaHe)2.ID Number
NEW-3HA82V-C-06sCLAYTON HAMERSKI FOR REGISTER OF DEEDS
Contributor Information Add Renpve
b. Job TI tl e/Profc ssion d. Commentsa. Full Neme, Meiling Address & Phone
(include city, stetc, & zip)CITY COUNCILWOMAN
c. Ern ploye r's Nam e/SpcciIic Field
e. Dectiof, Sum to Drte
DIMPLE AMJERA
6528 MATLEA CT
CHARLOTTE,NC 28215 CITY OF CHARLOTTE
100.00$
f. Prior g. Account Code h. Form ofPeyment i. In-Kind Description j. Drte (mm/dd/yyyy)k. Amount
tr 2 Credit Card 02/13/2020 100.00$
tr $
tr $
3. Contributor Information tl aaa E Renpve
b. Job Title/Profession d. Commentsr. Full Nrme, Mailing Address & Phone
(include city, stete, & zi p)
s. f,'mployer's Name/Spccific Fie ld
e. Dcction Sum to Date
MOTT BLAIR
4IIEWESTBROOKST
WALLACE, NC 28466
100.00$
f. Prior g. Account Codc h. f,'orm of Payment i. In-Kind Description j. Detc (mn/dd/yyyy)k. Amount
tr I Check 01/27t2020 100.00$
tr $
tr $
3. Contri butor In fornration EI aaa E Renpve
b. Job Tltle/Profession d. Commentse. f,'ull Neme, Mailing Address & Phonc
(include city, strte, &ziP)PHYSICIAN
6. tr'mployer's Neme/Specific Field
e. Dection Sum to Date
KEVIN CANNON
2220LIYE OAKPARKWAY
WILMINGTON, NC 28403 SELF
r00.00$
f. Prior g. Account Code h. Form ofPeyment i. In-Kind Description j. Date (mm/ddEyyy)k. Amount
2 Credit Card 0Ut4/2020 100.00$
$
$
4. Total only this Page 300.00$
5. Total of ALL CRO-1210 Pages
(This line must be on Ene 6 of Detalled Sammary page CRO-I r00)769.69$
Contributions from Individuals Pg J
Use this form to ort individual contributions over $50 or contributions under $50 if form CRO 1205
lot F.v.Yo
is not used
Amendment 4
El xo
210 o 10ns
u
tr
tr
2. ID Number
CLAYTON HAMERSKI FOR REGISTER OF DEEDS
3. Contributor Information E aaa EI Renpve
b. Job Tltle/Profession d. Commentse. Full Name, Meiling Address & Phone
(include city, stetc, & zip)ADMIN
c. Flployer's Neme/Specific Field
e. flectiotr Sum to l)etc
TROY COLEMAN
180 JACKSON ST NE APT 24IO
ATLANTA, GA 30312 BOSTON CONSULTING
GROUP
$69.69
f. Prior g. Account Code h. Form ofPryment i. In-Kind Description j. Date (mm/dd|yyy)k. Amount
tr I Electric Funds Tran 0U10t2020 69.69$
$
$
3. Contri butor Information E aaa E Renpve
b. Job Titlc/Profession d. Comme ntsa. Full Neme, Mailing Address & Phonc
(include city, state, & zip)
c. Errployerrs Name/Specific Field
e. Election Sum to Drte
VASSILOS A SAFFO
1974 HILLSBORO RD
WILMINGTON, NC 28403
200.00$
f. Prior g. Account Codc h. Form ofPayment i. In-Kind Description j. Dete (mm/ddfyyy)k. Amount
I Check 0t/28/2020 200.00$
$
Comments
field
$tr
e. Fbll Ne me, Mailing Address & Phone
(include ci strtc, & zip)
Add Rermve
e. Dection Sum to Drtc
Contri butor Information
b. Job Ti tle/Profession
PLANNER
RETIRED
fmployerts Nam
$100.00
AL SHARPE
613 CHESNUT ST
WILMINGTON, NC 2840I
f. Prior g. Account Codc h. Form ofPeyment i. In-Kind Description j. Date (mm/dd/yyyy)k. Amount
tr 2 Credit Card 0u09/2020 100.00$
tr $
$
$
$
Total this
line mul be on Ene 6 of Deailed Summory Page CRO-I100)
369.69
769.69
Total of ALL CRO-f210 Pages
Contributions from Individuals J
Use this formto individual contributions over $50 or contributions under $50 if form CRO 1205 is not used
Pg -L of
Ame.ndment/-
E kt] E. *o
210
NEW-3HA82V-C-065
tr
tr
tr
tr
Contributions from Individuals Pg3or
Amenfun
E ite
,ot !-
J
Use this form to report individual contnlbutions over $50 or contributions under $50 if form CRO 1205 is not used
CRG|2 0
tr No
NEW-3HA82V-C-06s
Commctrtr
e. Dectiotr Sum to Drtc
CLAYTON TIAMERSKI FOR REGISTER OF DEEDS
b. Job IitIc/Profcuion
SOR
6. Iln ployc r's Neme/SpeciIic trIeld
RETIRED
ANNE YORK
305 S. LUMINA AVE
WRIGHTSVILLE, NC 28480
fbll Nrme, Mriling Addrcss & Phonc
(includc city, stetc, & zip)
100.00$
[. Prior g. Account Codc h. Form ofPryment i. In-Kind Dcscripion j. Drte (nm/dd/yyyy)k. Amount
tr 2 Credit Card 0t/1212020 100.00$
$trl
! E,|tl 1=:-F,IIFEE+.E1?
$
100.00$
769.69$
,rE"i-,'-'_1'iffiffifl
trI ,,lti:,1.t::t.i.i..,;:';..i, ...i;i'r,,,,,'.
E]
ffi
Disbursements Pglof
Use this formto report eryenditures fromthe conrnittee for operating eryenses, contributions to candidate/political
conmittees and coordinated
Amendm2Yw,ot {
DI xo
CLAYTON HAMERSKI FOR REGISTER OF DEEDS
Contrihrions to
b. Coordineted Committce Nrme ommcnts
C PRINT
um to Drtc
286.76
C-oordinated
e.otr
$
udc ci strtc &zi
FullNanr, Mailing Address & Phone
[ $ate
c. I-cvel
Federal
I Urmicipatity
d (Speci
County:
f. Account Codc g. Form ofPeymcnt h. Purporc Codc l. Drte (mm/ddyyyy)j. A0outrt k. Requircd RemerLs
I Check B 0Ur6t2020 g 286.76 PALM CARDS AND
ated Committee Nrmc& Phone d. Comments
$
b.
NC
udc ci strtc &zi
FullNanrc, Mailing
INC.
[ $ate
c. l*vcl
Federal
Q Urmiclpality
d (Speci
Cormty:
e. Eection Sum to Drtc
$100.00
f. Account Code g. Form ofPeymcnt h. Purposc Codc i. Datc (mm/ddyyyy)i. ADortrt k. Reqnircd Rcmerks
I Debit Card CO 0t/10/2020 $ 100.00 TICKETS TO2O2O
-ttFt
il!!#HEFF
$IVTTLEDIT'NtrD UI-lAruI Y
b. Coordinetcd Commiftee Nrmc d. CoEmcnts
L.vcl Rcgistered (S
Federal
I state I tvtunicipality e. Eection Sum to Detc
MLK CELEBRATION COMMITTEE
NC
& PhoneFullNanrc, Mailing
ncludc &
150.00$
f. Account Code g. Form ofPryment h. Purpose Code i. Date (mm/ddlyyyy)j. Amount k. Required Remerks
I Debit Card CO 0U07t2020 $ r s0.00 TICKETS TO MLK
-E.#!!!
i!:!1+_-!t+!r!G $rrAN(2U_E l
536.76$
13a of Detatled Summary Page CRO-|100 tloperudng Experca)
CRGIl00 trConilb to Candtdatcdpoltdcal bmm)
CRO- I 1 0 0 f Coo rdinated Pany Expendtauzs)
(Tfis Ane pes in llae
(Thh line goes in llne 13b olDaalled Summary page
(This line goa in line 13c of Daoiled Summary
793.87$
-ll&dia
Salaries
Postage
Other
B* - Printing
tr* -Equiment
J - Penalties
C* -Firn&aising
G - Political Party
K* - Office fucnses
D - To Another C.andidate
H* -Ilddng PuHic Ofice kpenses
Q* -Donation tokgat kpense trhnd
*
FS-;---- , .-l t*":T'1 *lffiS8
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ft
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Amendment 4Disbursements Pg 2 or 2 p ves iD DI x,
Use this formto report e>ipenditures fromthe corrrnittee for operating eryenses, contributions to candidate/political
conmittees and coordinated
o
CLAYTON HAMERSKI FOR REGISTER OF DEEDS
to CandidateVPoliticaling Expenses
b. Coordinrtcd Committec Nemc d. CommGtrtsa. FullNanp, Mailing Address & Phone
(include city, strtc, & zip)
c. kvel Rcgirtered (Spccify)
trtr
County
Municipality:
I rederal
E sate e. Ecction Sum to Drtc
NEW HANOVER COUNTY NAACP
NC
80.00$
g. f,'orm of Pryment h. Purpose Code i. Dete (mm/dd/yyyy)j. Amouot k. Required Rcmerlsf. Account Code
I Check AO 0Ut6/2020 $ 80.00 ADVERTISMENT &
d. CommctrtsFullNanr,b.e&
ude
USPS
$
ttec
strte &zi
I rruoicipatlty:e, Ecction Sum to Drtc
27.50
c. l-cvrl Rcgirtered (Spccify)
Federal County
I sate
f. Account Codc g. Form ofPaymcnt h. Purpose Code i. Drtc (mm/ddWyv)i. Amount k. Rcquircd Rcnerks
I Debit Card I 0U16D020 $ 27.s0
$rffi
b. Coordlneted Committcc Nrme d. Commentsa. Full Nanrc, Mailing Address & Phonc
(includc city, stete, & zip)
c. [rvel Registered (Spccify)
trtr
County:
Municipality
I Fe&ral
E s"t"c. Eection Sum to Drte
ZAZZLE
NC
149.61$
f. Account Codc g. Form ofPeyment h. Purpose Code i. Dete (mm/dilyyyy)j. Amount k. Required Remrrks
I Debit Card B 0U0912020 $ 149.61 BUSINESS CARDS
$
:'1:i ; l; ,:: :
fi,:.r''il+'.257.tt$
(Thls line goes in line I3a of Detailed Summary Page CRO-|100 f OperutingExperces)
(Thls Ane goes in Erc 13b of Daalled Summary Page CRO-1100 tJContlb to CandidatdPolittcal bmm)793.87$
(Thls llne goes in line 13c of Detatled CRO-II00 f Coordlnalcd Party Expendturcs)
*D - To AnotherCandidate
H* -Ibldng PuHic Ofice kpenses
Q* - I)onation to Irgal kpense trhnd
B* - Printing
tr* -Egipent
J - Penahies
C* - Fhndreising
G- Political Parfy
K* - Office Erpcnses
-ll&dr
Salaries
Postage
Other
CRGI3lO
-l
Pege I of I
AmendmenGP[i Yes tr NoAggregate d Non-Media Expe nditures
form used to NC Non-Media of $50 or less.
NEW-3HA82V-C-065CLAYTON HAMERSKI FORREGISTER OF DEEDS
lrnrss 16.530t/0812020IDraftC
f] Remove
Add
TO EVENTlrrcrrr$ 25.000U1412020IDebit Card CDO
I Remove
Add
TO EVENTlrrcrrrs$ 50.00CO0U27/2020IDebit CardE Add
I Remove
TOEVENT
lrrcrrrs$ 50.000211s12020IDebit Card oEI Add
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f] Remove
I
INTING)
FORPARADEg 19.740U08/2020BDebit CardI
Remove
Add
fouts 28.620U09/2020C
Remove
EE
Add DraftI
239.89$
239.89
B*_- To Another Candilate
E - Salaries G - PoliticalP
$
Q* - Donations to Legal Expense Fund
* codes rcqujre detailed explanation in required remarhs field (g) , .,..
ffi#;€i1 ;,lffi&ffi
I
I
J - Penalties
Refunds/Reimburcements From the Committee rg 1 or 2 "rt 27.
Bxo
AmendmB#f
Use this form to rt refirnd s /reimb urs ements includ contributions retumed to the contributor
ffi r". :,: -:rtr, 1, t!,,,,;,'\i:i.il
NEW-3HA82V-C-065CLAYTON HAMERSKI FOR REGISTER OF DEEDS
d. IVpe of Committcc g. Commcntsa. fbll Namc, Mailing Addrcss & Phone
(includc city, statc, & zip)E PAC
E p-tyI Candidate
f] Referendm
e. Lcvel Rcgistcrcd (Specify)h. Originel Rcccipt Drte
trtr
Comty
Municipality:
I reaera
El $ate t2/02/2019
i. Original Rcccipt Amount
962.00$
CLAYTON HAMERSKI
I53 YORKTOWN DR.
WILMINGTON,NC 2E4OI
s. f,hr ploycr's Nrm clSpecilic field f. Purpoce Codc j. trlection Srn to Dttcb. Job Iltle/Profcssion
0.00$REALTOR KELLER MLLIAMS P
l. Form ofPayment m. Rcquired Remrrks n. Dete (nn/ddlyyyy)o. AmouDtk. Account Code
Debit Card 962.00
Commcnts
I 02/04/2020 $
'Lry of Com mittcc
(include ci strtc, &
h.o rl Rcccipt Drtc
PACCandidate
c. kvcl Rcgistcrcd
Cormty
I Uunicipality:
fbll Name, Mriling Address & Phonc
i. Originrl Rcccipt Amount
tt/29/2019
$92.00
FILING FEE IN KIND
REIMBI.JRSEMENT
I Referen&nn E] P.tty
Fe&ral
$ate
CLAYTONHAMERSKI
I53 YORKTOWN DR.
WILMINGTON, NC 2840I
f. Purpose Codc j. Dcction Sum to Datei. f,in ploycr's Neme/Speci Iic trIeldb. Job Iltle/Profcssion
P 0.00$REALTOR KELLERWILLI,AMS
n. Drte (nm/ddlyyyy)o. Amountl. Form ofPayment m. Rcquired Rcmrrksk. Account Code
PO BOX IN KIND REIMBI.]RSMENT 02/0412020 92.00$
ffi,i,,!lffi
I
-
&r'a'*ffifi*#*
Debit Card
d. I}pc of Committee g. Commentsr. trbll Name, Meiling Addrcas & Phonc
(include city, strtc, & zip)I candioate
fl neferendm
E PAC
El pu'ty
e. Level Rcgistered (Specify)h. Originel Rcccipt Dttc
trtr
County:
Municipality
I re&rat
I sate
tt/2912019
i. Originrl Reccipt Amouot
102.00$
CLAYTON HAMERSKI
I53 YORKTOWN DR.
WILMINGTON,NC 2840I
j. Eection Sun to Ihtcf. Purporc Codeb. Job Iltlc/Profesrion s. Fnr ploye r's Nrm c/Specilic trIe ld
P 0.00$REALTOR KELLERWILLIAMS
D. Drte (mm/dd/yyyy)o. AEouotk. Account Codc l. Form ofPaynent m. Rcquircd Rcmrrks
0210412020 102.00$I Debit Card WEBSITE INKIND REIMBURSEMENT
1,156.00$
1,192.59$
L - Returned to C-ontributor
P* - Reimhrrsement of In-Kinr
M - Overpaynrnt for Service
O* Other
N- F,:ceeded Limit
cRo-l320
Refunds/Reimbursements From the Committee ps 2 or 2
Use this formto contributions retumed to the contributor
CRAT320
Amendment {p, v.'!CIB xo
NEW-3HA82V-C-065CLAYTON HAMERSKI FOR REGISTER OF DEEDS
d. Ilpc of Committee g. Commentsa. Full Name, Mailing Address & Phonc
(include city, state, & zip)I Candidate
f] Referendrn
EI PAC
E partv
e, Levcl Registered (Spccify)h. Originel Receipt Date
trtr
Comty
Mmicipality:
I rederal
E sate tt/2912019
i. Original Receipt Amount
20.00$
CLAYTON HAMERSKI
I53 YORKTOWN DR.
WILMINGTON, NC 2840I
b. Job Tltle/Profession c. Dnployer's Name/Specific FIcld f. Purpose Code j. Eection Sum to Date
REALTOR KELLER WILLIAMS P 0.00$
k- Account Code l. Form of Payment m. Required Remerks n. Date (mm/ddlyyyy)o. Amount
thbit Card
Comments
I 20.0002/04/2020 $
ste
Cormty:
Ori
$
(include state, & zip)
nal Rece Amount
of Committeed.
PACCandidate
Full Name, Mailing Address & Phone
fl sate
I-e ve
Fe&ral
. Original Receipt Date
tU29/2019
16.59
OPEN BAMK ACCOUNT IN KIND
REIMBURSEMENT
I nererendrrr trCLAYTON HAMERSKI
I53 YORKTOWN DR.
WILMINGTON,NC 2840I
b. Job Tltle/Profession c. Enployer's Name/Specific trleld f. Purpose Code j. Dcction Sum to Date
REALTOR KELLER WILLTAMS P 0.00$
k. Account Code l. Form ofPeymcnt m. Required Remarks n. Drte (mn/dd/yyyy)o. Amount
1 Debit Card NAMETAG IN KIND
REIMBURSEMENT 02t04/2020 16.59$
36.s9$
1,192.59$
C.ontibution
P* - Reimbursement of In-Kinr
L-to M - Overpaynrent for Service
O* Other
l. Committee Fhll Name rnd Fund ifau
Information Add Renpve
Infornration Add Renpve
Utr Municipality:
Total this
5. Total of ALLCRGI320 Pages
(This line must be on line 1S of Detuilcd Summory Pap CRO-I 100)
*,
Codes detailed disbursenpnt code in (f) above)6.
1. Committee Full ame (and Fund if applicaHe)
NEW-3HA82V-C-065
Commcnts
Originrl Re Date
i.o nal Receipt Amount
(include stete, & zip)
I-evel Re stered (S
CLAYTON HAMERSKI FOR REGISTER OF DEEDS
12/0212019
Information
fbtl Name, Mailing Address & Phone
RenpveAdd
of Com m ittced.
PACCandidate
Comty
$962.00
CLAYTON HAMERSKI
I53 YORKTOWN DR.
WILMINGTON,NC 2840I fl sate f] urmicipality:
f] Referendm EI Putty
i. Eection Sum to Datef. Purpose Codes. Fmployer's Name/SpeciIic trIcldb. Job Title/Profession
0.00$PKELLER WILLIAMSREALTOR
o. Amountn. Drte (mm/ddlyyyy)m. Required Remerksl. Form ofPaymentk. Account Code
02/04/2020 962.00$FILING FEE IN KIND
REIMBURSEMENT
Debit Card
Comments
(include ci state, & zip)
i. Original Recti Amount
Information
F\rll Name, Meiling Address & Phone
RennveAdd
d. Type of Committee
PAC
)e. I*vel Registercd
Federal
b. Originrl RecciPt Drte
1v2912019
$92.00
CLAYTON HAMERSKI
I53 YORKTOWN DR.
WILMINGTON, NC 2840I I Sate fl tutrmicipAity
I neroendnn E Putty
j. flection Sum to Datef. Purpose Codes. f,'m ployerrs Nem e/Specific trleldb. Job Tltle/Profession
0.00$PKELLER WILLI,AMSREALTOR
o. Amountn. Date (mm/dd/yyyy)m. Required Remarksl. f,'orm of Pf,ymentk. Account Code
Debit Card 92.00
Comments
PAC
02104/2020 $I
Date
i. Originel Recci Amount
PO BOX IN KIND REIMBURSMENT
I sate
Information
FIrll Name , Mailing Address & Phone
(include city, state, & zip)E Purty
f] Muicipality
red (Spccify)
County 1U2912019
h. Original Rccei
d.'Ilpe of Committee
I Referendrn
c. Level
$102.00
CLAYTON TIAMERSKI
I53 YORKTOWN DR.
MLMINGTON, NC 2840I
Add tr Renpve
j. Dcction Sum to Datef. Purpose Codec. Enployer's Name/Specific Fieldb. Job Tltlefrofegsion
0.00$PKELLER WILLI,AMSREALTOR
o. Amountn. Date (mm/ddfyyy)m. Required Remarksl. Form ofPaymentk, Account Code
02t04t2020 102.00$WEBSITE INKIND REIMBURSEMENTDebit CardI
1,156.00$Total this
1,192.59$
*red
N - Exceeded Contibution Limit
mdisdetailedcode,bursenpnt (DCodes(List6.Purpose
L - Returned to C.ontributor M - Overpaynrnt for Service
Total of AIICRO.I320 Pages
cRo-t 100)line mug be on line 15
P* -Reimhrrsementof In-Kinl O* Other
Amendme
E fcP
ilL
ts NoRefunds/Reimbursements From the Committee pg 1 or 2
Use this form to refunds/reimburs includin contributions retumed to the contributor
320 ate
tlumber
I
2. ID Numberand Flrnd ifapoFull
NEW-3HA82V-C-065
Commcnts
o
i.o
$
CLAYTON HAMERSKI FOR REGISTER OF DEEDS
d. Tlpe of Committee
PACCandidate
e, Level Registered (Specify)
Federal County
Information
11t2912019
al Rcceipt Date
nrl Receipt Amount
20.00
Add tr Rermve
I sate fl Mrmicipality:
I Referendrm E P.rtyCLAYTON HAMERSKI
I53 YORKTOWN DR.
WILMINGTON, NC 2840I
Full Neme, Mailing Address & Phone
(include city, stete, & zip)
j. Eection Sum to Datec. Employcr's Nemc/Specific tield f. Purpose Codeb. Job Title/Profession
0.00$PREALTORKELLER WILLI,AMS
o. Amountm. Rcquired Remerks n. Drte (mm/ddlyyyy)l. Form ofPaymentk. Account Code
Debit Card 20.00
Commcnts
$I
Dete
$
I-evel Re stcred (S
(include state, & zip)
Origin al
02/04/2020
RernoveAdd
d.'Ilpe of Committee
PACCandidate
Comty
f] Municipality:Ll $ale
Information
. Full Name, Mailing Address & Phone
tU29l20t9
Originel Re
Amount
16.59
OPEN BAMKACCOI,JNT IN KIND
REMBURSEMENT
f] neferenarm E PurtyCLAYTONHAMERSKI
I53 YORKTOWN DR.
WILMINGTON,NC 2840I
j. Eection Sum to Drtef. Purposc Codec. f,mployer's Neme/SPecific fleldb. Job Title/Profession
0.00$PKELLERWILLIAMSREALTOR
o. Amoutrtn. Dete (mm/dd/yyyy)m. Rcquired Remarksl. Form ofPeymentk. Account Code
02/04t2020 16.59$Debit Card NAMETAGINKIND
REIMBURSEMENT
36.59$4. Total only this Page
1,192.59
N.Contibution Limit
$
Codes (List detailed disbursenpnt code in above)
L - Retumed to Contributor M -Overpayrrent for Serv ice
6.
a4eq{qrent j-
D({# Bt noRefundslReimbursements From the Committee pg 2 or 2
Use this formto refu nd s /reimb u rs ernents,contributions retumed to the contributor
CRGI
I
5. Total of ALL CRO-1320 Pages
(This line mast be on line I 5 of Deuiled Summary Page CRO'I 100)
P* - Reimbursement of In-Kinr O* Other
* Co&s reorire detailed explanetion itr required remarks field (m)