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Saunders Final Report Amendment Disclosure Report Cover ® Yes ❑ 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 1.C ittee Informah n - a.Full Name e.ID Number Committee to Elect Emma Saunders for BD of ED ZHA-8-L-3 b.Mailing Address(include City,State and Zip Code) d.Date Filed 3600 S College Road STE E 1/15/2013 PMB 378 Wilmington,NC 28412 JAN 15 2013 e.Phone Number Nf"r' D-1 '°'Elections 910-471-8702 2.Report ea 1W, *'Penod Start Date(mm/dd/yy) 4.Period End Dat' . Teasurer Full Name (mmldd/ 2012 10/21/2012 12/31/2012 Gwen Hill 6.Type 9LCo mmittee 9.Type of Repo f report from one category) ® Candidate Campaign ❑ Party Municipal State/Counts Referendum ❑ PAC ❑ Referendum ❑ Organizational ❑ Organizational ❑ Organizational Independent ❑ E]Expenditure Joint Fundraiser E] Thirty-five day Quarterly ❑ Pre-referendum ❑ Legal Expense Fund 7.Type of Ful ❑ Pre-primary ❑ First ❑ Final ❑ 'Booster Fund" ❑ Pre-election ❑ Second ❑ Supplemental Final ❑ Building Fund ❑ Pre-runoff ❑ Third ❑ Annual Semi-annual ❑ Fourth ❑ Special ❑ Mid Year Semi-annual ❑ Other: ❑ Year End ❑ Mid Year ❑ Final ❑ Year End 8.Number of Fundraisers this Report ❑ Special ® Final ❑ Special 11.Account Information '. 11.Account Information a.Financial Institution Full Name a.Financial Institution Full Name Wells Fargo b.Purpose c.Account Code b.Purpose c.Account Code Campaign Miranda Account d.Period Begin Balance d.Period Begin Balance $ 1039.02 $ CERTIFICATION 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 wi4Cte ed or r non-disclosed funds.I further certify that this report is complete,true and correct and that I have been trained by th Board o 1 t s Gwen Hill 1/15/2012 Printed Name of Signer ture of Appointed Treasurer Date FOR OFFICE USE ONLY Date Received: S- Employee: Delivery Method ❑ Normal Mail Date Postmarked: Employee: ❑ Registered Mail ® Hand Delivered Date Scanned: Employee: ❑ Electronically Filed ❑ Signer has not received Date Data Entered: Employee: 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 committee changes. CRO-t 000 NC State Board of Elections Aueust 2008 Amendment Detailed Summary H Yes F-1 No Use this form to summarize all disclosure reporting forms and to total monetary information. jCoTmt#e6Full ame (od Fund if applies, 2.T3W!# lul Own, Committee to Elect Emma Saunder for 1313 of 2012 Final Amendment Z A-8-L-3 Start of Election Cycle: January 1, 2009 Total this Total this Reporting Period Election Cycle 4) Cash on Hand at Start 1039.02 $ 00 5) Aggregated Contributions from Individuals (CRO-1205) $ 95.00 95.00 6) Contributions from Individuals (CRO-1210) $ 100.00 $ 8767.60 7) Contributions from Political Party Committees (CRO-1220) $ $ 8) Contributions from Other Political CommitteesRECE196_�� $ 50.00 50.00 9) Loan Proceeds JAN 1 5rC?'R34'0) $ $ 10) Refunds/Reimbursements To the Committee (CRO-1240) $ $ 11) Other Receipt Sources d,H 03 RE,d Ila) Interest on Bank Accounts (CRO-1250) $ Ilb) Contributions from Not-for-Profit Organizations (CRO-1250) $ 1300.00 11c) Outside Sources of Income (CRO-1250) $ $ 11d) Legal Expense Fund—Other Sources (CRO-1270) $ $ Ile) Exempt Purchase Price Sales (CRO-1265) $ $ 12) TOTAL RECEIPTS (Add lines 5,6, 7,8,9, 10, Ila, Ilb, Ile, Ild and Ile) $ 245.00 $ 10212.60 13) Disbursements 13a) Operating Expenditures (CRO-1310) $ 1159.88 $ 6066.04 13b) Contributions to Candidates/Political Committees (CRO-1310) $ $ 150.00 13c) Coordinated Party Expenditures (CRO-1310) $ $ 250.50 14) Aggregated Non-Media Expenditures (CRO-1315) $ 124.14 $ 746.46 15) Loan Repayments (CRO-1420) $ $ 16) Refunds/Reimbursements From the Committee (CRO-1320) $ $ 17) In-Kind Contributions (CRO-1510) $ $ 2999.60 18) TOTAL EXPENDITURES(Add lines 13a, 13b, 13e, 14, 15, 16 and 17) $ 1284.02 $ 10212.60 19) Cash on Hand at End(Add lines 4 and 12 together,then subtract line 18) $ 0.00 $ 0.00 20) Non-Monetary Gifts Given to Other Committees (CRO-1330) $ 21) Outstanding Loans(incl.ones from other campaigns) (CRO-1430) $ 22) Debts and Obligations owed By the Committee (CRO-1610) 23) Debts and Obligations owed To the Committee (CRO-1620) $ 24) Account Transfers Within the Committee (CRO-1 720) $ 7 25) Administrative Support (CRO-1710) $ $ 26) Forgiven Loans (CRO-1440) $ $ 27) 48-Hour Notice Reports Sum (CRO-2200) $ $ 28) Contributions to be Refunded (CRO-1215) $ $ CRO-1100 NC State Board of Elections August 2008 Amendment Contributions from Other Political Committees pg , of 1 ® Yes ❑ No j Use this form to report contributions from other candidate,referendum or PAC committees Committee Full Name Fund if applicable) Committee to Elect Emma Saunder BD of ED ZHA-8-L-3 Infor ation . " emove a.Full Name,Mailing Address&Phone b.Type of Committee d.Comments (include city,state,&zip) ® Candidate ❑ PAC Susi Hamilton for NC House F C.E ❑ Referendum 701 Market Street JAN 15 2013 c.Level Registered(Specify) PO Box 637 ❑ Federal ❑ County: Wilmington,NC 28401 ® State ❑ Municipality: e.Election Sum to Date 910-742-0537 NHC Bd of Electio $ 50.00 f.Account Code g.Form of Payment h.In-Kind Description i.Date(mm/dd/yyyy) j.Amount Miranda Check 12/6/2012 $ 50.00 3.Contributor Information' Add ❑ Remove a.Full Name,Mailing Address&Phone b.Type of Committee d.Comments (include city,state,&zip) ❑ Candidate ❑ PAC ❑ Referendum e.Level Registered(Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e.Election Sum to Date $ f.Account Code g.Form of Payment h.In-Kind Description i.Date(mnddd/yyyy) j.Amount $ 3.Contributor Information ❑ Add ❑ Remove a.Full Name,Mailing Address&Phone b.Type of Committee d.Comments (include city,state,&zip) ❑ Candidate ❑ PAC ❑ Referendum c.Level Registered(Specify) ❑ Federal ❑ County: ❑ State ❑ Municipality: e.Election Sum to Date $ f.Account Code g.Form of Payment h.In-Kind Description i.Date(mm/dd/yyyy) j.Amount $ $ $ 4.Total only this Page $ 50.00 5.Total of ALL CRO-1230 Pages $ 50.00 (This line must be on line 8 of Detailed Suninrary Page CRO-1100) CRO-1230 NC State Board of Elections April 2007 Amendment Disbursements Pg t of 2 ® Yes ❑ No Use this form to report expenditures from the committee for;operating expenses,contributions to candidate/political committees and coordinated party expenditures. MI ittee Full I iicable) 3.Type of Disbursement Lffease use se arate CRO-1310 forms Lor each went.) ® Operating Expenses ❑ Contributions to Candidates;Political Crnnmiaces ❑ Coordinated Party Expenditures 4.Payee Information ❑ Add ❑ . , a.Full Name,Mailing Address&Phone b.Coordinated Committee Name d.Comments (include city,state,&zip) Break Time Grille/Ten Pin Alle 127 S College Road c.Level Registered(Specify) Wilmington NC 28403 ❑ Federal ❑ County: 910-395-6658 ❑ State ❑ Municipality: e.Election Sum to Date $ 279.84 f.Account Code g.Form of Payment h.Purpose Code i.Date(mm/dd/yyyy) j.Amount k.Required Remarks Miranda Debit Card O 11/06/2012 $279.84 Dinner for Committee 4.Payee Information El Add ❑ Remove ° a.Full Name,Mailing Address&Phone h.Coordinated Committee Name d.Comments (include city,state,&zip) Greater Wilmington Business Journal �y (�C'\/�[1 c.Level Registered(Specify) 130 N Front Street r( X`"'G V v ❑ Federal ❑ County: Suite 105 �n N �{1 K 2013 ❑ State E] Municipality: e.Election Sum to Date Wilmington,NC 2840 HI v $ 241.00 910-343-8600 ---_' f.Account Code g.Form of Payment h.Purpose Code i.Date(mm/dd/yyyy) j.Amount k.Required Remarks Miranda Debit Card AO 10/23/2012 $241.00 Ad in business Journal 4.Payee Information ❑ Add ❑ Remo a.Full Name,Mailing Address&Phone b.Coordinated Committee Name d.Comments (include'city,state,&zip) Miracle Rock Ministries 3717 North Kerr Avenue c.Level Registered(Specify) Wilmington,NC 28405 ❑ Federal ❑ County: 910-343-0855 ❑ State ❑ Municipality: e.Election Sum to Date $ 417.65 f.Account Code g.Form of Payment h.Purpose Code i.Date(mm/dd/yyyy) j.Amount k.Required Remarks Miranda Money Order O 12/21/2012 $417.65 Contriution to 501-C3 5: btal onl this P" $ 938.49 6.Total.of ALL CRO 1310 Paggs (This line goes in line 13a of Detailed Summary Page CRO-1100 if Operating Expenses) (This line goes in line 13b of Detailed Summary Page CRO-1100 if Contrib to Candidates/Political Comm) $ 1 159.88 (This line goes in line 13e of Detailed Summary Page CRO-1100 if Coordinated Party Expenditures) 7.Purpose Codes expenditure code in h.)above) A*-Media B*-Printing C*-Fundraising D-To Another Candidate E - Salaries F*-Equipment G-Political Party H*-Holding Public Office Expenses I - Postage J - Penalties K*-Office Expenses Q*-Donation to Legal Expense Fund W"-Other *Codes require detailed explanation in required remarks field(k)JIM CRO-1310 NC State Board of Elections December 2009 Amendment Disbursements Pg 2 of 2 ® Yes ❑ No Use this form to report expenditures from the committee for;operating expenses,contributions to candidate/political committees and coordinated party expenditures. nd if applicable) Committee to Elect Emma Saunders BD of ED ZHA-8-L-3 3.T a of Disbursement ' tise use separate CRO-1310 ornts for each fyge o Disbursement ❑ Operating Expenses ❑ Contributions to Candidates%Political Committees ❑ Coordinated Party Expenditures 4.PayeelffINVERW Add ❑ Remove a.Full Name,Mailing Address&Phone b.Coordinated Committee Name d.Comments (include cite,state,&zip) Office Depot# 197 3727 Oleander Drive c.Level Registered(Specify) Wilmington,NC 28403 ❑ Federal ❑ County: 910-392-9013 ❑ State ❑ Municipality: e.Election Sum to Date $ 177.41 f.Account Code g.Form of Payment h.Purpose Code i.Date(mm/dd/yyyy) j.Amount k.Required Remarks Miranda Debit Card K 11/12/2012 $65.25 Ink Cartridge Miranda Debit Card B 11/19/2012 $73.44 Printer 4. a ee Ihformahoti°. �, �yr: , . �� emove , Thank You Cards a.Full Name.Mailing Address&Phone b.Coordinated Committee Name d.Comments (include city,state,&zip) Working 4 U Campaign Photo 3600 South College Road S`Tt c.Level Registered(Specify) Wilmington,NC 28412 JAN 15 2013 ❑ Federal ❑ county: 910-395-0029 ❑ State ❑ Municipality: c.Election Sum to Date NHC Bd of Elections $ 72.00 f.Account Code g.Form of Payment h.Purpose Code i.Date(mm/dd/yyyy) j.Amount k.Required Remarks Miranda Money Order O 12/13/2012 $72.00 Campaign Photos Emma Saunders 4.Payee Information ❑ Add ❑ Remove a.Full Name,Mailing Address&Phone b.Coordinated Committee Name d.Comments (include city,state,&zip) Choices Design 713-B Princess Street c.Level Registered(Specify) Wilmington,NC 28401 ❑ Federal ❑ County: ❑ State ❑ Municipality: e.Election Sum to Date $ 10.70 f.Account Code g.Form of Payment h.Purpose Code i.Date(mm/dd/yyyy) j.Amount k.Required Remarks Miranda Debit Card A 12/13/2012 $10.70 Business Cards 5.Total only this Page $ 221.39 Total of ALL CRO-1310 Pages (This line goes in line 13a of Detailed Summary Page CRO-1100 if Operating Expenses) (This line goes in line 13b of Detailed Summary Page CRO-1100 if Contrib to Candidates/Politieal Comm) $ 1159.88 (This line goes in line 13c of Detailed Summary Page CRO-1100 if Coordinated Party Expenditures) 7.Purpose Codes (List detailed expenditure code in(h.)above) A*-Media B*-Printing C*-Fundraising D-To Another Candidate E - Salaries F*-Equipment G-Political Party H*-Holding Public Office Expenses I - Postage J - Penalties K*-Office Expenses Q*-Donation to Legal Expense Fund O*-Other *Codes require detailed explanation in required remarks field(k) CRO-1310 NC State Board of Elections December 2009 Aggregated Non-Media Expenditures Page Amendment of t ® Yes ❑ No Optional form used to report NC Non-Media Expenditures of$50 or less. 1.Committee Full Name(and Fund if applicable) 2.ID Number 3.Payee Information Amend b.Account Code c.Form of Payment d.Purpose Code e.Date(nnm/ddlyyy') L Amount g.Required Remarks ❑ Add - ❑ Remove �lfanda -re,C-4- U /O ?> a /� $ a `f vo l,Jt6Srlt non+hly C�iw Add ❑ Remove $ Add ❑ Remove i fc d,. r f 73 f/ /a o/ $ / Add ❑ Remove M,re,,oft. 0�5�� "�! k ll S /a $ /3 1l5 /✓o i�ed�pes Add ❑ Remove trcrJc. G�i {- Caret 11 7 za vl�- $ 3i{ 7 a -/7, /G You Notes Add ❑ Rem Add ove $ /o• U o ❑ Remove ^(c,4, ti f U 11 e�f D/a $ 3, 00 Add c,,,,/c Fcc - ( of re c• ❑ Remove ire,da $ (o b O ""-44 ly lsuue C{,vJ,- Add ❑ Remove $ Add ❑ Remove $ Add ❑ Remove $ Add IVED ❑ Remove Add JAN 3 ❑ Remove $ Add ❑ Remove NHC B of Electio y Ll Add ❑ Remove �^ Add ❑ Remove $ Add ❑ Remove $ Add ❑ Remove $ Add ❑ Remove $ Add ❑ Remove S 4. Total only this Page /� I c. 5. Total of ALL CRO-1315 Pages (This line must be on line 14 of Detailed Sunama Page CRO-1100) 6. Pu des List detailed x enditure ode in above) Ajj •. B'' - Printing C* Fundraising D-To Another Candidate E - Salaries F* - Equipment G - Political Party H o_ ingWblic O i " -4-inses l-Postage,. J -Penalties K* -Office Expenses Donations to Legal Expense Fund O* -Other * Codes require detailed ex lanation in re uired remarks field CRO-1315 NC State Board of Elections December 2009