2013 Final Report Amendment
Disclosure Report Cover ❑ Yes El 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.Committee Information
a. Full Name c. ID Number
COMMITTEE TO ELECT STEVE SHUTTLESWORTH RHA-706-C-001
b.Mailing Address(include City,State and Zip Code) d.Date Filed
................................_
808 CAROLINA BEACH AVE N#1 01/24/2013
CAROLINA BEACH,NC 28428
e.Phone Number
ECE ' kY R^
2 Report Year 3.Period Start Date(mm/dd/yv) 1 Bkdo 1,Date,(mm/dd/ry) 5 Treasurer Full Name
2012 01/01/2013 01/24/2013 STEVE SHUTTLESWORTH
6.Type of Committee(Check One) 9 Type of Report (check only one type of report from one category)
in Candidate Campaign ❑ Parts Municipal State/County jReferenduin
❑ Joint Fundraiser ❑ PAC ❑ Organizational ❑ Organizational ❑ Organizational
❑ Referendum ❑ Legal Expense Fund ❑ Thirty-five day Quarterly ❑ Pre-referendum
7,., o F nd -ffappffotale,wcheck I r ..: ; ❑ 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 1O;S pectifiteportName'
❑ Other: ►L Final ❑ Year End
8.Number of Fundraisers this Report ❑ Special ❑ Final
0 ❑ Special
3.Account Information 3.Account Information
a.Financial Institution Full Name a.Financial Institution Full Name
BANK OF AMERICA
b.Purpose c.Account Code b. Purpose c.Account Code
CAMPAIGN FINANCE SAS
d.Period Begin Balance d.Period Begin Balance
$ 8.74 $
CERI I}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 t is report is complete,true and correct and that I have been trained by the NC State Board
vi'r P mr ri 01/24/2013
Printed Name of Signer ature of Appointed Treasurer Date
FOR OFFICE USE ONLY
Delivery Method
Date Received: l y3%t 3 Employee: ❑ Normal Mail
Date Postmarked: Employee: ❑ Registered Mail
® 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 committee changes.
CRO-1000 NC State Board of Elections December 2007
Amendment
Detailed Summary ❑ Yes El 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 3.1D Number
COMMITTEE TO ELECT STEVE 2012 Final RHA-706-C-001
SHUTTLESWORTH
Start of Election Cycle: January 1, 2012 Total this Total this
Reporting Period Election Cycle
4) Cash on Hand at Start $ 8.74 $ 176.74
RECEIPTS
5) Aggregated Contributions from Individuals (CRO-1205) $ 0.00 $ 0.00
6) Contributions from Individuals (CRO-1210) $ 0.00 $ 0.00
7) Contributions from Political Party Committees (CRO-1220) $ 0.00 $ 0.00
j �
8) Contributions from Other Political Committees Ee 0.00 $ 0.00
9) Loan Proceeds JANAIN4N 13$ 0.00 $ 0.00
10) Refunds/Reimbursements to the Committee (CRO-1240) $ 0.00 $ 0.00
11) Other Receipt Sources 148413effiell111.11.11.111
11a) Interest on Bank Accounts (CRO-1250) $ 0.00 $ 0.00
11b) Contributions from Not-For-Profit Organizations (CR0-1250) $ 0.00 $ 0.00
11c) Outside Sources of Income (CRO-1250) $ 0.00 $ 0.00
11d) 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 1 a,11 b,11 c,l Id and Ile) $ 0.00 $ 0.00
EXPENDITURES
13) Disbursements
13a) Operating Expenditures (CRO-1310) $ 0.00 $ 0.00
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-Media Expenditures (CRO-1315) $ 8.74 $ 176.74
15) Loan Repayments (CRO-1420) $ 0.00 $ 0.00
16) Refunds/Reimbursements from the Committee (CRO-1320) $ 0.00 $ 0.00
17) In-Kind Contributions (CRO-1510) $ 0.00 $ 0.00
18) TOTAL EXPENDITURES (Add lines 13a, 13b, 13c,14, 15, 16 and 17) $ 8.74 $ 176.74
19) Cash on Hand at End(Add lines 4 and 12 together,then subtract line 18) $ 0.00 $ 0.00
ADDITIONAL INFORMATION
10) Non-Monetary Gifts Given to Other Committees (CRO-1330) $ 0.00 `
11) Outstanding Loans (incl.ones from other campaigns) (CR0-1430) $ 0.00
12) Debts and Obligations owed by the Committee (CRO-1610) $ 0.00
23) Debts and Obligations owed to the Committee (CRO-1620) $ 0.00
24) Account Transfers Within the Committee (CR0-1720) $
25) Administrative Support (CRO-1710) $ 0.00 $ 0.00
26) Forgiven Loans (CR0-1440) $ 0.00 $ 0.00
17) 48-Hour Notice Reports Sum (CR0-2220) $ 0.00 $ 0.00
18) Contributions to be Refunded (CRO-1215) $ 0.00 $ 0.00
CRO-1100 NC State Board of Elections August 2008
Amendment
Aggregated Non-Media Expenditures Page 1 of 1 ❑ Yes ® No
Optional form used to report NC Non-Media Expenditures of$50 or less.
1.Committee.Full Name(and Fund if applicable) _ W. W 2.ID Number
COMMITTEE TO ELECT STEVE SHUTTLESWORTH RHA-706-C-001
3.Payee Information
a.Amend b.Account Code c. Form of Payment d. Purpose Code e.Date (mm/dd/yyyy) f.Amount g.Required Remarks
■ Add SAS Check 0 01/04/2013 $ 8.74 CONT.TO NOT FOR
❑ Remove PROFIT
4. Total only this Page $ 8.74
5. Total of ALL CRO-1315 Pages $ 8 74
(This line must be on line 14 of Detailed Summary Page CRO-1100)
6. Purpose Codes (List detailed expenditure code in(d) above)
B* - Printing C* - Fundraising D - To Another Candidate
E - Salaries ;.* §..ipment G - Political Party 11* - Holding Public Office +. , es
, bistage J-Penalties K* Office Expenses Q* - Donations to Legal Expense Fund
0* - Othe r
* Codes require detailed explanation in required remarks field (g)
CRO-1315 NC State Board of Elections December 2009
JAN 2 4 ZUi3
NHC Bd of Elections