Bizzell for Sheriff 2017 Year-End Disclosure Report

AmendmentDisclosure Report Cover Yes NoUse this form for general report and committee information, must be signed and submitted along with other detailed formsDo not use this form to update information1 Committee InformationBIZZELL FOR SHERIFF4515 BIZZELL GROVE CHURCH ROAD 01032018PRINCETON, NC 27569919 965-82103 Period Start Date mmddyy 4 Period End Date mmddyy |5 Treasurer Full Name2017 07012017 12312017 HEATHER FORD6 Type of Committee Check One 9 Type of Report check only one type ofreport from one categoryDa Candidate Campaign LJ Party Municipal [StateCounty [Referendum[J Joint Fundraiser [J] PAC [C] Organizational [] Organizational [J Organizational[] Referendum JJ Legal Expense Fund|[7] Thirty-five day Quarterly [] Pre-referendum7 Type ofFund -_ ifapplicable, check one CJ Pre-primary Cc] First [J Final[] Booster Fund [] Pre-election Cc] Second [_] Supplemental Final[] Building Fund [] _-s~wPrre-runoff CI Third [] Annual[] Presidential Election Year Candidates Fund Semi-annual Cj Fourth [] Special[-] NC Public Campaign Financing Fund CI Mid Year Semi-annualCc] Year End C Mid Year 10 Special Report Name[] Other [] 'Final Sd Year End8 Number of Fundraisers this Report CI Special CJ Final3 Account Information 3 Account InformationEXPENDITURESCERTIFICATIONI certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B 22D-22M ofChapter 163 of the NC General Statutes and that no funds are commingled with prohibited or other non-disclosedfunds I further certify that this report is complete, true and correct and that I have been trained by the NC State Board|ate 01032018Printed Name of Signer Signgture of Appointed Treasurer DateFOR OFFICE USEONLYog ¢ Delivery MethodDate Received ible Employee Ema CO] Normal MailCJ Registered MailDate Postmarked ee Employee - Er Hand DeliveredDate Scanned Employee C] Electronically FiledDate Data Entered Employee Cy Signer has not received- mandatory trainingPlease Note This formcannot be used to amend committee information such as the committee address, treasurer,assistant treasurer, custodian of books information, or account informationYou must amend the Statement of Organization CRO-2100A-E to make committee changesCRO-1000 NC State Board of Elections December 2007~ Detailed Summary Ove DS NoUse this form to summarize all disclosure reporting forms and to total monetary informationRECEIPTS5 Aggregated Contributions from Individuals CRO-12056 Contributions from Individuals CRO-12107 Contributions from Political Party Committees CRO-12208 Contributions from Other Political Committees CRO-12309 Loan Proceeds CRO-14100 RefundsReimbursements to the Committee CRO-12401 Other Receipt Sources11a Interest on Bank Accounts CRO-125011b Contributions from Not-For-Profit Organizations CRO-125011c Outside Sources of Income CRO-125011d Legal Expense Fund - Other Sources CRO-1270lle Exempt Purchase Price Sales CRO-1265EXPENDITURES3 Disbursements po REUSE FTI13a Operating Expenditures CRO-131013b Contributions to CandidatesPolitical Committees CRO-131013c Coordinated Party Expenditures CRO-13104 Aggregated Non-Media Expenditures CRO-13155 Loan Repayments CRO-14206 RefundsReimbursements from the Committee CRO-13207 In-Kind Contributions CRO-1510ADDITIONAL INFORMATION20 Non-Monetary Gifts Given to Other Committees CRO-133021 Outstanding Loans incl ones from other campaigns CRO-143022 Debts and Obligations owed by the Committee CRO-161023 Debts and Obligations owed to the Committee CRO-1620 000 | regards24 Account Transfers Within the Committee CRO-1720»5 Administrative Support CRO-171026 Forgiven Loans CRO-144027 48-Hour Notice Reports Sum CRO-2220CRO-1100 NC Sate Board of Elections August 2008AmendmentDisbursements Pe 1 of _1 DYes [NoUse this form to report expenditures from the committee for operating expenses, contributions to candidatepoliticalcommittees and coordinated party expenditures1 Committee Full Name and Fund if applicable 2 ID NumberBIZZELL FOR SHERIFF a3 Type of Dis bursement ease use separate CRO-1310 for r eacl Di4, Payee Information [J Add [1 __ Removea Full Name, Mailing Address PhoneJOHNSTON COUNTY SHRINE CLUB 1235 EAST PRESTON STREETSELMA, NC 27576 |_| Federal |_| CountyD1 state D1 Municipatty4 Payee Information C] Add J _ Removea Full Name, Mailing Address PhoneSMITHFIELD-SELMA CHAMBER OF COMMERCEPO BOX 467SMITHFIELD, NC 27577 -| Federal J CountyO sate LI Municipalityf Account CodeSBL | Check « JO---S-s@YSs08022017 | ~-10000 | DONATION4 Payee Information [C1] Add 1] _ Removea Full Name, Mailing Address PhoneTHE FORD FIRM, PLLCPO BOX 701CLAYTON, NC 27528 J Federal County919 550-2100 C1 state C Municipality5 Total only this Page 350006 Total of ALL CRO-1310 PagesThis line goes in line 13a of Detailed Summary Page CRO-1100 if Operating Expenses 35000This line goes in line 136 of Detailed Summary Page CRO-1100 if Contrib to CandidatesPolitical CommThis line goes in line 13c of Detailed Summary Page CRO-1100 if Coordinated Party Expenditures7Purpose Codes List detailed expenditure code in h aboveA - Media B - Printing C - Fundraising D - To Another CandidateE - Salaries F - Equipment G - Political Party H - Holding Public Office ExpensesI - Postage J - Penalties K - Office Expenses Q - Donation to Legal Expense FundO Other Codes require detailed explanation in required remarks field kCRO-1310 NC State Board of Elections December 2009