Amendment Cu No etailed forms Disclosure Report Cover Use this form for general report and committee informatio Bo not use this formio update information, F- Committee Information fs. Full Name eee [E10 Number SARTAIN FOR RALEIGH COMMITTEE ic Nailing address Glade City State and Zip Couey je Date Tie (0-N WALNUT CREEK PKWY (RECFEIVET 09:22/2009 RALEIGH, NC 27606 SEP 28 2009 iz: Report Vear [3. Period Start Full Name 2009 | 08/26/2009 09/21/2009 ATHAN POWERS ze (Chesk One) im CD Par Oke pendnore Join Fudciser [EJ Thitysive d c 1 Lees Expense ne LD Peesprimary CO Fim Fis TB Prestecto cons Ey sepctemenatPinat Tak DD re-unott Thi | asinuat Semi-annus TH Fowh speci eating Fe Mis Yeu Semi-annual TC Yexrtns [Micvea [Toy Speetat Report Name] 1 ones DI Fina Eo veins PovSeeeet Repent Nat is. Nabe CD Sees Di Final DD speciat Ti Account Info Ib Purpose CAMPAIGN ACCOUNT ‘Period Begin Balance alae s 60.16. 3 CERTIFICATION "cet that the Committe or Fund is in compliance with all applicable provisions of Article 224, 228 & 220-22M of Chapter 163 of the NC General Statutes and that no funds ate commingled with proubited or other non-disclosedl funds. 1 further certify that this report is complete, true and correct and that Ihave been trained! by the NC State Board of E a Nor ‘Sure of Appa FOR OFFICHUSEONLY Date Received: Expl P ! Registered Mail Date Postmarked: ployee ae Date Scanned: Employee: O Eketronicaly Filed Date Data Entered Enplyer: 1 Signeras not received mandatory t Please Note: thi formcannot be used to amend committee information such av the committee address, Weasuren, assistant treasurer, custodian of books information, or account information end the Statement of Organization (CRO-21008-6) to make conurittee changes TROTo0 NCS boneat Pea YousAmendment Detailed Summar Oves No Use this fonmto st Type of Report SARTAIN FOR R 2009 Pre-Election LEIGH COMMITTEE [Start of Election Cycle: January 1, __ 2009 ere alee 4) Gastron Handa Start 3 460.16 | $ 000 RECEIPTS 5) Aggregated Contributions from Individuals ccxo.1203) 1% 66 6) Contributions from Individuals cero. 5 34,092.50 7) Contributions from Political Party Committees ccno-1220) {8 100,00 8) Contributions from Other Political Committees, (€R0-1230 000 9) Loan Proceeds ccvo.1810){ 5 oo [s 100.00 (0) Refunds/Reimbursements to the Committee ccro-4y 15 0.00 | s 0.00 1) Other Receipt Sources Ha) Interest on Bank Accounts ecro-1250)| 5 200] § 030 1b) Contributions from Not-For-Profit Organizations (CR0-1250) 000s 0.00 He) Outside Sources of bncome ccxo-1250) 15 ooo [sooo 114) Legal Expense Fund- Other Sources 1c3-1270)) § p00 |e 0.00 Le) Exempt Purchase Price Sales (CR0.1265)| § 0.00 | 0.00 ba) TOTAL RECHPTS Ast ne 5,7 Siam Ps iiaostcot sya sc corn XPENDITURE 3) Disbursements a =| 13a) Operating Expenctitures ccxo-1310) 0.00 |S 135) Contributions to Candidates Political Committees (C0-1310] 3 goa |S 13c) Coordinated Party Expenditures (cR0.1310) 4) Aggregated Non-Media Expenditures (CR0-1515 5) Loan Repayments (€n0.1420) 6) Refundy/Reimbursements from the Committee (€h0-1320) 7) In-Kind Contributions 18) TOTAL EXPENDITURES (Ad ines (30-1510) 9) Cash on Handa End A ho a sop was eS) [Saran Sa ADDITIONAL INFORMATION, 0) Non-Nbnetary Gifts Given to Other Comnitiees——_(eR01880 [5 060 1) Outstanding Los (ne ones froma coro. 0.00 2) Debts and Obligations owed by the Ce (CRO-1610)| 000 3) Debts and Obligations owed to the Committee (CRO-1620)| § "000 '4) Account Transfers Within the Committee ycno-1720)| § ~ 0.00 5) Administrative Support (cro-17 10) | § p00 | s 0.00 36) Forgiven Loans a r—™— 7) Howe Notice Reports Sum cro.2220 3a |) 000 Sic aor § 000 [5 0.00 CROTON TOS bande eee Raga OTAggregated Contributions from Individuals rae) ot Gace v0 Optional form used to report NC Contributions From Individuals of $50 or kess ff; Commitice Full Name (and Fundit applicable SARTAIN FOR RALEIGH COMMITTEE [3. Contributor Information beamewa [nae TERT DATONG [Ema Bre | | poo |s 5000 ra “| oonsae07 Ps 3500 ee | wavs oo —_ “ooisa009 —[s-soon 15/2009 50.00 osis2009 | s 25.00 osn72009 | s 50.00 loa T ID Reaove oon22009 | s 25.00 s 20.00 9715/2009 Total only this Page 3 $430.00 . Total of ALL, CRO-1205 Pages (his ine mast be a tine Sof Detaled Summary Page CRO-1100) CRO-TD0S ROGte Bodo . $430.00