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Disclosure Report Cover <br />Amendment <br />® Yes ❑ No <br />Use this form for general report and committee information, must be signed and submitted along with other detailed forms. <br />Do not use this form to update information <br />1. Committee Information <br />a. Full Name <br />c. FD Number <br />COMMITTEE TO ELECT 1NGRID NURSE <br />IN2024 <br />b. Mailing Address (include City, State and "Lip Code) <br />d. Date Filed <br />P.O. Box 5862 <br />CONCORD, NC 28027 <br />04-0$-2025 <br />e. Phone Number <br />9803225447 <br />2. Report Year <br />3. Period Start Date (mmlddlyy) <br />4. Period End Date <br />mmlddl <br />5. Treasurer Full Name <br />2026 <br />01-01-2026 <br />02/14/2026 <br />GRACE LIEM GALLOWAY <br />ti. Type of Committee Check One <br />9, Type of Report <br />(check only one type a 're art <br />am one category) <br />® Candidate Campaign ❑ Party <br />Municipal <br />State/County <br />Referendum <br />❑ PAC ❑ Referendum <br />❑ Organizational <br />® Organizational <br />❑ Organizational <br />Independent ❑ Joint Fundraiser <br />❑ Expenditure <br />❑ Thirty-five day <br />Quarterly <br />❑ Pre -referendum <br />❑ Legal Expense Fund <br />❑ Pre-primary <br />❑ Pre -election <br />® First <br />❑ Second <br />❑ Final <br />❑ Supplemental Final <br />7. Type of Fund (if applicable, check one) <br />❑ "Booster Fund" <br />❑ Building Fund <br />❑ Pre -runoff <br />❑ Third <br />❑ Annual <br />Semi-annual <br />❑ Fourth <br />❑ Special <br />❑ Mid Year <br />Semi-annual <br />❑ Other: <br />❑ Year End <br />❑ Mid Year <br />10. S ecial Report Name <br />❑ Final <br />❑ Special <br />❑ Year End <br />❑ Final <br />j ❑ Special <br />8. Number of Fundraisers this Repo <br />0 <br />11, Account Information <br />11. Account Information <br />a. Financial Institution Full Name <br />a. Financial Institution Full Name <br />UWHARRIE BANK <br />b. Purpose I <br />c. Account Code <br />b. Purpose <br />c. Account Code <br />CAMPAIGN <br />BUSINESS <br />C' <br />IN -PERSON <br />q <br />APR I Q 2026 <br />d. Period Begin Balance <br />d. Period Begin Balance <br />S 408.80 <br />$ <br />CABARRl1S COUNTY <br />--BOARD OF ELECTIONS <br />CERTIFICATION <br />I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B, & 22D-22M of Chapter 163 of <br />the NC General Statutes and that no funds are commingled with prohibited or other non -disclosed funds. I <br />further certify that this report <br />is complete, true and correct and that I have been trained by the NC S e Bo rd of Elections. <br />GRACE LIEM GALLOWAY <br />b 04 - Q 7 <br />Printed Name of Signer Signature oFAppqTp&dTrcasurer <br />Date <br />FOR OFFICE USE ONLY <br />Date Received: —10— � 6 Employee: <br />Ic - Delivery Method <br />❑ Normal Mail <br />Date Postmarked: Employee: <br />❑ Registered Mail <br />Hand Delivered <br />: <br />Date Scanned ~ ° Employee: <br />r, <br />��N ❑ Electronically Filed <br />❑ Signer has not received <br />Date Data Entered: Employee: <br />mandatory training <br />Please Note: This form cannot be used to amend committee information such as the committee address, treasurer, assistant treasurer, <br />custodian of books information, or account information. <br />You must amend the Statement of Organization CRO-2100A-E to make committee changes. <br />CRO-10#0 NC State Board of Elections August 2008 <br />