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<LargeContributionReport xmlns:xsd="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.sbe.virginia.gov ContributionReport.xsd" xmlns="http://www.sbe.virginia.gov">
  <ReportHeader>
    <CommitteeCode>CC-21-00661</CommitteeCode>
    <CommitteeName>Sam Carter for Board of Supervisors</CommitteeName>
    <ReportYear>2021</ReportYear>
    <Address>
      <Line1>P.O. Box 756</Line1>
      <City>Appomattox</City>
      <State>VA</State>
      <ZipCode>24522</ZipCode>
    </Address>
    <FilingDate>2021-12-02</FilingDate>
    <StartDate>2021-09-03</StartDate>
    <EndDate>2021-09-03</EndDate>
    <SubmitterPhone>4343528909</SubmitterPhone>
    <SubmitterEmail>sam.carter@appomattoxcountyva.gov</SubmitterEmail>
    <FilingType>Report</FilingType>
    <IsFinalReport>false</IsFinalReport>
    <IsAmendment>false</IsAmendment>
    <AmendedReportNumber>0</AmendedReportNumber>
    <NoActivity>false</NoActivity>
    <ElectionCycle>11/2021</ElectionCycle>
    <OfficeSought>Member Board Of Supervisors</OfficeSought>
    <District>Election - Courthouse District</District>
  </ReportHeader>
  <ScheduleA>
    <LiA>
      <Contributor IsIndividual="true">
        <Prefix>Mr.</Prefix>
        <FirstName>Samuel</FirstName>
        <MiddleName>E</MiddleName>
        <LastName>Carter</LastName>
        <Address>
          <Line1>307 Morton Lane; P.O. Box 756</Line1>
          <City>Appomattox</City>
          <State>VA</State>
          <ZipCode>24522</ZipCode>
        </Address>
        <NameOfEmployer>Retired</NameOfEmployer>
        <OccupationOrTypeOfBusiness>Retired</OccupationOrTypeOfBusiness>
        <PrimaryCityAndStateOfEmploymentOrBusiness>Retired</PrimaryCityAndStateOfEmploymentOrBusiness>
      </Contributor>
      <TransactionDate>2021-09-03</TransactionDate>
      <Amount>850.00</Amount>
      <TotalToDate>0.00</TotalToDate>
    </LiA>
  </ScheduleA>
  <ScheduleB />
  <ScheduleE />
</LargeContributionReport>