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McManus 2019 Organizational Form Addendumof RECD IN PERSON Anddm,r FEB05Z0Z1 '* \HcBDoFEtEcrtoNS Statement of Organization Addendum Prgc Use this form to supply additional assistant treasurer informsion or additional account informalion This fomr must be fomr CRG350O if additiqral accounts are 2 ID Number r,iAcW\o.,rt-s Fo, 5.h"o I B.*rJ Full N'mt Asgisterrt Trcgsurer Informetion 5a.ne v1,.,\c-.,{l;P.: P.-l Iiruiel ldr&x FrlI \-ry Accod tr{ailtuU AddK (imludc Srdc. rd Zip Codc)b. hrporc 8 o Le P,he- (cr-(\e.a5;1;. t.ril t'\rr.Ju.5 i ,".. t7\t a 8{a t Ort [,Yre- do^n-{.rn g cr..rJ e Y qenseS e PkreNubc d.Erel-{&ss sAqtCodc d.TyFqto - t-tg-h991 l{ t=r^ },*,|^j"45gy+h,fht,<.- Add Full \mc Fr-il hsltrtir Full llrmc h llailing .{ddre (irc$c Ciar-, Ssr. { Zb Codt) c. Phoe Number &EreilAddrc e. .lsa{ Cod.d T}pc Full Nut firrciel letix Full fiue Rmve b. Meiling Addm (irchdc Ct_v, Stsac, rd Zi Codc)Prrpc cPtoeNubc d-Erf ,{drc r.-{CtutCod.,l Typ Full Name Add{id- Flmid In titEtion Full N-ue h y.ilitrg -{ddK {irdrd. Ciry, Srrrc, ild Zh CodG)hrpG. q Phqe Number d. EneilAddrc s Ae(mtcodc d.tpu I certify tha the Committee is in compliance with all provisiom of Article 22A, inchding thal no funds are commingled with fundsfor a federal or out-of-$ate PAC. I fiuther say thd rhic report is complete, tnle ord correct 'y1^:flrtt Fa1JenJa-rt-,t Printed Nme of Sigrer lcr,Rrrucarrox Dateof cRo-2110 NC State Bmd of El*tiqr April 200? Comndfee Full Narne (*nd tr'und Add Rwe Add 3. Assistsnt Infonnrtfun (t d-Add 3. Assistent Treesorer Iqfometft m Ad Rmqe .{ccoat Add 3. Asdstut Trrrsunr Ilfornatirn A& Rwqe