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McManus 2021 Organizational Form AddendumHEC'DIN PERSON Anildretrt FEB 05 2021 '* *hHcBDoFE[EcnoNS Statement of Organization Addendum p..G d Use this form 1o supply additional assistanl treasurer infomration or additional account information bl fomr CRG350O if additiqral accounls are Cornmlaee FuIl Furrd L ID Nunrber r,lAc-W\o.,tt-s Fo, 5.h", I B -*nJ Assktrnt Tressarcr Infrmrrtim FullNuc 1vlAt F*11Je^5a r.,a P*: P"-l e. Firrci{ Iffii<x Frll Ntc b. Meiting Addru (includg CiF, St"tG,.!d Zip CodG)b. hrpoc Eot. il,'\ , P'he-- ri cr-t\e-1b6rve ,r..'u.SIr^ r7\a ; 8{ a 1 On t,rrre- do..,o-{tr', .crnJ e { Qenses c Phm Nunber il.Errl-{&w eAttdCodc &rYF4Le - t tl-bs4n It l=rt4 att,l^y)etypy*h,( e,h Dn t,<.- AddAsdstant FullNme L hrid listrirx Fnll Nut h llriling -{ddm (irc&dt Citf; Srdl rd Zb Cod.)L kpoor c Ptqe Numbc d- Farllddrc .. -{cqrt Cod.d. T!'pc FullNuc TrcrmrerAsistrnt Iirrciel Idlrtix Full f{uc b. llriling Addrc (hchdr Ct1 Srdc, .rd Zb Cod.)LfuPE cPhoeNubs d- Eaei.fddrc q.AcmtCodc d. Type Add Full Name r Fimial Insitutba Full Nme h MlilirE ^.Lddrc (indd. Cif!! Srde, rd Zb CodG)L hrpoc s Phone Numbor d. EmnilAddrc l AamtCode d.rlpe I certify thd the Commitlee is in complime with all provisiors of Article 22A" including that no firods are commingled with fundsfor a federal m our-of-stde PAC. I fi[lfrer say lhd qi" r€port is corylete, tnre ard core.t- CERTIFIC.{TIO\ /l hinted Nme of Sigrer Date '71^:.Ta^. 1tz(t Fa"rJe... Signrtre ofAppoirted NC Stat8 B@d of El*ti6 April 2007 This form must be Add Rwc Acoodldomtftx {btcl.CRO-35@)Add Add Remve Add Rmwe Add I. Assistant Trcesrrer Informatirn Rmqe ^q,ocurt Add Remove cRo-2110