Loading...
Collogan 2020 Organizational FormStatement of Organization - Candidate Committee Use this form to create a new or update an existing candidate committee. This form must be form CRO-3500. An amended form is for each new election statement: New ID Nuuber (.c,utoeAl.J I<- €or u?r uOx Nrme of Commlttee A)g^) -Ltnr\\-tQ2'C--od55 Acutasc,eoru Df- Nt c 2its+ol^tl Phone Numberc. Commlttce Webrlte (Opdonrl) IAA-,fxet^: Ebt or'F.> Qo ut--ocr{.rl Full Neme AIIiIiation lf. Offcc Soughtffi-S-offa.,,r{Uu*4 I G^o-r"-\io.,". bef-.f- 9.9erviV b. Mrilhg Addrcss (include City, Stetc, rad Zltp Code) tto \ . Ptonc Numbcr d- Emdl Addrels Next Election Year rCO A)o^J *.a'orreraoao tr'ull Nrme i r'r"- Jurirdiction Neme .ltQo.aV f. De^\eJ+ Ll,5 ryTLO [z\). [,tti^ o$o,t1 l.]C- a%\o3 r otPl0 fuffc.o-2ozo Melling Addrere (tn$4{9Ctty- Strtd ltq zh 0ode;e.--reaagksv\mdZp Code) Phoue NumberPhone Number ,so-%b'S,Oqu4tt\--, (rcli Emril Addresr fr|+rai%.w\ noticesEmailof "r+lt,t€.,^J a C-t\; Nrme l(9cAl-G'6-\rEF^I EE\>FE\'-Flnrncld Incdtudon andStete'City, lI-v,tl-G7t{gr. Ef{^tatCrR rtjC- Account Code i$G- of rt ,-5 c. Type e-ttPhone Number Email Emeil Address /14(-o I certifu that the Committee is in compliance with all applicable provisions of Article 22A of Chapter 163 of the NC General Statutes and that no funds are conirningled with prohibited or other non-disclosed funds. I further certi$ that I certifu that the information above is correct, and I, as the candidate, appoint said treasurer to personally fulfill the IO ZO Printed Name of Candidate q Dat€ Printed Name of Treasurer Signature of Appointed Treasuret this report is complete, true and correct. upon the appointed treasurer and subject in Article 22A of Chapterduties and responsibilities imposed 163 of the NC General Statutes. State 2019 a .tL