Zapple 2021 Return to Active StatusNORTI.I CAROLINA
STATE BOARD OF ELECTIONS
Certification to Return to Active Status
This Certification is used by Candidate,Party, PACs and Referendum Committees which have previously
filed the Certification of Inactive Status and now wish to return to an active status.
This Certification is liled at the Board of Elections oflice where the committee's campaign reports
ArC fiIcd. RECD IN PERSON
FILED BY:
Committee Name:
Treasurer Name:
Treasurer Address:
(include city, state, & ztp)
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TreasurerPhone: 14o-*l+3*gttg
I certi$ that the above named candidate/political committee, which has been of inactive status and exempt
from filing disclosure reports, intends to accept contributions and/or make expenditures. This intention of
activity alters the status of the above named candidateipolitical committee to active status and requires
such committee to begin filing disclosure on the appropriate schedule. All contributions received and/or
expenditures made that have not been previously reported will be disclosed on the next scheduled report
and all subsequent reports will be filed as scheduled. An amended Statement of Organization (CRO-2100
A-G) must accompany this form.
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Signed
cRo-ji00 Certification to Return to Active Status