01_Bilzi Committee Forms AmendmentRECEIVED
North Carclina
State Board of Elections
506 N Harrington Street
R"l.bh, NC 27603
Kimbedy Westbrook-Strach
Deputy Director - Campaign Reporting
MAR 0 9 2012
NHC Bd Of Elections
Mtt Addrcss
PC)Box 27255
Ralcth,NC 27611_7255
(919733-7173
Fax:(9191715-8047
This Cenification is used by Candidate Committees to appoint a ffeasurer to the committee. This form is required and must accompany the Candidate's Statement of Organization
FILED BY:
Candidate Name:
Treasurer Name:
Treasurer Address:
(include city, state, & zip)
Treasurer Phone:
I certify that the above inforIInadon is correct,and I,as candidatc,appoint said treasurer to PersOnally ml■11
the duties and responsibilides imposed upon the appomted treasurer and suttCCt tO the penalties and
sanctions in S“b`λ ■′″″ゞ Щ 、Rι g“滋 ″ο
“
ο ′EJι c″ο ″Cα ″′α な が Of Chapter 163 ofthc North Carolina
General Statutes.
I understand that if the above Treasurer changes, it will be necessary to certify a new treasurer and amend
the existing Statement of Organization within l0 days of the vacancy. I further understand that the above
Treasurer is required to receive training by the State Board of Elections within three months of this
Note:This CertiEcation is to be rded at the Election Board where the comnlllteee's campaign reports are rlled.
Certification of Treasurer
ヽ
＼
RECEiVED
MAR 0 9 2012
NHC Bd Of Elections North Caroltna
State Board of Elections
506 N Harrington Street
R l.igh, NC 27603
Kimberly Westbrook―Strach
DcPuty DLcctor―Campalgn Repol■■