Fester Certification to CloseNorth Carohna
State Board of Elections
506 N HarriugtouStxeet
Raleigh NC 27603
Page 1 of 1
C�' VED
DEC 18 2012
NHC Bd of Elections
Kimberly Westbrook- Strach MailitagAddress
Deputy Director. — C aanpaign Reporting M Box 27255
Raleigh, NC 27611 -7255
(919) 733-7173
Fax: (919) 715 -5047
Certification to Close Committee
This Ccrtification is used to express the intent to close the committee after all funds have been properly
disbursed.
FILED BY:
Committee Name: �yj , TO ,? 5Z. OU
Treasurer Name:
Treasurer Address: T d '_ —*bx
(include city, state. & zip) wed �'�yJ ► 1—`T' hA L 20 19-) 2 —
Treasurer Phone: I ( b - .0 i" 1 ` 1 -C)-5
I certify that the above mentioned Committcc intends to close and cease existence. Upon signing this
certification. I declare that all funds have been distributed and reported Of required). In addition. no
contributions will be accepted or disbursements made after the --Final Report" is filed or this form is
signed. If the Committee at any future time intends to accept or spend funds in support or opposition of
any candidate or ballot issue. a new political committee must be formed and registered with the Board of-
Elections before such activities may commence.
Commiuccs that have filed under the $1.000 threshold will only be required to sign this Certification. No
"Final Report" will be required for committees meeting this criterion. Any Committcc that did not file
under the S1.000 threshold must submit a "Final Report' with this Certification. This report must have a
zero balance with no outstanding loans or debts.
bate Si_n siinaturc
Note: This Certification Is to be flk-d at the Election dloard where the committee's campaign reports are filed.
CRO-.i400 Certijicenio t to Close Committee Derenther 2009
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