Meeks Certification to Close �SA2
T J 4
,41:f RECEIV
North Carolina 2 0 `
State Board of Elections NHC Bd of Elections
506 N Harrington Street
Raleigh,NC 27603
Kimberly Westbrook-Strach Mailing Address
Deputy Director—Campaign Reporting PO Box 27255
Raleigh,NC 27611-7255
(919) 733-7173
Fax: (919) 715-8047
Certification to Close Committee
This Certification is used to express the intent to close the committee after all funds have been properly
disbursed.
FILED BY: l
Committee Name: I C k y re f'o r tiv I I rn /1�t -f orl C'�*,/CouC'
Treasurer Name: R l C F,V Mee XS
Treasurer Address: 3 6 / Q C g s w 2 f I S h6) 4.
.3o
(include city, state,&zip) w t m W L 2 O 1 03
Treasurer Phone: 1 0 I I b 7 $
I certify that the above mentioned Committee intends to close and cease existence. Upon signing this
certification, I declare that all funds have been distributed and reported (if 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.
Committees 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 Committee that did not file
under the $1,000 threshold must submit a "Final Report" with this Certification. This report must have a
zero balance with no outstanding loans or debts.
III►
1 2/19/ Il
Date Signed Signature
Note:This Certification is to be filed at the Election Board where the committee's campaign reports are filed.
CRO-3400 Certification to Close Committee December 2009