Bention,Jimmy_2022-4thAmendment
Disclosure Report Cover I ❑ Yes ® No
Use this form for general report and committee information, must be signed and submitted along with other detailed forms.
Do not use this form to update information
1. Committee Information
a. Full Name
c. ID Number
Committee to Elect Rev. Bention, Sr.
b. Mailing Address (include City, State and Zip Code)
d. Date Filed
302 Tucker Street
01/09/2023
Monroe, NC 28110
e. Phone Number
704-572-0879
2. Report Year
3. Period Start Date (mm/dd/yy)
4. Period End Date
;, Treasurer Full Name
(mm/dd/yy)
Latoya L. Bention
2022
10/23/2022
12/31/2022
6. Type of Committee (Check One)
9. Type
of Report (check only one type o re ort rom one category)
® Candidate Campaign ❑ Party
Municipal
State/County
Referendum
❑ PAC ❑ Referendum
❑
Organizational
❑ Organizational
❑ Organizational
Independent ❑ Joint Fundraiser
❑ Expenditure
❑
Thirty-five day
Quarterly
❑ Pre -referendum
❑ Legal Expense Fund
❑
❑
Pre-primary
Pre-election
❑ First
❑ Second
❑ Final
❑ Supplemental Final
7. Type of Fund (if applicable, check one)
❑ "Booster Fund"
❑ Building Fund
❑
Pre -runoff
❑ Third
❑ Annual
Semi-annual
® Fourth
❑ Special
❑
Mid Year
Semi-annual
❑ Other:
❑
Year End
❑ Mid Year
10. Special Report Name
❑
❑
Final
Special
❑ Year End
❑ Final
❑ Special
8. Number of Fundraisers this Report
I
11. Account Information
11. Account Information
a. Financial Institution Full Name
a. Financial Institution Full Name
Wells Fargo
b. Purpose
c. Account Code
b. Purpose
c. Account Code
Election
104
REC )
Committee
Donations
d. Period Begin Balance
d. Period Begin Balance
$ 302.96
$
rd of Elections
CERTIFICATION
I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B, & 22D -22M of Chapter 163 of
the NC General Statutes and that no funds are commingled with prohibited or other non -disclosed funds. I
further certify that this report
is complete, true and correct and that I have been trained
by the NC State Board of Elections.
Latoya L. Bention
,e,o., ,/,�,� 01/06/2023
Printed Name of Signer
ignature of Appointed Treasurer
Date
FOR OFFICE USE ONLY
Date Received: 1 "�10�
Employee:
Ivery Meth od
El Normal Mail
Date Postmarked:
Employee: Registered Mail
VHand
Delivered
Date Scanned:
Employee: ❑ Electronically Filed
❑ Signer has not received
mandatory training
Date Data Entered:
Employee:
Please Note: This form cannot be used to amend committee information such as the committee address, treasurer, assistant treasurer,
custodian of books information, or account information.
You must amend the Statement of Organization (CRO -2100A -E) to make committee changes.
CRO -1000 NC State Board of Elections August 2008
Amendment
Detailed Summary ❑ Yes ® No
Use this form to summarize all disclosure reporting forms and to total monetary information.
1. Committee Full Name (and Fund if applicable)
2. Type
of Report
3. ID Number
Committee to Elect Rev. Bention, Sr.
Fourth Quarter
Report
Start of Election Cycle: January 1, 222
Total this
Reporting Period
Total this
Election Cycle
4)
Cash on Hand at Start
S
302.96
$
0
RECEIPTS
5) Aggregated Contributions from Individuals
6) Contributions from Individuals
7) Contributions from Political Party Committees
8) Contributions from Other Political Committees
9) Loan Proceeds
10) Refunds/Reimbursements To the Committee
11) Other Receipt Sources
11a) Interest on Bank Accounts
............ .. ......... .
llb) Contributions from Not -for -Profit Organizations
Ile) Outside Sources of Income
- ...... .... ...... _ .._
lld) Legal Expense Fund —Other Sources
11 e) Exempt Purchase Price Sales
(CRO -1205)
(CRO -1210)
(CRO -1220)
(CRO -1230)
(CRO -1410)
(CRO -1240)
(CRO -1250)
(CRO -1250)
(CRO -1250)
(CRO -1270)
(CRO -1265)
$ 0
$
380
$ 500
$
3890
$
$
$ 1,750
$
1,750
$
$
$
$
$
$
$
$
$
$
$
$
$
$
12)
TOTAL RECEIPTS (Add lines 5. 6. 7, 8. 9, 10, Ila. nb. Ile, udand Ile)
$
2,250
$
6,020
EXPENDITURES
13) Disbursements
13a) Operating Expenditures
13b) Contributions to Candidates/Political Committees
13c) Coordinated Party Expenditures
14) Aggregated Non -Media Expenditures
15) Loan Repayments
16) Refunds/Reimbursements From the Committee
17) In -Kind Contributions
(CRO -1310)
(CRO -1310)
(CRO -1310)
(CRO -1315)
(CRO -1420)
(CRO -1320)
(CRO -1510)
$ 2,293.67
$
5,434.12
$ 0
$
300
$ 0
$
26.59
$
$
$
$
$
$
$
$
18)
TOTAL EXPENDITURES (Add lines 13a, 13b, 13c, 14, 15, 16 and ]7)
$
2,293.67
$
5,760.71
19)
Cash On Hand at End (,4dd lines 4 and 12 together, then subiraci line 18)
$
259.29
$
259.29
ADDITIONAL INFORMATION
20) Non -Monetary Gifts Given to Other Committees (CRO -1330)
21) Outstanding Loans (incl. ones from other campaigns) (CRO -1430)
22) Debts and Obligations owed By the Committee (CRO -1610)
23) Debts and Obligations owed To the Committee (CRO -1620)
24) Account Transfers Within the Committee (CRO -1720)
25) Administrative Support (CRO -1710)
26) Forgiven Loans (CRO -1440)
27) 48 -Hour Notice Reports Sum (CRO -2220)
28) Contributions to be Refunded (CRO -1215)
$
$
$
$
$
$
$
$
$
$
$
$
$
CRO -1100 NC State Board of Elections August 2008
Amendment
Contributions from Individuals Pg 1 of 2 ❑ Yes ® No
Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used
1. Committee Full Name (and Fund if applicable)
2. ID Number
Committee to Elect Rev. Bention, Sr.
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
Cyber Security
Richard Daunt
1020 Hallmark Way
Waxhaw, NC 28173
c. Employer's Name/Specific Field
BBH
e. Election Sum to Date
$ 0
f. Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
❑
104
CreditCard
N/A
10/23/2022
$ 100
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
Probation/Parole Officer
Corinthian Parker
1736-F Dickerson Blvd
STE112
Monroe, NC 28110
c. Employer's Name/Specific Field
NCDPS Adult Community Correcti
e. Election Sum to Date
$ 0
E Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
❑
104
CreditCard
N/A
10/23/22
$ 50
❑
$
❑
1
$
3. Contributor information F-1Add ElRemove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
Retired
Lynn A. Keziah
PO Box 311
Monroe, NC 28111
c. Employer's Name/Specific Field
N/A
e. Election Sum to Date
$ 0
f. Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
❑
104
Cash
N/A
10/25/2022
$ 100
❑
104
Check
N/A
11/09/2022
$ 150
❑
$
4. Total only this Page $ 400
5. Total of ALL CRO -1210 Pages N= $ Soo
(Thus lure must be on line 6 of Detailed Summaq Page CRO -1100)
CRO -1210 NC State Board of Elections April 2007
Amendment
Contributions from Individuals Pg 2 of 2 ❑ Yes ® No
Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used
1. Committee Full Name (and Fund if applicable)
2. 11) Number
Committee to Elect Rev. Bention, Sr.
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
Retired
William Griffin
2804 A.G.R. Nance Rd
Monroe NC 28110
c. Employer's Name/Specific Field
N/A
e. Election Sum to Date
$ 0
f. Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
❑
104
Check
N/A
10/25/2022
$ 100
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
c. Employer's Name/Specific Field
e. Election Sum to Date
$
f. Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
❑
$
❑
$
❑
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Job Title/Profession
d. Comments
c. Employer's Name/Specific Field
e. Election Sum to Date
$
L Prior
g. Account Code
h. Form of Payment
i. In -Kind Description
j. Date (mm/dd/yyyy)
k. Amount
❑
$
❑
$
❑
$
4. Total only this Page $ 100
Total of ALL CRO -1210 Pages$ 500
L_(Tijisline must be on line 6 of Detailed Summary Page CRO -1100)
CRO -1210 NC State Board of Elections April 2007
Contributions from Other Political Committees Pg
Use this form to report contributions from other candidate, referendum or PAC committees
Amendment
of I ❑ Yes ® No
1. Committee Full Name (and Fund if applicable)
2. ID Number
Committee to Elect Rev. Bention, Sr.
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Type of Committee
d. Comments
® Candidate ❑ PAC
❑ Referendum
Committee to Elect Mark Brody
5315 S Rocky River Road
Monroe, NC 28112-8055
c. Level Registered (Specify)
❑ Federal ❑ County:
® State ❑ Municipality:
e. Election Sum to Date
$ 0
E Account Code
g. Form of Payment
h. In -Kind Description
i. Date (mm/dd/yyyy)
j. Amount
104
Credit Card
N/A
10/24/2022
$ 1,500
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Type of Committee
d. Comments
® Candidate ❑ PAC
❑ Referendum
Dave Craven for NC
PO Box 487
Asheboro, NC 27204
c. Level Registered (Specify)
❑ Federal ❑ County:
® State ❑ Municipality:
e. Election Sum to Date
$ 0
1'. Account Code
g. Form of Payment
h. In -Kind Description
i. Date (mm/dd/yyyy)
j. Amount
104
Credit Card
N/A
10/28/2022
$ 250
$
3. Contributor Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Type of Committee
d. Comments
❑ Candidate ❑ PAC
❑ Referendum
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Election Sum to Date
$
E Account Code
g. Form of Payment
h. In -Kind Description
i. Date (mm/dd/yyyy)
j. Amount
4. Total only this Page $ 1750
5. Total of ALL CRO -1230 Pages $ 1750
(This line must he on line 8 of Detailed Summary Page CRO -1100)
CRO -1230 NC State Board of Elections April 2007
Amendment
Disbursements Pg t of 4 ❑ l es ® No
......._.. .
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Committee to Elect Rev. Bention, Sr.
.3. Type of Disbursement Please use separate CRO -1310 Lorins for each Lee o Disburse►neat.
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Online Platform
for accepting
donations
https:Hstripe.com/
185 Berry St #550
San Francisco, CA 94107
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 60.29
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
104
Bank Draft
O
10/23/2022
$3.20
Stripe
processing fee
104
Bank Draft
O
10/23/2022
$1.75
Stripe
processing fee
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
_
d. Comments
Online Platform
for accepting
donations
https:Hstripe.com/
185 Berry St #550
San Francisco, CA 94107
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 65.24
f. Account Code
g. Form of payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
104
Bank Draft
O
10/24/2022
$43.80
Stripe
processing fee
104
Bank Draft
O
10/28/2022
$7.55
Stripe
processing fee
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Campaignpartners.com
PO Box 118
Still River, MA 01467
617-500-7251
c. Level Registered (Specify)
❑ Federal ® County:
0 State ❑ Municipality:
e. Election Sum to Date
$ 397
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
104
Credit Card
O
11/09/2022
$49
Monthly website
fee
104
Credit Card O 12/09/2022 $49 Monthly website
fee
Pae $ 154.30
5. Total only this
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses)
(This line goes in line 13b of Detailed Summary Page CRO -1100 if Contrib to Candidates/Political Comm) $ 2,293.67
(This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Parry Expenditures)
7. Purpose Codes (hist detailed expenditure code in (h.) above)
A* - Media B* - Printing C* - Fundraising D - To Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
1 - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field k)
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg 2 of 4 ❑ Yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Committee to Elect Rev. Bention, Sr.
3. Type of Disbursement tPlease use se arate CRO -1310 Lorms for each type of Disbursement.
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Food Lion
Monroe, NC 28110
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 0
f. Account ( ode
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
104
Credit Card
O
10/26/2022
$37.76
Early Voting
Supplies
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
The Village Grill
1730 Dickerson Blvd Ste J
Monroe, NC 28110
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 0
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
L Required Remarks
104
Credit Card
O
10/27/2022
$12.68
Early Voting
Lunch
4. Payee information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Walmart Supercenter
Charlotte, NC 28227
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ O
E Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
104
Credit Card
O
10/30/2022
$101.27
Early Voting
Supplies
Pae $ 151.71
5. Total only this
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Sunnnary Page CRO -1100 if Operating Expenses)
(This line goes in line 13b of Detailed Summary Page CRO -1100 if Contrib to Candidates/Political Comm) $ 2,293.67
(This line goes in line 13e of Detailed Summary Page CRO -1100 if Coordinated Party Expenditures)
7. Purpose Codes (List detailed expenditure code in (h.) above)
A* - Media B* - Printing C* - Fundraising D - To Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field k)
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg 3 of 4 ❑ les ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Committee to Elect Rev. Bention, Sr.
3. Type of Disbursement Please use se arate CRO -1310 Lorms Lor each e o Disburse►nent.
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Walmart Supercenter
2406 W Roosevelt Blvd
Monroe, NC 28110
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 0
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
104
Credit Card
O
10/31/2022
$104.62
Early Voting
Supplies
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Target
6350 Weddington Rd
Wesley Chapel, NC 28104
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 0
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
104
Credit Card
O
11/01/2022
$112.84
Supplies
4.,Pa ee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
Dave's Auto Repair
1570 Lynn Street
Monroe. NC 28110
704-288-0111
c. Level: Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 0
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
104
Credit Card
O
12/06/2022
$1,668.39
Auto Repair
Pae
5. Total only this
$ 1,885.85
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses)
(This line goes in line 13b of Detailed Summary Page CRO -1100 if Contrib to Candidates/Political Comm) $ 2,293.67
(This line goes in line lac of Detailed Summary Page CRO-II00 if Coordinated Party Expenditures)
7. Purpose Codes (List detailed expenditure code in (h.) above)
A* - Media B* - Printing C* - Fundraising D - To Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field k)
CRO -1310 NC State Board of Elections December 2009
Amendment
Disbursements Pg 4 of 4 ❑ Yes ® No
Use this form to report expenditures from the committee for; operating expenses, contributions to candidate/political
committees and coordinated party expenditures.
1. Committee Full Name and Fund if applicable) 2. ID Number
Committee to Elect Rev. Bention, Sr.
3. Type of Disbursement Please use separate CRO -1314 forms for each t e oL Disbursement.
® Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party Expenditures
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
BP
1004 N Charlotte Ave
Monoroe, NC 28110
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 0
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyy))
j. Amount
k. Required Remarks
104
Credit Card
O
11/09/2022
$44.69
Gas
104
Credit Card
O
12/09/2022
$20.00
Gas
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
include city, state, & zip)
b. Coordinated Committee Name
d. Comments
BP
1004 N Charlotte Ave
Monroe, NC 28110
c. Level Registered (Specify)
❑ Federal ® County:
❑ State ❑ Municipality:
e. Election Sum to Date
$ 64.69
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
104
Credit Card
O
12/09/2022
$37.12
Gas
$
4. Payee Information ❑ Add ❑ Remove
a. Full Name, Mailing Address & Phone
(include city, state, & zip)
b. Coordinated Committee Name
d. Comments
c. Level Registered (Specify)
❑ Federal ❑ County:
❑ State ❑ Municipality:
e. Election Sum to Date
$
f. Account Code
g. Form of Payment
h. Purpose Code
i. Date (mm/dd/yyyy)
j. Amount
k. Required Remarks
Pae $ 101.81
5. Total only this
6. Total of ALL CRO -1310 Pages
(This line goes in line 13a of Detailed Summary Page CRO -1100 if Operating Expenses) $ 2,293.67
(This line goes in line 13b of Detailed Summary Page CRO -1100 if Contrib to Candidates/Political Comm)
(This line goes in line 13c of Detailed Summary Page CRO -1100 if Coordinated Parry Expenditures)
7. Purpose Codes (List detailed expenditure code in (h.) above)
A* - Media B* - Printing C* - Fundraising D - To Another Candidate
E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses
I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund
O* - Other
* Codes require detailed explanation in required remarks field (k)
CRO -1310 NC State Board of Elections December 2009