Earley,John_2023-Committee-formsStatement of Organization -Candidate Committee
Use this form to create a new or update an existing candidate committee.
This form must be accompanied 6v fnrm run_Isnn e o ava F _ ..:__A
s his statement.
New l Amended
1. Committee information
A. Name of Committee d. ID Number
JOHN K. EARLEY�� q8L
b. MailingAddress include City, State and Zi Code) e. Date O
- aotaed
4603 JACQUELYNE DR INDIAN TRAIL, NC 28079 7/19/2023
c Committee Website (Optional) _ f. Phone No ober
980-595-2284
L. Candidate information
a. Full Name
e. Party Armistice
_
JOHN KELLY EARLEY
REPUBLICAN
b. Mailing Address (include City, State, and Zip Code)
L Omce Sought
4603 JACQUELYNE DR INDIAN TRAIL, NC 28079
�J�pJul
INDIAN TRAIL TOWN 88UNCIL
. Phone Number d. Email Address
g. Next Election Year
h. Jurisdiction
980-595 2284 indiantrailwall@gmail.com
2023
INDIAN TRAIL
[mail coof re on notices
3.reasurer Information
4. Assistant Treasurer Information
a. Pull Name _
a. Full Name
SUSAN BOWLES
b. Mailing Address (include City, State, and Zip Code)
b. Mailing Address (include CRY, State and Zip Code)
5207 CHELSEY LANE MONROE NC 28110
C. Phone Number
it. Email Address
e. Phone Number
d. Email Address
704-226-7634
classicalkids@charter.net
Send re ort notices It email Yes No
_EmdiIcoDv of report notices
5. Custodian of Books Information ee er of Records
6. Account Information (tnel. CRO -3500)
a. Full Name
A. Financial Institution Full Name
JOHN K. EARLEY
AMERICAN BANK
b. Mailing Address (include City, State, and Zip Code)
4603 JACQUELYNE DR INDIAN TRAIL, NC 28079
312 N Charlotte Ave Monroe NC 28112
. Phone Number
it. Email Address
b. Account Code
c. Type
980-595-2284
indiantraiiwall@gmail.com
86
CHECKING
CX Email copy of report notices
I certify that the Committee is in compliance with all applicable provisions of Article 22A 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. /
SUSAN BOWLES �[J.,.0'__4_ L?I971AFi.t 7/24/2023
Printed Name of Treasurer Signature of Appointed Treasurer Date
I certify that the information above is correct, and I, as the candidate, appoint said treasurer to personally fulfill the
duties and responsibilities imposed upon the appointed treasurer and subject to the penalties in Article 22A of Chapter
163 of the NC General Statutes.
JOHN K. EARLEY k k 7/24/2023
Printed Name of Candidate Signature of Candidate Date
rw2 1 rnn A
NC State Board of Elections November2019
(g)
NORTH CAROLINA
STATE BOARD OF ELECTIONS
RE- IVED
JUL 2 4 2023
Union Co. 6- F
Certification of Threshold
This Certification is used to declare or withdraw a committee's intent to raise or spend $1,000 or less in the
current election cycle.
This Certification is only valid for political party committees and candidates for a county office,
municipal office, local school board office, soil & water conservation district board of supervisors, or
sanitary district board.
This Certification is riled at the Board of Elections office where the committee's campaign reports
are filed.
FILED BY:
Committee Name:
JOHN K. EARLEY
Treasurer Name:
SUSAN BOWLES
Treasurer Address:
5207 CHELSEY LANE
(include city, state, & zip)
MONROE, NC 28110
Treasurer Phone:
704-226-7634
Check One:
x I certify that this committee intends to neither receive nor expend more than $1,000 during the current
election cycle under the procedures set forth in G.S. 163-278.10A. This certification will remain in effect
until the end of the election cycle for this committee. If this committee exceeds $1,000 in contributions or
expenditures during this election cycle, I understand that I must immediately notify the appropriate board
of elections and file required campaign finance reports.
THIS DECLARATION CAN ONLY BE MADE AT THE BEGINNING OF AN ELECTION CYCLE.
_ I am withdrawing my Certification to remain at or under the $1,000 threshold. I will now be required
to file the next scheduled report for all contributions and expenditures that have not been previously
reported from the beginning of the current election cycle. I further agree to file all future reports required.
7/24/2023
Date Signed �— Signature
CRO -3600
Certification of Threshold
NORTH CAROLINA
STATE BOARD OF ELECTIONS,-)
JUL 211 2023
Union Co Board o! Efecfions
Certification of Financial Account Information
This Certification is used to report confidential bank account information for all financial accounts
established by the committee and must accompany the Statement of Organization Form
FILED BY:
Committee Name: JOHN K. EARLEY
Treasurer Name: SUSAN BOWLES
Treasurer Address: 5207 CHELSEY LANE
(include city, state, & zip) MONROE, NC 28110
Treasurer Phone: 704-226-7634
I certify that the information provided below is true and accurate. I am providing all account information for the above
named Committee. These account numbers include all bank accounts utilized, credit card accounts, money market or
savings accounts, or any other financial account used for any purpose by the Committee.
The information provided on this form is considered confidential and is not subject to public disclosure. The information
provided is only used for the purposes of an audit or investigation or as required by a court of competent jurisdiction.
Each treasurer (or candidate) must designate below an account code (any number or letter or combination of
numbers and letters) by which to refer to the account number on reoorts. If an account number is used as the "account
code," confidentiality of the account number is presumed to have been waived.
The treasurer shall maintain all moneys of the political committee in a bank account or bank accounts used exclusively by
the political committee and shall not commingle those funds with any other moneys.
Tvrw of account Financial Institution Address
Account Number Account Code
CHECKING AMERICAN BANK 312 N Charlotte Ave Monr NSC
a /
°�t
I r
By signing this statement, I authorize agents of the State Bo�tions to inspect all accounts
7/24/2023 �,�,
Date Signed Signature of Candidate or Treasurer
For Candidate Committees Only
❑ In lieu of providing account information, I certify that this committee will not raise any money nor spend any money
except that which is the candidate's personal funds. I furthermore understand that an audit or investigation could
warrant the probe of any personal bank account that is being used for campaign expenditures.
By signing this statement, I authorize agents of the State Board of Elections to inspect applicable accounts.
Date Signed
CRO -3500
Certification of Financial Account Information
of Candidate or Treasurer
�'1 NORTH CAROLINA
STATE BOARD OF ELECT,.1QIOD
JUL7 tl )n�.,
Union C;,,
Candidate Designation of Committee Funds
This form is used by candidate committees only and allows the candidate to designate in the event of their death,
how the committee's funds are to be disbursed using the eight allowable methods outlined in 163-278.16B(a).
This Designation is filed at the Board of Elections office where the committee's campaign reports are filed.
Candidate Name:
Committee Name:
Treasurer Name:
JOHN K. EARLEY
JOHN K. EARLEY
SUSAN BOWLES
If Candidate is own treasurer, designate an agent to carry out designations:
Committee ID #: PJM g , L
Level Registered:
1 JOHN K. EARLEY
[State] [County] If county, specify: UNION COUNTY
hereby direct that in the event of my death or incapacity all
(Name of Candidate)
funds remaining in my Campaign Committee account(s) (after payment of permitted outstanding
debts or reasonable expenses for winding up the Committee or closing office) be paid in the
following manner as permitted by N.C. Gen. Stat. 163-278.16B(a).
Name of Entity Plan for Disbursement (eg. Amount or %)
(Seket from §163.278.168(x))
LIGHTHOUSE FAMILY CHURCH 100%
2.
By signing this form, I certify that the foregoing entities are eligible beneficiaries under N.C.
Gen. Statute 163-278.16B(a). A copy of this form should be maintained with the Committee
records.
Signature of Candidate:
Date:
14163t3.1;t
7/24/2023
Candidate Designation of Committee Funds