Price,Todd_2023-Committee-formsStatement of Organization - Candidate Committee Is this statement:
, 1 ❑ new ❑' Amended
Use this form to create a new or update an existing candidate committee.
This form must be accompanied by form CRO -3500. An amended form is required for each new election year.
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. Name of Committee "+ d. In Number
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:;Treasurer'. Iiiformatioii"
4. Assistant TreasureMi formation
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I certify that the Committee is in compliance with all applicable pro ' ions of Article 22A of Chapter 163 of the NC
General Statutes and that no funds are commingled with prohibits or other non -disclosed funds. I farther certify that
this report is complete, true and cogect. s
76) m 7/z
Printed Name of Treasurer Sijn a of Appointed Treasurer Date
I certify that the information above is correct, and I, as the candidate, 1point said treasurer to personally fulfill the
duties add responsibilities imposed upon the appointed treasurer su ject to the penalties in Article 22 of C apter
163 of th� Cjeri�ral tes. �,
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PrintedName of Candidate store of Candidate Date
CRO -2100A NC State Board of Elections November 2019
O
a
NORTH CAROLINA
STATE BOARD OF ELECTIONS
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 filed at the Board of Elections office where the committee's campaign reports
are filed.
FILED BY:
Committee Name:
Treasurer Name:
Treasurer Address:
(include city, state, & zip)
Treasurer Phone:
C Kk One:
VV 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 threshol I will now be required
to file the next scheduled report for all contributions and expenditures that not been previously
repoXILz-
Date
om the beginning of the current election cycle. I further agree to a reports required.
Sued Signature
CRO -3600
CeiWflcation of Threshold
VOTE
NORTH CAROLINA
STATE BOARD OF ELECTIONS
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:
If Candidate is own treasurer, designate an agent to carry out designations:
Committee ID M & im V 5�
Level Registered: [State] [County] If county, specify: UA%/ON
I, /� ,11 , hereby direct that in the event of my death or incapacity all
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
��yy (Selectjrom,,,§//163-278.16/B(�)
1. Alk;y57 2/Vcic° r`/DKU✓
2.
3.
Plan for Disbursement (e¢. Amount or %)
TIVV is o ;70)
By signing this form, I certify that the foregoing
Gen. Statute 163-278.16B(a). A copy of this tiln
records.
Signature of Candidate:
Date:
CRO -3900
beneficiaries under N.C.
ned with the Committee
Candidate Designation of Committee Funds