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Smith,Thomas_2023-StmtOrg-AmendedStatement of Organization - Candidate Committee Is this statement: ❑ New Q 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. 1. Committee Information . Name of Committee it. ID Number Smith4WCDZ Committee CJMPHF b. Mailing Add" (include City, State and Zip Code) e. Date Orgamind 1840 Tangle Briar Ct, Matthews NC 28104 07/20/23 C. Committee Website (optional) E Phone Number 704-877-8825 . Candidate Information- . Full Name e. Party Affiliation _ Thomas Julius Smith Republican b. Mailing Address (include City, State, and Zip Code) E office Sought 1840 Tangle Briar Ct Weddington Town Council Matthews, NC 28104 . Phone Number d. Email Address g. Neat Election Year h. Jurisdiction District 2 704-877-8825 TJSDG7680@gmail.com 2023 0 Email copy of report notices . Treasurer Information 4. Assistant Treasurer Information . Full Name a. Full Name Jinger Kelley b. Mailing Address (include City, State, and Zip Code) b. Mailing Address (includeN9,1 tat ode) 236 Summerhouse N 9 J 2�2 Norwood, NC 28128 . Phone Number d. Emil Address a Phone Number 828-776-2774 jinkelley@yahoo.com Send report no(ices by email �j Yes No =Enlail Copy of report notices 5. Custodian of Books Information (Keeper of Records 6. Account Information (incl. CRO -3500) A. Full Name a. Financial Insfitufion Full Name Thomas Julius Smith rruist b. Mailing Address (include Clt), State, and Zip Code) Track campaign contributions & expenses 1840 Tangle Briar Ct Matthews, NC 28104 . Phone Number Id. Emil Address b. Account Code It. Type Checking 704-877-8825 1 TJSDG7680@gmail.com 01 ❑✓ 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. Jinger Kelley"22:wr o 11 C) I a-3 Printed Name of Treasurer tok6f Appointed TneasumO Date I certify that the information above is correct, and 1, as the candidate, appoint said treasurer to personally fulfill the uties and responsibilities imposed upon the appointed treasurer and subject to th penalties in Article 22A of Chapter 163 of the NC General Statutes. Thomas 1 Smith // Printed Name of Candidate Signature of Candidate CRO -2100A NC State Board of Elections November 2019