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Yercheck,Richard_2023-Committee-formsStatement of Organization - Candidate Committee is this statement: ■ New C3 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. Comtttittee - a. Namc of Committee_ _ d. ID Number Richard A. Yercheck for Monroe City Council . Mailing Address (include City, State and Zip Code) e. Date Organized 3004 Manchester Ave Monroe NC 28110 07.09.2023 . Committee Website (optional) f. Phone Number nn Road 01 Electiotl5 704-774-8001 2. Candidate Inforrialis . Full Name e. Party Affiliation Richard Allen Yercheck Republican . Mailing Address (include City, State, and Zip Code) E Office Sought 3004 Manchester Ave Monroe NC 28110 Monroe City Council . Phone Number d. Email Addren g. Next Election Fear h. Jurisdiction 704-774-8001 ElectRichardYercheck@gmail.com 2023 City of Monroe ■ Email copy of report notices . Tn er Inforro .,. Full Name a. Full Name Kichard A. Yercheck NONE h—Mailing Address (include City, State, and Zip Code) Is. Mailing Address (include City. State and Zip Code) 3004 Manchester Ave Monroe INC 28110 . Phone Number d. Email Address c. Phone Number d. Email Address 704-774-8001 lectRichardYercheck@gmaii.com Send re tort notices ha email ®) CS NO Email ut r ofre port notices otBooksInformation (Kee er of Records 6. ACakooit� - `_ ,� . Full Name a. Financial Institution Full Name Richard A. Yercheck First National Bank . Mailing Address (include City, State, and Zip Code) 3004 Manchester Ave Monroe NC 28110 2593 W. Roosevelt Blvd Monroe NC 28110 . Phone Number d. Email Address b. Account Code c. Type 704-774-8001 ElectRichardYercheck@gmail.com ■ 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 on -di sed funds. I further certify that this report is complete, true and correct. Richard A. Yercheck �/ /. , 2 Printed Name of Treasurer Signattueof Appointe reasurer Dale I certify that the information above is correct, and 1, as the candidate, appoint said treasurer to personally fulfill the duties and responsibilities imposed upon the appointedXeasurer and subject to the enalties in Article 22A of Chapter 163 of the NC General Statutes.(Richard A. Yercheck- a,* /q, 2' Printed Name of Candidate Signature of andidate Date CRO -2100A NC State Board of Elections November 2019 O VOTE rT1T� NORTH CAROLINA STATE BOARD OF ELECTIONS 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: Richard A. Yercheck for Monroe City Council Treasurer Name: Richard A. Yercheck Treasurer Address: 3004 Manchester Ave Monroe NC 28110 (include city, state, & zip) Treasurer Phone: 704-774-8001 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 retorts. 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. Tvne of metnmt Finnnetnl Incthoti. Add. A.v.n..n1 N..mAn. e.........,t r..we np,, FiaS� Q I I J By signing this statement, l authorize agents of the State Bu of Elections to inspect a ccounts provided. .r . 2 ate Signed Signat re of andidaz or Treasurer For Candidate Committees only ❑ In lieu of prov� ' g acco t information, i certify that this co ttee will not rais any money nor spend • y money except tha hich is the c didate's personal funds. I fu ermore understand th t an audit or inves' ation could warran a probe of any per nal bank account that is mg used for campaign ex nditures. By going this statement. I a urize agents of th tate BoayA pf Elea-,y'ons to insp t appli bl ounts. Date Certification of Financial Account fnforniation or