De Iulio,Mike_2025-SOGStatement of Organization - Candidate Committee Is this statement:
New El 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 forth is required for each new election year.
1. Committee Information
a. Name of Committee
it. In Number
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b. Mailing Address include City, State and Zip Code
e. Date Organized
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c. Committee website (Optional)-
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2,Candidate Information
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al Full Name
a. Party Affiliation:
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b. Mailing Address (include City, State; and Zip Code)
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c. Phone Number
it. Email Address
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h. Jurisdiction
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3. Treasurer Information
4. Assistant Treasurer Information
a. Full Name -
a. Full Name
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b. Mailing Address (include City, State, and Zip Code)
b. Mailing Address (include City, State and Zip Code)
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c. Phone Number
it. Email Address
c. Phone Number
it. Email Address
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S.CustodianofBooks Information (Keeper of Records
6. Account Information {tncl CRO -3500)
a. Full Name
a. Financial Institution Full Name
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b. Mailing Address (include City, State, and Zip Code)
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d. Email Address _
b. Account Code
c. Type
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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.
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Printed Name of Treasurer Signature of rated 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 treasur rd subject to the penalties in Article 22A of Chapter
163 of the NC General Statutes.
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Printed Name of Candidate Signa Candidate Date
CRO -2100A NC State Board of Elections November 2019