Rentsch,Wayne_2025-SOGStatement of Organization - Candidate Committee Is this statement:
❑ Netx ❑ 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 torn is reauired for each new election vear.
1. Committee Information
a. N�a�meeyf Committee I,
d. In Number
-
YY rt, it t, a e L z f(,e' dLr.
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h. Mailing Address (include City, State and Zip Code)
e. Date Organized
620 ouv-k G.,i5t 14ke Taf Af& s? FO
07/197lz!5 ,
c. Committee Website (Optional)
f. Phone Number
70Y-22/-5'713
2. Candidate Information
a. Full Name
e. Party Affiliation
I-
-DQ K a 5 j f L
b. Mailink Address (Include City, State, and Zip Code)
f. Office Sought
6620 Cos, -f fc..w01 64,aet
Luk74, �ouHe,r �
1 - to ITark Nc 7819
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c. Phone Number
-goy-zzl-
d. Email Address
g. Next Election Year
h. Jurisdiction
�Y ��
,✓,� ,� it LAKOPARe
7197 s'
❑ Email copy of report notices
3. Treasurer Information
4. Assistant Treasurer Information
a. Full Name
a. Full Name
Wq V vie 1, 1 143 'Ft*-t4C L
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b. Mai_Ii Address (Include ,State, and Zip Code)
,� ZO Oar.�C S,N S,feee i -
b. Mailing Address (include City, State and Zip Code)
Lake f4ek lk 7g07
. Phone Number
'70q-zzi-
d. Email Address
w4YNE r>z
c. Phone Number
d. Email Address
471
�akEp.e4e�
1
Send report notice;INVimail LJ Yes 0 No
Email co 1v i .;)oil notices
?—Custodian of Books Information (Keeper of Records
6. Account Information (ine(. CRO -3500)
aI.-Full Name
a. Financial Institution Full Name
UNION COUNTY
b. Mailing Address (include City, State, yd Zip Code)
L
60219 C01+414�t,e S -we -et
JUL 112025
1,.446 prb241A)C, 2 KO -7
. Phone Number
d. Email Address
:✓,4 PO R L,ak,� T i{R K
b. Account Code �S p
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❑ Entail 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. //]]
Printed Name Treasurer
of Signature of Appointed Treasurer Date
1 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 appointed treasurer and subject to the penalties in Article 22A of Chapter
153 of the NC Gen�efr�al Statutes.
Printed Name of Candidate Signature oCCandidate Date
CR0-2100A NC State Board of Elections November 2019
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 S 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)
W4
L.ke, —?a r
Lake, 74.,E N L zSo�q
Treasurer Phone: 704� Z. 7-1— T V 3
ChZk One:
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 S1,000 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.
1 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 gree to file all future reports required.
--,L,26�4
ZO
Date Signed signature
CRO -3600 Cernfen(ron ol'Threshold
NORTH CAROLINA
a
UMd STATE BOARD OF ELECTIONS
Confidential
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: /Jl� r& Z %IfK C eF2
Treasurer Name: AY /V ,r-- `2 l -C f G
Treasurer Address: (i 2 0 C a t2 `!%l A : r C E T
(include city, state, & zip) L, ,!Z`t! P IUK; /-)r 2 Fd 7;_
Treasurer Phone: '1 �I� — Z, / 3
I certify that the information provided below is true and accurate. 1 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 desienatg below an account code (any number or letter or combination of
numbers and letters) by which to refer to the account number on reports. 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.
Type of account Financial Institution Address Account Number Account Code
By signing this statement, I authorize agents of the State Board of Elections to inspect all accounts provided.
Date Signed Signature of Candidate or Treasurer
For Candidate Committees Only
fl 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 off ections to i(nss ect appliiccableycounts.
Z �A
P.G✓w /l int%!�/t/G✓�
Date signed Signature of Candidate or Treasurer
CRO -3500 Certification olFinanc•ial Account brlormation
NORTH CAROLINA
mT� STATE BOARD OF ELECTIONS
Additional account numbers:
Type of Account Financial Institution Address Account Number Account Code
Date Signed Signattue of Candidate or Treasurer
CRO-3500 Cer(ilication of Financial Account Information