Dobbins,David_2025-SOGStatement of Organization - Candidate Committee Is this statement:
Er New E3 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
a. Name of Committee
d. 10 Number
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145,1044C
b. Mailing Address (include City, Stat nd Zip Cade)
e. Date Organized
307 etre
L 9911
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c. Committee Website ,(Optional). -
f. Phone Ntuber
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2. Candidate Information
a. Full Name _ -
e. Party Affiliation
Lea Dab /Ms Sr.
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b. Mailing Address (include City, State, and Zip Code)
f. Ofri,pe S.a hI
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1—3011
c. Phone Number
d. Email Address
g. Next Mection Year
h. Jurisdiction
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547 -Email copy of re ort notices
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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
d. Email Address.
Phone Number
d. Email Address
Send report notices by email✓❑'Yes
LYNo
U Email cc of re ort notices
5.'Custodian of Books Information (Keeper of Records
6. Account Information :(incl. CBO -3500)
a. Full Name��rr-•- - - -
a. Financial institution Full Name
/Zih�h Vr.
b. Mailing Address (include City, State, and Zip Code)
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b. Account Code c. Type
c. Phone Number- d', Email Address
0 93-1563 u Z
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, trueandcorrect. �] C
L/II &JI .(1066/AS _Tr / JO ZJ
Printed Name of Treasurer Signature of Appo ed Treasurer Date
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 appointed treasurer and subject to the penalties in Article 22A of Chapter
163 of the NC General Statutes.
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Printed Name of Candidate Signature of Candidate Date
CRO -2100A NC State Board of Elections November 2019