Belmonte,Elizabeth_2025-SOGStatement of Organization - Candidate Committee Is his statement:
New ❑ 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
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d. ID Number
KIR P8'
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b. Mailing Address (include City, State and Zip Code)
e. Date Organized
100 33 Cy-e,C cc�e �n��a �rctt� �C .22079
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. Committee Website (Optional)
I. Phone Number
X03 597 7dHl
2. Candidate Information
a. Full Name
e. Party Affiliation
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W. Mailing Address (include City, State, and Zip Code)
6039 Cre-4 Ct-rde.
I. Office Sought
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c .Phone Number
d. Email Ad ess
g. Next Election Year
h. Jurisdiction
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mail co of re ort notices
3. Treasurer Information
4. Assistant Treasurer Information
a. Full Name
it. Full Name
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It. Mailing Address (include City, State, and Zip Code)
6039 Crej'+ Circle-
It. Mailing Address (include City, State and Zip Code)
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. Phone Number
d. Email Address
c. Phone Number
it. Email Address
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U Email co ry of re ort notices
5. Custodian of Books Information (Keeper of Records
6. Account Information (incl. CRO -7500)
a. Full Name
UNION
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a. Financial Institution Full Name
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h.Mailing Address (Include City, State, and Zip Code)
JUL 10 2025
c. Phone Nu
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Account Code
c Type
❑ 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 torr ct.
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Printed Name of Treasurer 1"notare ut Appointed 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 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
CttU-21VVA NC Slate Board of Elections November 2019
VOTE
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NORTH CAROLINA
STATE BOARD OF ELECTIONS
Certification of Threshold
UNION COUNTY
CAMPAIGN FINANGC
This Certification is used to declare or withdraw a committee's intent to raise or spend $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 supenisors, 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)
(003`3 CdeY}(•c-e—
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Treasurer Phone: oQO 3— Sq t7 — %a c/ I
Che k 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 $1,000 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.
i am withdrawing my Certification to remain at or trader 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 forth agree to file all future reports required.
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Date Signed Signature
CRO -3600 Certification of Threshold