Anderson,Gary_2025-SOG AmendedStatement of Organization - Candidate Committee Is this statement:
Q •Nen- g] 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 fonn is required for each new election year.
1. Comimttee Information
a. Name of Committee
b. MaiJing Addresj (include City, State and Zip Code)
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c. Committee Website (Optional)
d. ID Number
de. Date Organized
f. Phone Number
2. Candidate Inforraation H
a. Full Name
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e. Partv Afllliation
3. Treasurer information
b. Mailing Adcress (include City, State, and Zip Code)f. Offic^ought-J'd?fi <p
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c. Phone Number d. EmailS^dress
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2. Next Election Year
□ Email copy of report notices
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a. Full Name
b. Mailing Addrey (include City, State, and Zip Code)
c. Phone Number d. Email A(^^s
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5. Custodian of Books Information (Keeper of Records) ,
a. Full Name
b. Mailtng Address qnclude City, State, and Zip Code)
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c. Phone Number d. £ni:^Address . D. Account u
□ £mail copy of report notiggs
b. Account Co
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h. Jurisdiction
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4. Aissistaht Treasurer Information-
a. Full Name
b. Mailing Address (include City, State and Zip Code)
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c. Phone Number d. Email Address
LD Email copy of repoit notic"es|>tices.J
6. Account Informatidnj r (incl. CRO-3SOO}
a. Financial Institution Full Name
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de c. Type
CAMPAIGN FINANCE
DEC 0 5 2025
RECEIVED
I certify that the Conunittee 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 «port is complete, true and correct.r>njAy[/ P[)Ar^PJ/^o iA3e3/if>nl
Phnied Name of Treasurer Sisnature/of Appointed Treasurer
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 Chapter163 of tbe^'C General Stamtes. 1 / A 1 I 1 /
PrintedjS'ame of Candidate Signa/^e of Candidate ' Date
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CRO-2100A ^NC State Board deflections November 2019