Boag, Terry_2025-SOGstatement of Organization - Candidate Committee IsjMs statement:
IZ □ AmendedUse this form to create a new or update an existing candidate committee.
This form must be accompanied by fonn CRO-350Q. An amended form is required for each new election year.
1. Committee Information
a. Name of Committee d. ID Number
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b. Mailing Address (include City, State and Zip Code) -e. Date Organized
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c. Committee Website (Optionai)f. Phone Number,
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2. Candidate Information
a. Full Name " - "e. Party Affiliation
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b. Mailing Address (include City, State, and Zip Code)f. Office Sought
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c. Phone Number d. Email Address g. Next Election Year h. Jurisdiction
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3; Treasurer Information 4. Assistant Treasurer Information 1 £ *
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 c. Phone Number
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Send report notices bv email l^ Yes . U No □ Email copy of report notices
5; Custodian of Books Information (Keeper of Records)6. Account Information {inch CRO-i500)
a. Full Name a; Financial Institution Full Name
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b. Mailing Address>(include City, State, and Zip Code)I ' . *■ . - .
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c. Phone Number d. Email Address b. Account Code c. Type
CHCC^frJ0 Email copy of report notices
I certify that the Conunittee is in compliance with all applicable provisions of Article 22A of Chapter 163 of the NO
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 of Treasurer Si^turc of App&mtcd 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.
\{i 0£C-'ZJ)T.SPrinted Name of Candidate signature of CaQidate Date
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