Harbour, Wilden_2025-SOGstatement of Organization - Candidate Committee
Use this form to create a new or update an existing candidate committee.
This_formjnustje^ccompanied by form CRO-3500. An amended form is required for each new election year.
Is this statement:
Q Amended
I. Committee Information
a. Name of Committee d. ID .Number
b. Mailing Address finclude City, State and Zip Code)e. Date Organized
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c. Committee Website (Optional)f. Phone .Number
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I. Candidate Information ' " , ,
a. Full Name e. Party Affiliation
b. Mailing Address (include Citv-, State, and Zip Code)f-'Offic^ Sought
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c. Phone Number d. Email Address g. Next Election Year h. Jurisdiction
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0 Email codv of report notices ^
3. Treasurer Information . .4;Assistant Treasurer Information
a. Full Name a. Full Name WHL/tiVED
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b. Mailing Address (include Cit\', State, and Zip Code)b. Mailing Address (include City, State and Si^Botfe)
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c. Phone Number d. Email Address c. Phone Number d. Email Address
Send report notices bv email f^Yes'' DNd
5. Custodian of Books Information (Keeper of Records)6. Account Information,' - (ind.CRO-3S^OO) .
a. Full Name a. Financial Institution Full Name
b. Mailing Address (include Cit%', State, and Zip Code)
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c. Phone Number d. Email Address b. Account Code c. Type
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PojitJts/S Email copy of report notices
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I certify that the Committee 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 ofTreasurer Signature of Appointed Treasurer ' / Date
1 certify that the information above is correct, and I, as the candidate, appoint said treasurer to personally fulfil! 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