Tucker, Barry_2025-SOG NewStatement of Organization - Candidate Committee Is.this statement:
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Use this fonn 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. 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 (Optional)f. Phone Number
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2. Candidate Information
a. Full Name c. Party Affiliation
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b. Mailing Address (include City, State, and Zip Code)f. Ofllcc 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
a. Full Name a. Full Name
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b. Mailing Address (include City, State, and Zip Code)^ MaUing Addtqss (include City, State atri^Zjfl Opdfl) oniCsifi/5 jIiu. Bp jJc ^^1(0 '■
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c. Phone Number d. Email Address BO/^Pl®l®pe0l®B3i|ON£d. Email AddiB^ARD Uh tLtU I iui>Jo
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5. Custodian of Books Information (Keeper of Records)6. Account Information (incl. CRO-3500)
a. Full Name a. Financial Institution Full Name
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b. Mailing Address (include City, State, and Zip Code)
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c. Phone Number d. Email Address b. Account Code c. Type
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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 correct.gf/zpi/ I2{llI9.'5'
Printed Name ofTreasurer Signature of Appointed Treasurer Date
I certify that the information aboye 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