Moyer,Taylor_2026-Stmt-OrgStatement of Organization - Candidate Committee js this 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.
I. Committee:Information
a. Name of Committee
d. ID Number
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b. Mailing Address (include City, State and Zip Code) _
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e. Date Orga ized _
40-7/11 6
c. Committee Website (Optional)
I. Phone Number
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3,Candidate Iuforntation ,?
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a. Full Name
e. Party Affiliation
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b Mailibg Address -(include Clry; 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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Email copy of report notices
KTreasurer.Informationl ' : . _.
47;AssistantTreasurer Inforutation
a. Full Name
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a. Full Name ni
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CAMPAIGNFINAN-
b. Mailing Address (include City, State, and Zip Code)
b. Mailing Address (include City, State and Zi o�}g
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c. Phone Number
d. Email Address
c Phone Number
d. Email A '""
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Send report notices by email ®Yes ❑ No
Email copy of report notices
S. Custodianiof Books Inforination, Kee er�of•Records ,i
6z'Accountr£nformation,' (lncL'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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I � 1 8 2026
c. Phone Number
d. Email Address
b. Account Code
c. Type -
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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 closed funds. I further certify that
this report is complete, true and correct.
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Printed Name of Treasurer Siat Uropp -ted Treasurer ate
I certify that the information above is correct, and I, as the candidate, appoint said tre to personally fulfill the
duties and responsibilities imposed upon the appointed treasurer and penalties in Article 22 f.Chapter
163 of the NC General Statutes.
Printed, Name of Candidate pat of Candidate Date
CRU -2110M NCStatc Board of Elections November 2019
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