Petterson,Heidi_ 2026 Amended SOOStatement of Organization - Candidate Committee
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 re
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It. Committee Website (Optional) If. Phone Number
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a. Full Name_
e. Party Affiliation
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b. Mailing Address (include City, State, and Zip Code)
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d. Email Address
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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(_ndude City, Sa, ar
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c. Phone Number
d. Email Address
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Financial
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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 commutgled with prohibited or other non -disclosed funds. 1 further certify that
this report is cont Tete, tme and correct.
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Printed Name of Treasurer Signature of Appointed Treasurer. Date
I certify that die information above is correct, and 1, as the candidate, appoint said treasurer to personally fulfill the
Iuties 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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Print ted Name of Candidate Signature of Candidate Date
CRO -2100A NC State Board of Elections November 2019