Burroughs,Weston_2021-Stmt-of-OrgStatement of Organization - Candidate Committee Is this statement:
0 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.
1. Committee Information
a. Name or Committee
Committee to Elect Weston Burroughs
_ _ d. In ?lumber
. Mailing Address (include City, State and Zip Code)
e. Date organized
67.10 1J o Itl 6
'
'I'L" .i L keo 7112120/2021
. Committee Website (Optional)
—
I. Phone Number
8v- q9So
2. Candidate Information
. Full Name
James Weston Burroughs
e. Party Affiliation _
Democrat
. Mailing Address (include City, State, and Zip Code)
f. Office. Sought
UCPS Board of Education, At -Large
/ T ��
d ✓ i f o
. Phone Number I
d. Email Address
g. Next Election Year
h. Jurisdiction
10a-10-o'Ipo
weston@westonforucps.com
2022
UnionCounry
El Email co of report notices
3. Treasurer Information
4. Assistant Treasurer Information
a. Full Name
Cristal Robinson
a. Full Name
COUNTY
. Mailing Address (include City, State, and Zip Code)
b. Mailing Address (incl I>aiApG
67;o 4910FA14o,teve, RI 5)ic 1 #11W
T
DEC 2 0 2021
c. Phone Number Id. tiAddress
c. Phone Number
d. E
-70,1 •37e -476 ro b:„ro o
Send report notices by email EJ Yes LJ N;-
LJ Email copy of report notices
5. Custodian of Books Information (Keeper of Records
6. Account Information (incl. CRO -3500)
a. Full Name
a. Financial Institution Full Name
Wells Fargo
b. Mailing Address (include City, State, and Zip Code)
. Phone Number
Id. Emil Address
1b. Account Code
It. Type
Checking
001
❑ Email copy of report notices
I certify that the Committee is in compliance with all applicable provisions of Article 2 of Chapter 163 of the NC
General Statutes and that no funds are commingled with prohibited or other no . closed funds. I further certify that
this report is complete, true and correct.
Cristal Robinson 12/20/2021
Printed Name of Treasurer Si of Appointed Treasurer Date
I certify that the information above is correct, and 1, 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.
James Weston Burroughs 12/20/2021
Printed Name of Candidate Sitmature of Candidate Date
CRO -2100A NC State Board of Elections November 2019