Helms,Brian_2022-!-Stmt-of-OrgStatement of Organization - Candidate CommitteeIs his statement:
New E3 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 reauired for each new election year.
1. Committee Information
. Name of Committee
-
d. ID Number
W'AO 465 i
. MaBing Address (include City, State and Zlp Code)
–A061
e. Date Organized
421 I 81 Z
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. Committee Website (Optional)
It. Phone Number
2 -
. Candidate Information
a. Full Name
e. Party Affiliation
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—49ALaw
b. Mailing Address (include City, State, and Zip Code)
f. Office Sought
1821 3 -Ae. MoAcoE f fr , ?elrz
CDAeilyr 'ane
. Phone Number
I d. Email Address
g. Next Election Year
h. Jurisdiction
600)Z19-01135
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snail co of re ort notices
3. Treasurer Information
4. Assistant Treasurer Information
. Full Name
a. Full Name
1kJ= PAWS
b. Mailing Address (include City, State, and Zip Code)
Is. McWng Address (include City, State and Zip Code)
Ig2A #bAe0 kk28112
. Phone Number
Id. Emil
c. Phone Number
d. Email Address
0 Z11 -0q351
1Address
i1Clm5Nc Mn:I•COro
Send report notices by email "es LJ No
U Email co of re ort not
5. Custodian of Books Information (Keeper of Records
6. Account Information (incl. CRO -3500)
a. Full Name
a. Financial Institution Full Name
b. Mailing Address (include City, State, and Zip Code)
c. Phone Number Id. Email Address
b. Account Code
c. Type
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 non -disclosed funds. I further certify that
this report is complete, true and correct.
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Printed Name of Treasurer Signature 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.''
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^(n/ • Al!Z' 2 25 2022
Printed Name of Candidate
Signature of C idate bate
CXUdl Y0A NC State Board of Elections November 2019