Marcolese,Robert_2019-OrgStmtStatement of Organization - Candidate Committee
Use this form to create a new or update an existing candidate committee.
This form must be accompanied by forms CRO -3100 and CRO -3500 when amendin
Amendment
El Yes 0 N
only re -submit if applicable)
1. Committee Information
. Full Name
c. In Number
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. Mailing Address (include City, Sate and Zip Code)
d. Dale Organized
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e. Phone Number
. Candidate Information []Candidate's Primary Committee
. Full Name
e. Candidate ID Number
-Party Affiliation
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(Indicate Non-partisan if applicable)
. Mailing Address (include City, Sate, and Zip Code)
g. Office Sought
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. Phone Number
I d. Email Address
h. Next Election Year
1. Jurisdiction
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❑Email copy of notices
. Treasurer Information
4. Custodian of Books Information
. Full Name _
a. Full Name
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b. Mailing Address (include City, Sate, and Zip Code)
b. Mailing Address (include City, Sate,
100 lY1 � 1�, �1 a,+ Coca
PAARVIrA, tn1.C_ 2-g173
JUL 182019
c. Phone Number
d. Email Address
c.Phone Number
d.Email Addr Union Co. Electior
704-705'0 401
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I prefer to receive notices by email ETYes No
E3EmaiI copy of notices
5. Assistant Treasurer Information
JU Add
❑ Remove
6. Account Information (,net. CRO -3500)
Add
Q Remove
. Full Name
a. Financial Institution F 1 Name
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. Mailing Address (include City, Sate, and Zip Code)
b. Purpose
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c. Phone Number
d. Email Address
c. Account Code
d. Type
d I
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Email co of notices
CERTIFICATION
I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B & 22D -22M of
Wneral Statutes and that no funds are commingled with prohibited or other non -disclosed funds.
port is complete, true and correct.
Signer Signature of Appointed Treasurer Date
CRO-2I00A I NC State Board of Elections July 2011
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2 2019
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Amendment
Statement of Organization - Candidate Committee ❑ Yes ❑ No
Use this form to create a new or update an existing candidate committee.
This form must be accompanied by forms CRO -3100 and CRO -3500 (when amendine. only re -submit if applicable).
1. Committee Information
. Full Name
c. ID Number
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HTAA4X7
. Mailing Address (include City, State and Zip Code)
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d. Date Organized
e, Phone Number
. Candidate Information ❑Candidate's Primary Committee
. Full Name
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e. Candidate ID Number
IL Party Affiliation
CPv5)l,%C-A 1
(Indicate Non-partisan if applicable
. Mailing Address (include City, State, and Zip Code)
g. Office Sought
0113 0A E21 %AGE OFl,c at"itr
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V,1kj,0Ut or— MAP V)Id 00Val
. Phone Number d. Email Address
Is. Next Election Year
L Jurisdiction
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.cd n ((;;
❑Email copy of notices
. Treasurer Information
4. Custodian of Books Information
. Full Name E tt/_ �
a. Full Name
. Mailing Address (include City, State, and Zip Code)
b. Mailing Address (include City, State,
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M aa/l r4 t C- 781�3
JUL 18 2019
. Phone Number
Id. Email Address
c.Phone Number
d.Email Addrev Union Co. EI
704-705-0
RV1>9" 1,t4V E1.dZe<7Mq
L.rcwt
1 prefer to receive notices by email
Yes No
Ll Email copy of notices
. Assistant Treasurer Information
Add
❑ Remove
6. Account Information (tncd. Ce0-3J00) ILI raj
a. Financial Institution Full Name ILI Remove
FIF i 1A —i" --PD P,
. Full Name
b. Mailing Address (include City, state, and Zip Code)
b. Purpose
ry fJ I� 5 Fo a }� ERtTYiC+E
CAVYAPAI&4
. Phone Number
d. Email Address
c. Account Code
d. Type
d 1
C I -t r;' -v-1 A (r
Email co of notices
CERTIFICATION
1 certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B & 22D -22M of
port is complete, true and correct.
IMneral Statutes and that no funds are commingled with prohibited or other non -disclosed funds.
Name Signer Signal= of Appointed Tteasurer (Date 1
CRO -2100A I NC State Board of Elections July 2011
�L
NORTH CAROLINA
STATE BOARD OF ELECTIONS
Certification of Threshold
This Certification is used to declare or withdraw a committee's intent to raise or spend $1,000 or less in the
current election cycle.
This Certification is only valid for political party committees and candidates for a county office,
municipal office, local school board office, soil & water conservation district board of supervisors, or
sanitary district board.
This Certification is filed at the Board of Elections office where the committee's campaign reports
are riled.
FILED BY:
Committee Name:
Treasurer Name:
Treasurer Address:
(include city, state, & zip) %`(, A R �1 tJ , ?A, C_. 2F3 Z'3
Treasurer Phone: -7014— —10.5- 0,4057 JUL
Chec One: Diboll C
_ I certify that this committee intends to neither receive nor expend more than $1,000 during the curren
election cycle under the procedures set forth in G.S. 163-278.10A. This certification will remain in effect
until the end of the election cycle for this committee. If this committee exceeds $1,000 in contributions or
expenditures during this election cycle, I understand that I must immediately notify the appropriate board
of elections and file required campaign finance reports.
THIS DECLARATION CAN ONLY BE MADE AT THE BEGINNING OF AN ELECTION CYCLE.
I am withdrawing my Certification to remain at or under the $1,000 threshold. 1 will now be required
to file the next scheduled report for all contribution p nditures that have not been previously
reported from the be inning of the current election cy e. I rt r e to file all future reports required.
Doig
Date Sign Signature
CRO -3600 Cerlificalion of Threshold
AM
VOTE
rTiT
NORTH CAROLINA
STATE BOARD OF ELECTIONS
Certification of Treasurer
This Certification is used by Candidate Committees to appoint a treasurer for the committee. This form is
required and must accompany the Candidate's Statement of Organization.
This Certification is filed at the Board of Elections office where the committee's campaign reports
are filed.
FILED BY:
Candidate Name:
Treasurer Name:
Treasurer Address:
�,t
e
t;�
(include city, state, & zip) fa �1 ( I V ` C • 2
Treasurer Phone:
I certify that the above information is correct, and I, as candidate, appoint said treasurer to person-My
ll
duties and responsibilities imposed upon the appointed treasurer and subject to the penalties and
sanctions in Subchapter VOL Regulation of Election Campaigns of Chapter 163 of the North Carolina
General Statutes.
I understand that if the above Treasurer changes, it will be necessary to certify a new treasurer and amend
the existing Statement of Organization within 10 days of the vacancy. I further understand that the above
Treasurer is required to receive training by the State Board of Elections within three months of this
appointment according to Article 163.278.9(k). -1-1
DdteSigned
CRO -3100
Certification qj 71 easurer
Electic
vo�i NORTH CAROLINA
STATE BOARD OF ELECTIONS
Certification of Financial Account Information
This Certification is used to report confidential bank account information for all financial accounts
established by the committee and must' 1accompany the Sta went of Organization Form.
FILED BY:e Ttw �g�ah
Committee Name:
m — '
Treasurer Name: AIIZIgE. V k ptuc
Treasurer Address: 100 — iA+ O
(include city, state, & zip) 12�Z SU0110,013 •0c) ut
Treasurer Phone: Z £ lfif
I certify that the information provided below is true and accurate. I am providing all account
named Committee. These account numbers include all bank accounts utilized, credit card a
savings accounts, or any other financial account used for any purpose by the Committee.
The information provided on this form is considered confidential and is not subject to public disclosure. The information
provided is only used for the purposes of an audit or investigation or as required by a court of competent jurisdiction.
numbers and letters) by which to refer to the account number on reports. If an account number is used as the "account
code," confidentiality of the account number is presumed to have been waived.
The treasurer shall maintain all moneys of the political committee in a bank account or bank accounts used exclusively by
the political committee and shall not commingle those funds with any other moneys.
Tvoe of account Financial Institution Address
Account Number Account Code
By signithis statement, I authorize agents of the S to Bo o El ct o inspect all accounts provided.
n
7 22 of �`
ate Sign98 Itignature of Candidate or Treasurer
For Candidate Committees Only
In lieu of providing account information, I certify that this committee will not raise any money nor spend any money
except that which is the candidate's personal funds. I furthermore understand that an audit or investigation could
warrant the probe of any personal bank account that is being used for campaign expenditures.
By signing this statement, I authorize agents of the State Board of Elections to inspect applicable accounts.
Date Signed Signature of Candidate or Treasurer
CRO -3500 Certification of Financial Account Information
gmat� c�bsa�ytKE►\
O t
9RW
t
By signithis statement, I authorize agents of the S to Bo o El ct o inspect all accounts provided.
n
7 22 of �`
ate Sign98 Itignature of Candidate or Treasurer
For Candidate Committees Only
In lieu of providing account information, I certify that this committee will not raise any money nor spend any money
except that which is the candidate's personal funds. I furthermore understand that an audit or investigation could
warrant the probe of any personal bank account that is being used for campaign expenditures.
By signing this statement, I authorize agents of the State Board of Elections to inspect applicable accounts.
Date Signed Signature of Candidate or Treasurer
CRO -3500 Certification of Financial Account Information