Smith,Sandra_2021-Stmt-of-OrgStatement of Organization - Candidate Committee Is this statement:
Q 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 ear.
1. Co
. Name of Committee
d. ID Number
Sandra Smith For Clerk Committee
. Mailing Addrem (mclude city, state and Zip Code)
- e. nate Organized
4706 Nesbit Rd, Monroe, NC 28112
DEC 0 7 2021 12/06/2021
. Committee Website (Optional)
f. Phone Number
CMW
ECEIVED 704-291-0806
•Full Name
e. Party AfftIiation
Republican
Sandra Smith
. Mailing Address (include City, Slate, and Zip Code)
f. Office Sought
4706 Nesbit Rd, Monroe. NC 28112
Clerk of Court
. Phone Number
d. Email Address
g. Next Election Yeaz
It. Jurisdiction
State/Local
704-291-0806
sdwsmith@gmail.com
2022
Email copy of report notices
. Fall Name
a. Full Name
Sandra B Norris
Mailing Address (include City, State, and Zip Code)
b. Mailing Address (include City, State and Zip Code)
1921 Mountain Springs Church Rd, Monroe, NC
28112
. Phone Number d Email AMrem
c. Phone Number
lL Faecal Address
704-989-3754 sbnorris486@aol.com
Send re ort notices be email El 1 -es Vo
Email copy of report notices
C Inf r of Records
6. _ . .
a- Full Name
a. Financial Institution Full Name
American Bank
,. )Tailing Address (include City, State, and Zip Code)
. Phone Number
Id. Email Address
b. Account Cade
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.
Sandra B Norris /\
// 18V;6� 12/06/2021
Panted Name of Treasurer
signature or Appointed Treasurer Date
I certify that the information above is correct, and 1, as the candidate, appoint said treasurer to personally fulfill the
uties and responsibilities imposed upon the appointed tr
er and subjec]to the ties in Article 22A of Chapter
63 of the NC General Statutes.
11Sandra Smith
12/06/2021
Printed Name of Candidate ISignature
M'Candidate Date
CRO -2100A NC State Board of Elections November 2019