Thompson,Julie_2021-CommitteeStatement of Organization - Candidate Committee Is this statement:
❑ 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 of Committee
d. In Number
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b. Mailing Address (include City, State and Zip Code)
e. Date Organized
35o3 Roy.,. -.y D•:,,e h. .,r I-II 28110
4-r I III "Ll
c. Committee Website (Optional)
f. Phone Number
y$u 328 VZb'i
2. Candidate Information
a. Full Name
e. Party Affiliation
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b. Mailing Address (include City, State, and Zip Code)
f. Office Sought
W03 Qrmny 0""d. i'�an r/1, He Zg114
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c. Phone Number
It. Email Address
g. Next Election Year
1b. Jurisdiction
984-328'0263
,j'rh.—Fs.., aG 7421�q,.,,;1.
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za21
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[{ Email co of re ort notices
3. Treasurer Information
4. Assistant Treasurer Information
a. Full Name
a. Full Name
'Da..:d S Qur<w;+c
b. Mailing Address (include City, State, and Zip Code)
b. Mailing Address (include City, State and Zip Code)
181E G.,c- A/ted
M.., i. t• HG Z9110
c. Phone Number
d. Email Address
c. Phone Number
d. Email Address
to,
Send report notices by email UYes ❑ No
OEmail 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
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b. Mailing Address (include City, State, and Zip Code)
UNION COU
yy0t W, 2.oye-.-elf- p)„d
l"1.,.,re IyL 22110 .1
CAMPAIGN FIN
1111 19 qn'l
c. Phone Number
d. Email Address
b. Account Code
c. Type
10 398- 1490
001
RECEIV
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, hue and correct.
Printed Name of Treasurer Si re of Appointed Treasurer Date
I certify that the information above is correct, and I, 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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Printed Name of Candidate Signature of Candidate Date
CRO -2100A NC State Board of Elections November 2019
FY
D
VOTE
® NORTH CAROLINA
MrJ STATE BOARD OF ELECTIONS
I Certification of Financial Account Information I
This Certification is used to report confidential bank account information for all financial accounts
established by the committee and must accompany the Statement of Organization Form.
FILED BY:
Committee Name: (NVIG bmilsoYi WV Cib Colli iOi I
Treasurer Name: )DLk Ab PJUC1LUn b/1
Treasurer Address: M I W/ 6
(include city, state, &zip) Mo"VoPjt4G 7�k\0
Treasurer Phone: EM -4215-4100
I certify that the information provided below is true and accurate. I am providing all account information for the above
named Committee. These account numbers include all bank accounts utilized, credit card accounts, money market or
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.
Each treasurer (or candidate) must designate below an account code (any number or letter or combination of
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.
Type of account Financial Institution Address
Account Number Account Code
By signing this statement, I authorize agents of the State Board
of Elections to inspect all accounts provided.
Date Signed SrgnahZC'61'L'a7falYlatE'or`P�surer
For Candidate Committees Only
U 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
l�J�`R'JY9 COUNTY
CAMPAIGN FINAJ'!r'
JUL 19 2071
CRO -3500 Certification of Financial Account Information
ImMTE)NOPTH CAROLINA
STATE BOARD OF ELECTIONS
Candidate Designation of Committee Funds
This form is used by candidate committees only and allows the candidate to designate in the event of their death,
how the committee's funds are to be disbursed using the eight allowable methods outlined in 163-278.16B(a).
This Designation is filed at the Board of Elections office where the committee's campaign reports are filed.
Candidate Name: 5+ p n
Committee Name: U u& l ti. s v �_ , L %1-� Ce • e
Treasurer Name: �� T• f3 soi'. fit,
If Candidate is own treasurer, designate an agent to carry out designations:
Committee ID #: z
Level Registered: [State] [County] If county, specify:
I, �J p +•^ hereby direct that in the event of my death or incapacity all
(Name of Candidate)
funds remaining in my Campaign Committee account(s) (after payment of permitted outstanding
debts or reasonable expenses for winding up the Committee or closing office) be paid in the
following manner as permitted by N.C. Gen. Stat. 163-278.16B(a).
Name of Entity
(Select from §163-278.16B(a))
1. IhG �� e i tra%5 `"larQ Lk,t JeGn,i lir e
4-j A Bade �.
2.
!>d
Plan for Disbursement (eg. Amount or %)
166
By signing this form, I certify that the foregoing entities are eligible beneficiaries under N.C.
Gen. Statute 163-278.16B(a). A copy of this form should be maintained with the Committee
records.
Signature of Candidate:
Date: 1•+5-71
CRO -3900
Candidate Designation of Committee Funds
w UNION COUNTY
CAMPAIGN FIN4^'^E
JUL 19 Mi
RECF