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<br />N.C.G.S. S 143-157.1 FORM <br /> <br />SOS revised 08/2005 <br /> <br />Appointment Reporting 2004-2005 (Side 2) <br />Please provide the information requested below. Record information ONLY for appointments made/announced <br />between July 1,2004 and June 30, 2005. If you have not made appointments during this time period, please check off the <br />appropriate box in Letter D and return the form to the Department of the Secretary of State. Remember: Submit separate <br />forms (no format substitutions) for each body receiving appointment. A sample form from sections A, B, C and D is <br /> <br />Drovided below as a guide. <br />Sample A. Name of body/official (Appointing Authority) making appointments: <br /> Jones Citv Council <br />Sample B. Board, Commission, Councifor Committee to which an appointment was made (please <br /> submit a sevarate form for each entitv): <br />I Smith Countv Board of Education <br /> What is the total authorized membership for the body receiving appointments? (The <br />Sample e. authorized number; not necessarily the same as number actually serving): <br /> 27 <br />Sample D. APPOINTMENTS FROM 7/1/04-6/30/05 Number of Appointments . <br /> (ONLYapp'ts made during this period by <br /> authority submitting report; NOT all . <br /> serving members, unless all appointed <br /> during the period! <br /> . 1. Number of women appointed 6 <br />(please make sure that 1+2=3 in 2. Number of men appointed 4 <br />both columns) . 3. Total appointments made to membership . 10 <br /> bv this annointin" authority <br /> <br />A. Body or Official <br />making <br />Appointment(s) <br />B. Board, Comm'n, <br />Councilor <br />Committee receiving <br />aDDointment(s) <br />C. Total Membership <br /> <br />D. Appointments <br /> <br />(please make sure that <br />I +2=3 in both columns) <br /> <br />(Mark Box to Right if no <br />Appointments were made <br />to the specific entity listed <br />above) <br /> <br />Name and Address of <br />Person Filing <br />Information <br /> <br />. <br /> <br />APPOINTMENT REPORTING 2004-2005 FORM <br />Name of body/official (Appointing Authority) making appointments: <br />Cabarms County Board of Commissioners <br /> <br />Board, Commission, Council or Committee to which an appointment was made (please submit a <br />seDarate form for each entity): <br />Social Services Board <br /> <br />What is the total authorized membership for the entity receiving appointments? (The authorized <br />number; not necessarily the same as number actually serving): <br />5 (Cabarms BOC aoooints 2) <br />APPOINTMENTS FROM 7/1/04-6/30/05 Number of Appointments <br />ONLY app'ts made during this period by <br />authority submitting report; NOT all serving <br />members, unless all aDDointed during the Deriod) <br />1. Number of women appointed <br /> <br />2. Number of men appointed <br />3. Total appointments made to membership by <br />this appointing authority <br />Or: <br />o No Appointments made to this entity during this time <br />(mark box if the Body or Official making appointments made no <br />appointments to this particular entity, specified above, during the <br />time of7/112004-6/3012005) <br /> <br />I <br />o <br />I <br /> <br />. <br /> <br />Attention Filer: Please provide the following information. <br />Your name and title: Susie Bonds, Clerk to the Board <br />Address: PO Box 707, Concord, NC 28025 <br /> <br />. <br /> <br />Telephone: 704-920-2110 Fax: 704-920-2820 <br />County: Cabarrus <br />Your e-mail;stbonds@cabarmscounty.us J _ I <br />Org! Agency e-mail; .. <br />Please specify the best wav to contact vour organization (Le.email, fax, or letter): email <br />