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<br />~ <br /> <br />N.C.G.S. 9143-157.1 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. jfyou 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 />rovided below as a uide. <br />Sample A. <br /> <br />Sample <br /> <br />B. <br /> <br />Sample C. <br /> <br />Sample D. <br /> <br />(Please make sure that 1+2-3 in <br />both columns) <br /> <br />A. Body or Official <br />making <br />Appointment(s) <br /> <br />B. Board, Comm'n, <br />Council or <br />Committee receiving <br />a ointment s <br />C. Total Membership <br /> <br />D. Appointments <br /> <br /> <br />(Please make sure that <br />1+2=3 in both columnsf <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 />Name of body/official (Appointing Authority) making appointments: <br />Jones Citv Council <br /> <br />Board, Commission, Councilor Committee to which an appointment was made (please <br />submit a seDarate form for each entitv): <br />Smith Countv Board of Education <br /> <br />What is the total authorized membership for the body receiving appointments? (The <br />authorized number; not necessarily the same as number actually serving): <br />27 <br /> <br />APPOINTMENTS FROM . 7/1/04-6/30/05 <br />(ONLY app'ts made during this period by <br />authority submitting report; NOT all <br />serving members, unless all appointed <br />durin the eriod <br />I.Number of women appointed <br /> <br />2. Number of men appointed <br />3.. Total appointments made to membership <br />b this a ointin authori <br /> <br />Number of Appointments <br /> <br />6 <br />4 <br />10 <br /> <br />, <br /> <br /> <br />. . <br />APPOINTMENT REPORTING 2004~2005 FORM <br />Name of body/official (Appointing Authority) making appointments: <br />Cabarrus County Board of Commissioners <br /> <br />Board, Commission, COWlcil or Committee to which an appointment was made (please submit a <br />senarate form for each entity): <br />Region F Aging Advisory Committee <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 />36 Cabarrus BOC a oints 4 <br />APPOINTMENTS FROM 7/1/04-6/30/05 <br />ONLY app'ts made during this period by <br />authority submitting report; NOT all serving <br />members, unless all a ointed durin the eriod) <br />I. Number of women appointed <br /> <br />2. Number of men appointed <br />3. Total appointments made to membership by <br />this a ointin authori <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 of 7/1/2004-6/30/2005) <br /> <br />Number of Appointments <br /> <br />I <br />o <br />1 <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 />Fax: 704-920-2820 <br /> <br /> <br />~ <br />J- \ <br /> <br />Le. email, fax, or letter): email <br />