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1..J_Amendment <br />D isbursements Pg o f -D Yes <br />Use th is form to rep o rt ex p en d itures from th e committee for;o p erating ex p en s es ,co n trib u tio n s to can d idate/p o litical <br />co mmittees an d co o rd inated party ex p en d itures . <br />D No <br />1.Commi ttee F ull N a me (and F und if a pplica bl e)l 2.ID N um ber <br />Corm!Ht ee fo Elek B3.cs CIR Cf I <br />3 .Type o f Disburse me nt (Please use (C(9.13]9 forms for each typ e of n :+I <br />DI Operating Expenses LI Contributions to Candidates/Political Committees LI Coordinated Party Expenditures <br />4 .P ay ee Info rm a ti o n LJ Add LI Re mov e <br />a.Full Name,Mailing Address &Phone b.Coordinated Committee Name d.Comments <br />(include city ,state,&zip ) <br />S'#aleEpleqee»Credi+lo o <br />6o Rah4 e4 D c.Level Registered (Specify) <br />LI Federal LI County: <br />C o l,Mc 28020 D State D Municipality:e.Election Sum to Date) <br />704-788-34+}$M <br />f.Account Code g.Form of Payment h.Purpose Code i.Date (mm/dd/yyyy)j.Amount k.Required Remarks <br />I ba r{0 o1/a/z02a $p,0 <br />I Drax 0 03/13 /2 0 2 3 $j .a 0 <br />4 .P a y ee Info rma ti o n □Add <br />,□Remove <br />a.Full Name,Mailing Address &Phone b.Coordinated Committee Name d.Comments <br />(include city state.&zi) <br />Sale Enpl oqee>Cued+er <br />c.Level Registered (Specify)60 Raised Nu?LI Federal LI County: <br />Conco Y,Nc 2so2 D State □Municipality:e.Election Sum to Date <br />10 4 -788-34++$I4 <br />f.Account Code g.Form of Payment h.Purpose Code i.Date (mm/dd/yyyy)j.Amount k.Required Remarks <br />I De+t 0 ·3/3/e23 $1 o) <br />4 brat o ol/13/2023 $1.a c' <br />4 .P a y ee Info rm atio n I □Add □Remove <br />a.Full Name,Mailing Address &Phone b.Coordinated Committee Name d.Comments <br />(include city,state,&zip) <br />}ale non=e>Cor union <br />o Ralsovd D Nu c.Level Registered (Specify) <br />LI Federal LI County: <br />Concord ,NC 3 8 0 2 7 D State □Municipality:e.Election Sum to Date <br />904-738-344¥$150° <br />f.Account Code g.Form of Payment h.Purpose Code i.Date (mm/dd/yyyy)j.Amount k.Required Remarks <br />I Del 6 e5ho/023 $/.00 <br />I Dest o 6L /13/023 $1 0 <br />5.To ta l o nl y thi s P a g e <br />. <br />$ <br />6 .To ta l o f AL L CRO-13 10 Pa g es <br />(This line goes in line 13a ofDetailed Summary Page CRO-1100 if Operating Expenses) <br />$•(This line goes in line 13b ofDetailed Summary Page CRO-I 100 if Contrib to Candidates/Political Comm) <br />(This line goes in line 13c ofDetailed Summary Page CRO-I100 ifCoordinated Party Expenditures) <br />7 .Purpo se Codes (List detailed expenditure code in (h.)above) <br />A -Media B-Printing C-Fundraising D -To Another Candidate <br />E -S alaries F Equip ment G-P oli tical P arty H -Holding Public Office Expenses <br />I -P ostage J -P enalties K-Office Expenses O -Dona tio n to Leg a l Expen se Fu nd <br />0-Other -Co des requi re deta iled ex plana tio n in required remarks fi eld (k) <br />CR O-13 1 0 NC State Board of Elections December 2009