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Outstan ding Loans rg 2 «3 Amendu mt <br />]Ye No <br />Use this form to report any outstanding loans received during a previous reporting period and until the loan is paid in full. <br />1.CommitteeFull Name (and Fund ifa --.---~-.2.ID Nuber <br />Con#le lo EiexB,Bas Ce o b u.er <br />3.Lender Info rmation □-Add □Remove <br />a.Full Name,MailingAddress &Phone b.Job Tide/Prof ion d.Comments <br />(include city,state,&zip) <br />C L ER K or &or <br />Re "B "B A c csWun-CB9uS Co a r!e.Start Date (/dd/yyyy) <br />139 op C H+RotT koo e.Eployer's Nae/SpecificField <br />8///2c ue <br />Co 4,NC 2 0 2 1 NC P0 f.Ed Date (mi/did/yyyy) <br />179-521-3097 / <br />g.Rate h.Security Fledged i.Original Loan Amount i.R ing Loan Balance <br />¢%N}/n $5,coo%°$5,0co o> <br />k.Full Name of Lending Institution <br />.L.Loan Nuber <br />N/9 <br />3.Lender Information •'---□Add □Remove :- <br />a.Full Name,Mailing Address &Phone b.Job Title/Profession d.Comments <br />(include city,state,&zip)CR or Ca rWR"B "B aasWArm-Csu s C o e.Start Date (mu/dd/yyyy) <br />139 OLD CHRRLTE R6AD c.Employer's Nae/Specific Feld 03/as /zer, <br />Co+cc,NC 38027 /yd 0o f.Ed Date (in/dd/yyyy) <br />1 0 -52 1 -3 @ 8 7 w/ <br />g.Rate h.Security Fledged i.Original Loan Amoat j .Remaining Loan Balance <br />$%[$ <br />" <br />o0 $l,eooo oa <br />0 0 0 . <br />k.Fall Name of Lending Institution L.Loan Nuber <br />N/a <br />3.Lender Info rma tion -□-Add ..□Remove-··. <br />a.Full Name,Mailing Address &Phoe b.Job Tide/Profession d.Comments <br />(include city,state,&zip)C L R K o C r <br />Wan Un«ex 'B14"B Acs C+Aus Co o r Y e.Start Date (au/dd/yyyy) <br />1639 LD CnRL6 RD c.Ea»ployer's Nae/SpecificField o r/s1 /2 o r+C oco±,NC 3807 Ne 000 f.Ead Date (/dd/yyyy) <br />Ro-521-3 0 8 7 w/ <br />g.Rate h.Security Fledged i.Original Loan Amount j.Remaining Loan Balance <br />d %N /n $2,ooo <br />oc $,ooo°° <br />k.Full Name of LendingInstitution L.Loan Number <br />N/n <br />4.Total only thisPage ."--$8 ooo°"---... <br />5.Total of ALL CRO-1430Pages --'-':"--°.·-$(This tine mustbe ontine 21 ofDetailed S ay Page CRO-LIO)- <br />CRO-1430 NC StateBoard ofElections December2007