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Amendment <br />Contributions from Individuals Pg I of I ❑ yes ® No <br />Use th is Form to report individual contributions over $50 or contributions under $50 if form CAD 1205 is not used <br />1. Committee Full Name (and Fund if applicable) <br />2. ID Number <br />BAILEY FOR CABARRUS <br />CAB-RUN22-C-001 <br />3. Contributor Information <br />❑ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />b. doh EdelProfession <br />d. Comments <br />[include city, state, & zip] <br />NO JOB TITLE <br />MITCHELL WATTS <br />c. Employer's NamelSpecilic Field <br />PO BOX 39 <br />CONCORD, NC 28026 <br />NOT EMPLOYED <br />e. Flection Sum to Date <br />1.000.00 <br />f. Prior <br />g. Account Code <br />h. Form of Payment <br />i. In -Kind Description <br />j. Date (mmlddlyyyy) <br />k. Amonnt <br />❑ <br />01.. . <br />Check <br />09/04/2025 <br />$ <br />1,000.00 <br />❑ <br />$ <br />4. Total only this Page <br />1,000.00 <br />5. Total ofALL CRO-1210 Pages <br />(This line muss be online b ofDelailed Summary Page CRO-1100) <br />$ <br />I,440.00 <br />CRO-1210 rv[, state soaraot t;iections April Zuu r <br />