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Disclosure Report Cover De Yes Amendment o No <br />Use this form for general report and committee information, must be signed and submitted along with other detailed forms. <br />F)n not iice thic form to undwe. information. <br />010 <br />1. Committee Information <br />Full ~lame <br />c. ID Number <br />Mailing Address (include City, State and Zip Code) <br />d. Date Filed <br />�v !✓r.0Pj> 'Ajcv' lZyr <br />e. Phone Number <br />9 2344.;;6 <br />Report Year <br />3. Period Start Date (mmldd./yy) 4. Period End Date (mmid ) 5. Treasurter:Full Name <br />f <br />;;.vas <br />� <br />/�•►s_'ay I,,_ -�a-' cvell,�-L- h� <br />�ype of Conunittee Check Coe <br />9.. Type of Report (check <br />Municipal <br />only one type of report <br />from one category) <br />- <br />Candidate Campaign ❑ Party <br />Sta ounty <br />Referendum <br />❑ PAC ❑ Referendum <br />❑ organizational <br />❑ Organizational <br />El Organizational <br />❑ Independent Expenditure ❑ Joint Fundraiser <br />❑ Thirty-five day <br />Quarterly <br />❑ Pre -referendum <br />❑ Legal Expense Fund <br />❑ Pre-primary <br />❑ First <br />❑ Final <br />❑ Pre -election <br />❑ Pre -runoff <br />❑ Second <br />❑ Third <br />❑ Supplemental Final <br />❑ Annual <br />7. Type of Fund (ifappikable. chec,,w) <br />❑ Booster Fund <br />Semi-annual <br />❑ Fourth <br />❑ Special <br />1] Building Fund <br />❑ Mid Year <br />Semi-annual <br />❑ Year End <br />❑ Mid Year <br />10. Special Report Name <br />❑ Other <br />❑ Final <br />❑ special <br />Year End <br />❑ Final <br />S. Number of Fundraisers this Report <br />❑ special <br />11. Account Information <br />11. Account Information <br />a. Financial Institution Full Name <br />a. Financial institution Full Name <br />RECEIVED <br />.44 /91111 A - <br />b. Purpose <br />c. Account Code <br />b. _Kwwse - <br />c. Account Code <br />DEC 2 2 2025 <br />d. Period Begin Balance <br />d. Period Begin Balance <br />CABARRUS COUNTY <br />$ <br />BOARD OF ELECTIONS <br />$ <br />CERTIk'ICATION <br />I certify that the Committee or Fund is in compliance with al applicable provisions of Article 22A, 22B & 22D-22M of Chapter 163 <br />of the NC General Statutes and that no funds are commingled with prohibited or other non -disclosed funds. I further certify that this <br />report is complete, true and correct and that I have been trained by the NC State Board of^Elections. <br />f <br />Printed Name of Si ner Signature of Appointed Treasurer Date <br />FOR OFFICE USE ONLY <br />d-off Phi <br />Delivery Method <br />Date Received: Employee: <br />❑ Normal Mail <br />❑ Registered Mail <br />Date Postmarked: Employee: <br />® Hand Delivered <br />r r N <br />r [3 Electronically Filed <br />Date Scanned: Employee: <br />noreceived <br />Date Data Entered: Employee: 0 nda vner has ry training <br />Please Note: This form cannot be used to amend committee information such as the committee address, treasurer, <br />assistant treasurer, custodian of books information, or account information. <br />You must amend the Statement of Organization (CRO-2100A-E) to make committee changes. <br />L'IC01-I (XV NUState Hoard of UlWions August ZVU6 <br />