Laserfiche WebLink
Amendment <br />In -Kind Contributions Pg of ❑ Yes ❑ No <br />Ilse this form to report nun -monetary contributions, donations, goods or services provided to the comnuttee or fund. <br />Ilse C:RO-1 21 5 if in -Kind Contrihutiom were or will be refunded within 7 days- <br />I. Committee Full Name (and Fund if applicable) <br />2.11D Number <br />ll <br />CC,jiAA0AA§Q_c'J'PA- <br />3. Contributor Information ❑ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />b. Type of Contributor <br />C. Comments <br />(include city, state, & Ap) <br />[� or'" f I (}� <br />❑ Indiridual <br />Candidate <br />Cry^ <br />! <br />❑Pony <br />Vjj,&,-YJ� C <br />❑ PAC <br />'V6VO+ <br />❑ Referendum <br />d. Election Sum to Date <br />❑ Other Receipt Source <br />_.........-- <br />$ <br />e. Description <br />f. Date (nunIdd/yyyy) <br />g. Falr NlnrliCt Ainoun1 <br />F, <br />$ '5 C <br />. Contributor Information ❑ Add ❑ Remove <br />Full Name, Mailing Address & Phone <br />b. Type of Contributor <br />C. Comments <br />(include city, state, & Apt <br />❑ Individual <br />❑ Candidate <br />❑ Party <br />❑ PAC <br />Referendum <br />d. Election Sum to Date <br />❑ Oiher Receipt Source <br />$ <br />e. Description <br />------------ <br />f. Date (mmlddlyy-y-r) <br />g. Fair Market Amount <br />3. Contributor Information ❑ Add ❑ Remove <br />a. Full Name, Bailing Address & Phone <br />b. Type of Contributor <br />c. (. onlatcnta <br />(include city, state, & alp) <br />❑ Individual <br />❑ Candidate <br />❑ P.Ay <br />❑ PAC <br />❑ Referendum <br />d. Election Sinn to Date <br />❑ Other Receipt Source <br />$ <br />e. Description <br />f. Date (mtnlddlyyyy) <br />g fair Market Amount <br />$ <br />4. Total only this Page <br />5. Total of ALL CRO-1510 Pages <br />$ r <br />ffh4 line musr be on line 17 of Delalled 5nmmary Page CRO-IIOp) <br />CRCs-1510 NC Stata Board of Elections December 2007 <br />