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Amendment <br />Outstanding Loans PP. of 3 ❑ Yes © No <br />Use this form to wort any outstanding loans received dt>Zing a previous reporting period and until the loan is paid in full. <br />1. Commiit+ee Full Name and Fund if a lkaMe 2. lD Number <br />L' on,me�v S e.c l�- t �L cis C►� d ' ��� <br />3. Leader Information ❑ Add. n Remove <br />a. Full Name, Maifrag Address & Prone <br />(include city, state, &tip) <br />b. Job ThIdPrefession <br />d. Comments <br />C(e;r K Cnt W L vjr <br />Cab0,,tii',,_5 (:�p� <br />�i+•-�-iPr� ��AA�ta "-�ccs-F �AI��S <br />17e.rti+1 Lct ri F1rr. i t3 �- <br />L_Dn�x,a, N e Agoa� <br />e. Start Date (mm/ddlyyyy) <br />r Employees IVamdSpeei6c F�e3d <br />Qai j I ! <br />1 <br />��.. <br />t: End Date (raotlddlyyyy) <br />Al /I <br />g, Rate <br />iw Security Pledged <br />i. iA igioaf 1 ma Amount <br />J. Remaining d aan Balm" <br />t] p <br />� i <br />n v <br />k. Folt Name of Lending Institution <br />L Eone Nomber <br />tY �tq <br />13. Lender informatiou U Add LI Remove <br />a. Fail Name, Maffing Address & Phone <br />(include city, state, & rip) <br />k Job irldeIProfeldw <br />d. Comments <br />��y. <br />CI �'C � 0� 11 <br />(�—abc wir S C Vn <br />['f1QYsl� hr �a, o <br />1 <br />DO Pe1n-u Lana *15Z Rn\ 1()4 <br />Clb'� I [i C 'AS025 <br />c.StartDate (mm/ddlyyyy) <br />c. Employer's Name5pecific Field <br />n <br />►C NOC <br />C End Date (mmlddy"" <br />N. R <br />g. Rate <br />h. Security Pledged <br />i, OrWnal Loan Amount <br />j. Remaining Lunn Babace <br />°/n <br />fl <br />� <br />©Uo . <br />It Full Name of Lending Institution <br />L Loan Number <br />n <br />I J. inane Mormation IJ Add f I Remove: l <br />a. Fuit Name, Maifieg Address & Phone <br />(include city, state, & zip) <br />h..iob TidwVrofession <br />d. Comments <br />P n Rm o + <br />'j` <br />G0V,,C= C a�Uai <br />e. Start Date (mmlddlyyyy) <br />e. Employers Name Specific Field <br />01 /Oq /:o[`� <br />{ <br />ll C.AGE <br />f End Dare (mom s l <br />N <br />g. Raft <br />IL Security Pledged <br />k 0ftinal loan Amnmat <br />1. Remaining Loan Balance <br />C)% <br />1A <br />LA <br />+'7 <br />e7{ � � <br />- '.j ` � G 0 <br />L Fuld Name of Leading lustftutiou <br />i_ Lawn Number <br />i1 <br />4. Total anty this Pa <br />5. Total of ALL CRO-1430 Pages <br />(77ris Itnenursl be vn Tire2l afDeiailed SuRaara�v Pgge CIQU-IIpiU} � <br />CRO-1430 NC State Board of Elections December 2RD7 <br />