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Disbursements <br />Amendment <br />Pg of ❑ yes No <br />Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political <br />committees and coordinated party exvmditrres <br />1. ommittee Full blame (and Fund if appiieable) <br />0 JC01'I'e-J -Rwats ['_1e.,(VC a Ccx 4 <br />ID umber <br />. Type of Disbursement (Please use separate CRO-131O forms &r each type of I3isbursemenl.} <br />Operating Expenses _ Contributions to Candidates/Polipcal Committees Coordinated. Fart Expenditures <br />4. Payee Information E3 Add ❑ Remove <br />a. Full blame, Mailing Address & Phone <br />include dty, state, & OP) <br />b- Coordinated Committee Nance <br />d. Comnatns <br />I <br />3�� ��� <br />L,� fl <br />�y <br />ev-- EU8- 3�0( <br />c. Level Registered (Spey) - <br />�ede�l �❑-0011nI}�: <br />[I state ❑ Municipality: <br />e. Eleefion7 Sum to hate <br />$ 3(7 j , so <br />. Accauat Code <br />t <br />g. Farm of Payment <br />b. Purpose Code <br />L Date (mmlddlyyyy) <br />j. Amonnt <br />L PAqtsired Remarks <br />$ <br />. Payee Information Add Remove <br />Full Name, Mailing Address & Phone <br />(include city, state, & zip) <br />b. Coordinated Committee Name <br />d. Comments <br />— T <br />G Level Registered (.Specify) <br />cyy de d El County: <br />❑ State ❑ Municipality: <br />e. Election Sum to Date <br />. Account Code <br />g. Form or Paymcat <br />h- Purpose Code <br />i. Date (mm/ddiyyyy) <br />.. Amount <br />k Required Remarks <br />. Payee Information E3 Add Remove <br />Full Name, Mailing Address & Phone <br />(WeWle city, state, & zip) <br />b. Coordinated Committee Name <br />& Comments <br />e. Level Registered (Specify) <br />IDF—Fwer,d —0 county: <br />❑ State ❑ Municipality: <br />e. Fdection Stutz to Date <br />$ <br />. Account Cade <br />g. Form of Payment <br />h. Purpose Code <br />L Date (mmfddlyyyy) <br />'. Amount <br />k. Required Remarks <br />. Total only this <br />Page $ <br />6. Total of ALL CRO-1310 Pages <br />(This line goes in line 13a of Derailed Summary rage CRO-1100 if Operating Expenses) $ <br />(This line goes in line 13h of Derailed Summary Page CRQ4100 if Contrite to CandidateslPohWeal Comm) <br />(Thu line goes in line 13c o Detailed Summary Page CRO-1100 if Coordinated Party E enditures) <br />7. Purpose Codes (List detailed expenditure code in (h.) above) <br />A* - Media B* - Printing C* - Fundraising D - To Another Candidate <br />- Salaries F'* - Equipment G - Political Party H* - Holding Public Office Expenses <br />I - Postage ] - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund <br />O* Other <br />* Codes require detailed exolanation in required remarks field k <br />CRU-131 U NC State Board of Elections December 2iH19 <br />