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Contributions from Individuals <br />Amendment <br />Pg I of -- ® Yes ❑ No <br />Use this form to report individual contributions over $50 or contributions under $50 if form CRO 1205 is not used <br />1. Committee Full Name and Fund ifapplicable) <br />2. ID Number <br />COMMITTEE TO ELECT INGRID NURSE <br />IN2024 <br />3. Contributor Information ❑ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />(include city, state, & zip) <br />b. Job TitlelProfession <br />d. Comments <br />RETIRED <br />CHECK #8396 <br />ALFRED BROWN <br />100 GROVE AVENUE <br />CONCORD, NC 28025 <br />c. Employer's Name/Specific Field <br />CITY COUNCILMAN <br />e. Election Sum to Date <br />$ 100 <br />E Prior <br />g. Account Code <br />h. Form of Payment <br />i. In -Kind Description <br />j. Date (mmlddlyyyy) <br />k. Amount <br />❑ <br />$ <br />❑ <br />$ <br />❑ <br />$ <br />3. Contributor Information ❑ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />(include city, state, & zip) <br />b. Job TillelProfession <br />d. Comments <br />RETIRED <br />CHECK # 3819 <br />J. SCOTT PADGETT <br />693 S UNION STREET <br />CONCORD, NC 28025 <br />c. Employer's Name/Specific Field <br />MAYOR <br />e. Election Sum to Date <br />$ 250 <br />E Prior <br />g. Aceount Code <br />h. Form of Payment <br />i. In -Kind Description <br />j. Date (mmlddlyyyy) <br />k. Amount <br />❑ <br />$ <br />3. Contributor Information ❑ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />(include city, state, & zip) <br />b. Job Title/Profession <br />d. Comments <br />RETIRED <br />CHECK 96297 <br />RUTHIE ROBERTS <br />131 CAL BOST ROAD <br />MIDLAND, NC 28107 <br />c. >Employer's Nam elSpecifiie Field <br />CLERK OF COURT <br />e. Election Sum to Date <br />$ 100 <br />f. Prior <br />g. Account Code <br />h. Form of Payment <br />L In -Kind Description <br />j. Date (mmlddlyyyy) <br />k. Amount <br />❑ <br />$ <br />❑ <br />$ <br />❑ <br />$ <br />4. Total <br />only this Page $ <br />otal o€ ALL CRO-1210 Pages $ lure must be on line b of Detailed Summary Page CRO-1100) <br />L(TA4 <br />CRO-1210 NC State Board of Elections April 2007 <br />