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Amendment <br />Disbursements Pg 2 of 2 ❑ Yes ® No <br />Use this form to report expenditures from the committee for operating expenses, contributions to candidate/political <br />committees and coordinated parts evenditures <br />1. Committee Full Name (and Fund if applicable) <br />2. ID Number <br />BAILFY FOR CABARRUS <br />CAB- l - - <br />3. Type of Disbursement (Please use sgparale CRO-1310 fortrrsfor each type of Dishllrsement.l <br />❑ Operating Expenses ❑ Contributions to CandidatesTo lit ical Committees ❑ Coordinated Party Expenditures <br />4. Payee Information ❑ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />b. Coordinated Committee Name <br />d. Comments <br />(include city, state, &zip) <br />THE BLIND FOX <br />c. Level Registered (Specify) <br />207 WEST AVE <br />KANNAPOLIS, NC 28081 <br />❑ Federal ❑ County: <br />e. IIection Sum to hate <br />[] State ❑ Municipality: <br />$ 727.32 <br />f. Account Code <br />g. Form of Payment <br />It. Purpose Code <br />i. Date (mmlddlyyyy) <br />j. Amount <br />k. Required Remarks <br />01 <br />Debit Card <br />C <br />02/25/2026 <br />$ 727.32 <br />FR BEV FOR MEET & <br />$ <br />5. Total only this Page $ 727.32 <br />6. Total of ALL CRO-1310 Pages <br />(This line goes in lirte 13a of Detailed Summary Page CRO-1160 if Operating Expenses) � $ 4,153.79 <br />(This line goes in line 13h of Derailed Summary Page CRO-1100 if Cotnrib to Candidates/Polideal Comm) <br />(This line goes in line 13c of Detailed Summary Page CRO-1100 if Coordinated Party Expenditures) <br />7. Purpose Codes (List detailed expenditure code in (h.) above) <br />A* - Media B* - Printing C* - Fundraising D - To Another Candidate <br />E - Salaries F* - Equipment C - Political Party H* - Holding Public Office Expenses <br />I - Postage J - Penalties K* - Office Expenses Q* - Donation to Legal Expense Fund <br />O* Other <br />* Codes require detailed explanation in required remarks field (k) <br />CRO 1.310 NC State Board of Elections tlecernber 2009 <br />