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Contributions from Individuals <br />Amendment <br />Pe I of 5 m Tec ❑ Na <br />Use this form to report indn idual contributions over S, 0 or contributions under S50 if form CRO 1205 is not used <br />L Ctmtmittee Full Nome (aHd Fed iii �lic�le� T <br />............................................. . <br />2. ID'_ umber <br />COMMITTEE TO ELECT ROBERT KIRK <br />3. Contributor Information ❑ Add 0 Remove <br />a. Full Name, 3failing Address & Phone <br />b. Job TitleProfessiaa <br />d, Comments <br />(include city, state, St zip) <br />... .......... ................................................... ........................... _........................ <br />.....• ••........................................................................................................................................ <br />MEIJICAL FIELD <br />JEFF ANDREWS <br />TECHNICIAN <br />c. taxplorer'sNs me!5peeWw FieW <br />....................................................................... I .................... <br />3255 Lock Erne Ave <br />Kannapolis, NC 28081 <br />Performance Orthopedics of the <br />e.flection Sum to Date <br />Carolinas <br />] 100.00 <br />f. Prior <br />.............................................--- <br />Z. Account Code <br />h. Farm of Payment <br />-----• •---------------- <br />L In -Kind Description <br />j. Date (sums dd. ■ v ul <br />k Amount <br />❑ <br />01 <br />Check <br />01/1812026 <br />S 100.00 <br />❑ <br />S <br />❑ <br />5 <br />3. Contributor Infvtwation ❑ _add ❑ Remove <br />a. Full N-awe.Mr, iling ?Address & Phone <br />b. ,lob Title -Profession <br />d. Comments <br />(include city, state. S zip) <br />.... .... <br />---------------------- <br />NO JOB TITLE <br />•.....-..................,................ <br />MORRISON CARTER <br />c, Employer's tiame.+Speeifk Field <br />........................................................................................... <br />10120 W Flamingo Rd Ste 4153 <br />Las Vegas, NV 89147 <br />NOT EMPLOYED <br />e. Election Sum to Date <br />100-00 <br />f. Prior <br />.................... <br />g. ?kccouut Code <br />..................... .........................1 <br />h. Form of Payment <br />............ ................__ ._....._..._. <br />L In -Kind Description <br />_................-........._........_._.._... m.-. <br />j. Date (nim d&yyyy} <br />.--••----------------•-•..-•--•------------.. <br />. 'tmoua ht <br />W......................... <br />0 <br />01 <br />Check <br />01/15/2026 <br />3 100.00 <br />❑ <br />S <br />3. Contributor Imfornmatiott ❑ A4d ❑ €(e Ve <br />a. Full Name.. Mailing Address Jq Phone <br />h, Jab Title.Prufession <br />................................................................................................................................................................ <br />d. Comments <br />(include city. state..- zip) <br />................................... <br />MANAGING DIRECTOR <br />CHERYL CRUTCHFIELD <br />c. Empla►•er's tiamefSpeeifle Field <br />...................................................................................... <br />9817 MT PLEASANT RD S <br />MIDLAND, NC 28107 <br />CASCO SIGNS <br />e, Election Sum to Date <br />5 500.00 <br />E Prior <br />g. 'account Code <br />...................................................................................._..................................................................... <br />h. Form ofPs) -ment <br />i.1In--Kind Description _........._............................-........._..................................._....................................... <br />j. Date (mm4loyy y) <br />k Amount <br />0 <br />01 <br />Check <br />01/30/2026 <br />S 500.00 <br />4. Total onk this Page 5 700.00 <br />5. Total of UL CRO-I2I0 Pages ; <br />f nirs line ruresr be on lme 6 of Deratled Sommtan- Pa#e CRO-1109) 7,377.40 <br />CRO-1 210 -:C 3:__ _.-_.e..-r- jP'Ll �CC <br />