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Contributions frow Indhiduals <br />Amendment <br />Pg 7 of 14 Ely.. 13 N. <br />Use this form to report in&vidual contributions over S50 or contributions under S50 if form CRO 1205 is not used <br />1.CQwMdtteeFull N=e(audFMdffj1 vlkiralw <br />.................... ........ . ........ I ................ . r-1-1.1 ................ —I.- . . .... ... . ......... <br />3.ID Number <br />...... .............. . ....... <br />COMMITTEETO ELECT K-PdSTEL SWAYZE <br />3. Contributor Information ❑ Add [I Remove <br />a. Full Name, Mailing .Address & Phone <br />b. Job Title-Pruies"on <br />---- ------------ I ....................... ......... - ................................... <br />a. Comment <br />...... .................................... <br />(include city-, state. & zip) <br />.--- -- -- - ------------------- -.- I ..... . ........ - ............... ....... . .... . ... ................. <br />LAWYER <br />RICHARD KOCH <br />c. Employer's Name -Specific Field <br />............... <br />9949 CLARKES VIEW PLACE <br />CONCORD. NC 28027 <br />LAW OFFICE OF RICHARD <br />e. Election Sum to Date <br />- -------------- ................. <br />KOCH <br />500.00 <br />L Prior <br />g. Account Code <br />---- - ---------- <br />k Form of Payment <br />--------- - ----------------- I....._ __ .......... <br />i. In -kind Description <br />........................................ ................. <br />j. Date <br />. .......................... . ... ­ ...................... <br />kAmount <br />. 11 ------------------ 1111-- .......................... <br />13 <br />123456 <br />Check <br />02/01/2026 <br />S 500.00 <br />11 <br />5 <br />3. Contributor information 0 Add 0 Remove <br />3. Full Name! N"iling Address a Phone <br />b. Job Tidi-Profes"ou <br />11 ............................................... . . . . ...... . .... - --- <br />d. COMMentE <br />-------------- . ................ ............................ <br />(include city, state, & zip) <br />I - -------- - --- -, ..................... . ....... . . . . ......... . . . . .................. . . <br />RETIRED <br />SHANNON LEDER <br />c. Employer's NamerSpecific Field <br />---------------------------------------I.................--- ------------------- <br />805 MCGREGOR DR NE <br />CONCORD, NC 28025 <br />RETIRED <br />e. Election Sum to Date <br />-------------------- ­ ........... ­­ ............................ <br />S 500-00 <br />f Prior <br />C. Amount Code <br />............... 11-11.1111111 ------- <br />h. Form of PV=ent <br />------------------------------- ................. <br />i. In -Bind Description <br />.................... .... - ---------- ---- - ---- ..... . .......... <br />j. Date (mmidsllyyyy) <br />k Amount <br />.................................. <br />13 <br />123456 <br />Check <br />01/02/2026 <br />S 500,00 <br />13 <br />5 <br />❑ <br />S <br />3. Contr*mw h&rmadw 0 Add 0 Remove <br />a. Full.Nwne, Mailing Address & Phone <br />b. Job TitlePmfesaiou <br />........................................---- . . ..... - ------ - - <br />4L Comments <br />- ------------------------ - --- ................................ <br />(include city, state, A zip) <br />.............. . . .... . ........ -­ ....... . . . ............ . ... . . . ............. . .............. <br />RETIRED <br />I <br />MICHELLE MCCARTAN <br />Employer's Name�specifie Field <br />. ....... 111-11--- ........... . .... . ... <br />5662 BURCK DRIVE <br />CONCORD, NC 28027 <br />RETIRED <br />e. Election S-- to Date <br />.... . ........... I ...... . . - - ---- I ........... . <br />S 250.00 <br />f Prior <br />ff, Account Code <br />..1-11-11.1-1 ......... - - - ------- - <br />lt� Form of Payment <br />............... . . ................ . .......... <br />i. In -Kind Description <br />-------------------------- ................................. <br />i. Date (wWddlyyyy) <br />... ........ 11-111..- ... . .. . ...... .. <br />IL Amount <br />......................... <br />13 <br />123456 <br />Credit Card <br />02/11/2026 <br />S 250.00 <br />❑ <br />S <br />4. Total 0*- tMS Page S 1,250.00 <br />5. Total of AT I CRO-1210 Pages S 12,334.45 <br />Min blue inwsrtw an hue 6 of Ddioded Sptminon- Page (JUM100) <br />CRO-1 210 NC State Board of h1acun" -44)m ZAIV <br />