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JLnenAment <br />Disbursements Pg L_ of 4 0 Yes El No <br />Use this farm to report expenditures from the committee far operating expenses, contributions to candidate political <br />comrnittees and coordinated vartv expenditures <br />2. ED Number <br />A. camaw" ........... ....... . ..................... 11 ........................................ .................. ...... <br />COMMITTEE ro ELECT KI(I S FEL SWAYZE <br />3.Typea(DbbmrsemeRt fRea-w use separate CRO-131 0 fat W ftdwi* opc d.Xs_butQ <br />M Q s t­in­­!!­&�­2�'�', ................... 0 C m t­n'b­i';­t'i'o' n s to - C "a n- d­ id -a- _r­--__-,.- Political'C-0, M­_Mt­t­,-­-_­s- ' ­­13 C dM­_ t, a-d 'Y' t, w e'�' ................... <br />4. Payee Information 0 Add 0 Remove <br />2. FuU.N-ame- Mailing- Address & Phone <br />b.CoorJ;u-tedConunitteeNwue <br />. . ........ <br />d.Co--ents <br />................. <br />---------------------------------------------------------------------------------------------- <br />CHICK FIL A <br />c. Level Registered (Specify) <br />El i nl----------- - 13 - _: --------------- <br />CONCORD ATTHE VILLAGE <br />CONCORD, NC <br />e, Election Sum kn Date <br />...................... <br />El staw- 0 Nlurticipalitv: <br />............. 11-.111--.1.1 ......................................... <br />S 9934 <br />f.Account Code <br />g. Form of Payment <br />... ..... - <br />h. Purpose Code <br />- - - - - --------- <br />i. Date (nn&4&yyyy) <br />j. Amount <br />k Required Remarks <br />. . ................. ......................................... <br />123456 <br />03/03/2026 <br />S 99.34 <br />MEALS <br />S <br />4. Payee information 0 Add 0 Remove <br />a- FullName-Mailing Address & Phone <br />b. Coordinated Committee Name <br />............... . . .... . ................................... _­_ - ­­­------ <br />d.Co--eaft <br />----- - - -------- - -- . ..... . .......... _­­ - - ­--------- <br />........................................................ <br />CONSTANT CONTACT <br />c, Loral Registered (Specify) <br />890 WINTER STREET, SUITE 300 <br />WALTHAM, MA 02451 <br />e. Election Sum to Date <br />-❑0 stt,- 0 m=i6pafity- <br />---- - - - -------------- --------- - -❑ - --- -------------------- <br />S 319.50 <br />f Account Code <br />F, Form of Payment <br />. ......... ­­­ ............... <br />h. Purpose Code <br />..... ............ <br />i Date (mmid&.Tyy) <br />I ............ <br />j. AjaQuat <br />­--------------------- <br />L Required Remarks <br />------------------------------------ - -------------------------------- - --------- <br />123456 <br />Electric Funds Tran <br />1 <br />03102/2026 <br />5 26550 <br />4. Payee h&rmation 0 Add 0 Remove <br />a- Full Name, XLmling Address & Phone <br />b, Coordinated Committe-eName <br />- --- -------------------------------------------------------------­ <br />d. Comments . ............. <br />...................................... . . . . . ..... . ...... . ......... . .................... <br />GOOGLF <br />c. Level Register" (SpedEr) <br />1600 AMPHITHEIATRE PARKWAY <br />MOUNTAIN VIEW, CA 94043 <br />a, Election Sum to Date <br />........... ­ -1 ..... . .... <br />[3 state [3 m=6PZ11t'V: <br />---------- <br />S 212.73 <br />fAccount Code <br />................... I ........... <br />g. Form of Payment <br />111- ............. I . .......... <br />h. Purpose Code <br />. . ........ <br />i. Date <br />. . .. . . ­ ............ .............. <br />.................... <br />k Required Remarks <br />. ....... . . ­ - ---­-------- <br />123456 <br />Electric Funds Tran <br />A <br />02/27/2026 <br />S 50.00 <br />600GLEADS <br />123456 <br />Liectrie Funds Tran <br />A <br />03102/2026 <br />S 152.73 <br />GOOGLE ADS <br />& Total only this Page <br />567.57 <br />6. Total of ALL CRO-1310 Pages <br />(This line goes in line 1312 ofDercded SuRiAricn- Page CRO-11 00 if OpeTeang Expei"Mia <br />5 5L099.91 <br />(Tkiir line goes in line 13b ofDemded sunini47n. Page CRO-11 00,Tf Confrib to candidarevp0heiral coj"Arl), <br />(Tkiy line goes in fimor Be of Derailed Sunjinery Pale CRO-1100 If Caw-dinr-&d Pon- E_xF@ftdi1We!r) <br />7. Purpose Codes QjM detailed expenditure code in (h-) above) <br />B* - Printing C* - Fundraising D - To Another Candidate <br />E Salaries F* —Equipment G -Political Party H* - Bolding Public Oflice Irpenses <br />I - Postage j - Penalties K* - Office Eww" Q* - Donation to Legal Expense Fund <br />0* Other <br />L*Co4s re quire detailed explanation in required remarks field (1, <br />CR 0-1310 NC Stang Board c' Eldon D--c-.mnb-- 2CCV5 <br />