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Disbursements <br />Amendment <br />Pg 4 of 4 [3 V.,, M No <br />Use tins farm to report expendinres from the committee for operating expenses. contributions to candidate political <br />committees and coordinated narry expenditures <br />1. Cominduee FaU Name (and F=4 if a linable) <br />............. ................. I-- . . .... ......................................................... .............. . ............... . . ...... . ..... ------ <br />2. 11)'Number <br />------------------------------ ................. <br />CONIM11TH:T0 ELECT KRIS ]T.I, SWAYZE <br />3. Type of Dbbursement ttae <br />...........................fPdattsa <br />y�w................. - ---------------------------------- I .......................... ............ : ------------------- ........................ . ............ ..... <br />to ti'!al ccmmateei arry F-%ip-anditwes <br />4. Payee Inforntation [I Add 0 Remove <br />a- Full Name, -N-lailing Address & Phone <br />b, Coordiurted Committee -Name <br />. . ...................................................................... <br />d, Cow eata <br />......................... ........ ............................. <br />--------- - -------------------------------- ....... . . . .................... <br />US POSTAL SERVICE <br />c. Lewel Registered (Specify) <br />M El-d- �- 13-' t"-v: <br />0 Stata [3 <br />............... . ............ <br />66 MCCACHERN BLVD SE <br />CONCORD, NC 28025 <br />Election SUM to Date <br />..... ............. <br />98,N) <br />L.Axcount Code <br />----------------- -- - ------- - ----- - - 1.1111-111—.1 <br />g, Form of Payment <br />11-1-11 -, ............... <br />k. Purpose Code: <br />. - <br />i, Date <mmdd.yyjy) <br />-------- - - <br />j..tmouna <br />....... . ... . . I .. <br />IL Required Remarks <br />................. . ..... . ...... I ........................... . . <br />123456 <br />Eketric Funds Tian <br />1 <br />05/1512026 <br />$ 98.00 <br />-5. Total orth- dtis Page 98.00 <br />6. Total of ALL CRO-13 10 Pages <br />(This fine foes in line 13a of Derailed Ssimmirri, Page CRO-11 00 V Operating Expenses) 5 5,099.91 <br />ffhfir line goes in line 13b of Doweled Sn-"Inirri, Page CRO-11 00 if connib to ca?ddidn'te'v'Pohdral Comm) <br />(Thn line goes in line 13c of Derailed Surtirpian Prsr CRO-11 00 if Coordinewd Pam, Expendifw-rs) <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* - E4UiPWeJ1t G - Political Parm H11- - Holding Public Office Expenses <br />I - Postage J - Penalties K* - Office Expenses Q* -Donation to Legal Expense Fund <br />0* Other <br />Codes require detailed ex teld (k) planation in required remarks f <br />CRO-1 310 'NC State Board o- F-I,-cttom Vxe-inber <br />