Laserfiche WebLink
Amendment <br />Disbursements PC 3 of ❑ Yes ❑ No <br />Use this form to report expenditures from the committee for operating expenses, contributions to4-didatelpolitical <br />committees and coordinated parry expenditures. <br />1. Committee Fall Name and Fund if appiicable 2. ID Number <br />rn i e P 6ectNall ,e_ <br />3. Type of Disbursement Please use sYiparate CRO-1310 fornzy for each of Disbursement <br />❑ Operating Expenses ❑ Contributions to Candidates/Political Committees ❑ Coordinated Party F.rtpenditures <br />4. Payee Information Add El Remove <br />a. Full Name, Mailing Address & Phone <br />(include eit , state & zip) <br />b. Coordinated Committee Name <br />d. Commtnts <br />pi. zz 4 Fkkt- <br />att(-C L SV <br />Y <br />'C DVI gait. D ..i C <br />c. Level Registered (Specify) <br />❑ Federal County: <br />❑ State ❑ Municipality: <br />e. Election Sum to Date <br />$ <br />f. Account Code <br />g. Form of Payment <br />h. Purpose Code <br />i. Date (mmlddlyyyy) <br />j. Amount <br />k. Required Remarks <br />CA <br />4. Payee Information ❑ Add ❑ Remove <br />a. Full Namt, Mailing Address & Phone <br />include city, state, & zip) <br />b. Coordinated Committee Fume <br />d. Comments <br />C-4+1 CK , F 1 +t - <br />�� �� ��G <br />c. Level Registered (Specify <br />❑ Federal <br />❑ State <br />County: <br />Municipality_ <br />e. Election Sum to Date <br />F. Account Code <br />g. Form of Payment <br />h. Purpose Code <br />i. Date (mmlddlyyyy) <br />j. Amount <br />k. Required Remarks <br />4. Payee Information ❑ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />include city, state, &,zi <br />b. Coordinated Committee Name <br />d. Comments <br />�(+ 1sEiK F- ! A <br />CO N 60P 0 L <br />c. Level Registered (Specify)❑ <br />Federal County: <br />❑ State Municipality_ <br />e. Election Sum to (late <br />f. Account Code <br />g. Form or Payment <br />b. Purpose Code <br />i. Date (mmlddlyyyy) <br />j. Amount <br />k. Required Remarks <br />C4+s H <br />Page $ <br />S. Total only this <br />6. Total of ALL CRO-1310 Pages <br />(This line goes in line 13a of Detailed Sa►nmaiy Page CRR-1100 ff operating Expenses) <br />(This fine goes in line 13b of Detailed Summary Page CRO-1100 rf Coatrib to Candidares/Paildcal Comm) j❑� <br />(This fine goes in line 13c of Detailed Summary Page CRO-1100 if CoordPnaled Party Expenditures) <br />7. Pur ose Codes(List detailed expenditure code in above <br />A* - Media B* - Printing C* - Fundraising D _ To Another Candidate <br />E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses <br />l - Postage d - 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-1310 NC State Board of Elections December 2009 <br />