Laserfiche WebLink
Amendment <br />Disbursements Pg _4 of ❑ Yes ❑ No <br />Use this form to report expenditures from the committee for; operating expenses, contributions to c didatelpolitical <br />committees and coordinated party expenditures. <br />1. Committee Full Name and rand if applicable) - -- - 2. ID Number <br />M2 [ N �a <br />3. TylLe of Disbursement Please use orate CRO-1310 forins for each type of Disbursement) <br />Operating Expenses ❑ Contributions to Candidates/Political Commiiter's ❑ Coordinated Party Expenditures <br />4. Payee information Ll Add ❑ Remove <br />a- Full Name, Mailing Address & Phone <br />(include city, state & zip)�S <br />b. Coordinated Committee Name <br />d. Comments <br />❑� <br />ll <br />US PS <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 />a. Purpose Code <br />i. Date (mmlddlyyyy) <br />j. Amount <br />k. Required Remarks <br />G <br />�,AL-Y C+,- <br />6 -)-,b <br />$ 116. tv <br />4. Payee Information ❑ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />(include city, state. & zip,)f'17t <br />b. Coordinated Committee Name <br />d. Comments <br />D „r( <br />JVt� �' ryz <br />�'r <br />N �� { �� <br />A Ile y — N h <br />G'nco tiD C -7 <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 />It. Purpose Code <br />i. Date [mmldcilyyyy) <br />j. Amount <br />k. Required Remarks <br />C44 <br />G. <br />D 6'r}o � � <br />$ 4 q . 7-z <br />4. Payee Inforf atioa ❑ Add ❑ Remove <br />a. Full Name, Mailing Address & Phone <br />include ci , state, & xi <br />b. Coordinated Committee Name <br />d- Comments <br />i i�i1l n� <br />'�rou - � � � � ►� 3 3 1 <br />c. Level Registered (Specif ) <br />❑ Federal P9 County: <br />❑ State ❑ Municipality: <br />e. Election Sum to Date <br />$ <br />f. Account Code <br />g. Form of Payment <br />It. Purpose Code <br />L Date (mmlddlyvyy) <br />j. Amount <br />k. Required Remarks <br />Pa e $ r• <br />5. Total only this <br />b. Total of ALL CRO-1310 Pages <br />(This line goes in fine 13a afDetailed Summary Page CRO-7100 if Operating Expenses) $ <br />(This line goes in line 13h of Detained Su►nnmry Page CR&11 ad f Contrib to Can&dateslPolltical Comm) <br />(This line goes in line 13c of Detailed Summary Page CRO-1100 if Coordinated Pony Expenditures) <br />7. Purpose Codes(List detailed expenditure code in h. above <br />A* - Media 0* - Printing C* - Fundraising D -'Fo Another Candidate <br />E - Salaries F* - Equipment G - Political Party H* - Holding Public Office Expenses <br />I - 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 />C•RO-1310 NC State Board of Elections December 2009 <br />