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Amendment <br />D' 1 R <br />ISC OSIII'tr UPUI L CQVeI- ❑ Yes® No <br />Use this formfor general reportand committee information, must be signed and submitted along with other detailed forms. <br />Do not use this form to update information. <br />1. Committee Information <br />a. Full Name <br />c. 11) number <br />COMMITTEE TO ELECT PAM ESCOBAR <br />RECEIVED <br />.. , <br />b. Mailing Address (include City, State and Zip Code)I <br />d. [late Filed <br />1115 ANDUIN FALLS DRJAN <br />02 <br />01/21/2024 <br />CHARLOTTE, NC 28269 <br />CA13ARRUS COLWTY <br />e. Phone Number <br />BOARD OF ELECTIONS <br />(980) 494-3235 <br />2. Report Year <br />3. Period Start Date (mm/ddlyy) <br />4. Period End Date (mm/dd/yy) <br />5. Treasurer Full Name <br />2023 <br />07/01/2023 <br />12/31/2023 <br />CATHERINE PARRISH <br />6. Type of Committee (Check One) <br />9. T <br />of Report (check only one type ofre ort from one category) <br />® Candidate Campaign ❑ Parly <br />Municipal <br />State/County <br />Referendum <br />❑ Joint Fundraiser ❑ PAC <br />❑ <br />Organizational <br />❑ Organizational <br />❑ Organizational <br />❑ Referendum ❑ Legal Expense Fund <br />❑ <br />❑ <br />❑ <br />Thirty-five day <br />Pre-primary <br />Pre -election <br />Quarterly <br />❑ First <br />❑ Second <br />❑ Pre -referendum <br />❑ Final <br />❑ Supplemental Final <br />7. T Ypeof Fund (if applicable, check one) <br />❑ "Booster Fund" <br />❑ Building Fund <br />❑ <br />Pre -runoff <br />❑ Third <br />❑ Annual <br />❑ Presidential Election Year Candidates Fund <br />Semi-annual <br />❑ Fourth <br />❑ Special <br />❑ NC Public Campaign Financing Fund <br />❑ <br />Mid Year <br />Semi-annual <br />© <br />Year End <br />❑ Mid Year <br />10. S peciat Report Name <br />❑ Other: <br />❑ <br />❑ <br />Final <br />Special <br />[l Year End <br />[] Final <br />1 El Special <br />8. Number of Fundraisers this Report <br />0 <br />3. Account Information <br />3. Account Information <br />a. Financial Institution Full Name <br />a. Financial Institution Full Name <br />UVIJIIARRM BANK <br />PAYPAL <br />b. Purpose <br />c.:lecount Code <br />b. Purpose <br />c. ,Iecount Code <br />COMMITTEE <br />1 <br />CAMPAIGN <br />2 <br />TRANSACTIONS <br />CONTRIBUTION PORTAL <br />d. Period Begin Balance <br />d. Period Begin Balance <br />FOR WEBSITE <br />$ <br />220.00 <br />S 0.00 <br />CERTH ICATION <br />I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B & 22D-22M of <br />Chapter 163 of the NC General Statutes and that no funds are commingled with prohibited or other non -disclosed <br />funds. I further certify that this report is complete, <br />true and correct and that I have been trained by the NC State Board <br />`ti <br />OA-maL kvc Q� 9-kZ15sk - (l.�a,pq-,j 01/21/2024 <br />Printed Name of Signer <br />Signature of Appointed Treasurer Date <br />FOR OFFICE USE ONLY <br />I <br />Date Received: ! LZ' <br />Employee: Delivery Method <br />❑ Normal Mail <br />❑ Registered Mail <br />Date Postmarked: <br />Employee: <br />❑ Hand Delivered <br />r <br />�! ® Electronically Filed <br />Date Scanned: <br />Employee: <br />Date Data Entered: <br />❑ Signer has not received <br />Employee: <br />mandatory training <br />Please Note: This form cannot be used to amend committee information such as the committee address, treasurer, <br />assistant treasurer, custodian <br />of books information, or account information. <br />You must amend the Statement of Organization CRO-2100A-E to make committee changes, <br />l_l[rFI UUU lNl- Mate MUG Or Elections December 1W/ <br />