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0 <br />VOTE <br />rT1T� <br />NORTH CAPOLINA <br />STATE BOARD OF ELECTIONS <br />Candidate Designation of Committee Funds <br />This form is used by candidate committees only and allows the candidate to designate in the event of their death, <br />how the committee's funds are to be disbursed using the eight allowable methods outlined in 163-278.1613(a). <br />This Designation is filed at the Board of Elections office where the committee's campaign reports are filed. <br />Candidate Name: w , alz%,2. ,C ae-y- ,r A-e <br />Committee Name: coo -.- -� / 9,_r To Y/e-� 0, // &,.r4 «-e-- <br />Treasurer Name: Air <br />If Candidate is own treasurer, designate an agent to carry out designations: 5kA-r-- T3—r� <br />Committee ID #: <br />Level Registered: [State] [County] If county, specify: Cam- r e <br />11 MMAw ,l.-• 41�1rb -, , hereby direct that in the event of my death or incapacity all <br />(Name of Candidate) <br />funds remaining in my Campaign Committee account(s) (alter payment of permitted outstanding <br />debts or reasonable expenses for winding up the Committee or closing office) be paid in the <br />following manner as permitted by N.C. Gen. Stat. 163-278.16B(a). <br />Name of Entity <br />(Select from §1 d3-278.1 b8(a)) <br />2. 'V� fVP C1 <br />3. <br />Plan for Disbursement (ea. Amount or <br />fn 0 <br />RECEIVED <br />IN-PFRSQN <br />DEC 2 2 2025 <br />CABATP :" PUNTy <br />By signing this form, I certify that the foregoing entities are eligible beneficiariaora "�-ETICNS <br />Gen. Statute 163-278.16B(a). A copy of this form should be maintained with the Committee <br />records. <br />Signature of Candidate: <br />Date: <br />CRO-3900 <br />Candidate Designation of Committee Funds <br />