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VOTE <br />�T1T <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 163-278.16B(a). <br />This Designation is riled at the Board of Elections office where the committee's campaign reports are filed. <br />Candidate Name: Thomas B. Hill <br />Committee Name: Thomas Hill 2026 <br />Treasurer Name: 'r , �' It %L� RECEIVED <br />If Candidate is own treasurer, designate an agent to carry out designations: NIA <br />Committee ID#: 5 <br />Level Registered: <br />[State] Count if county, specify Cabarrus <br />CABARRUS COUNTY <br />BOARD OF ELECTIONS <br />1, Thomas B. Hill hereby direct that in the event of my death or incapacity all <br />(Naine of Candidate) <br />funds remaining in my Campaign Committee account(s) (after 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 Entii! <br />(Seket from f 163-278.16B(a)J <br />1. Libertarian Party of North Carolina <br />2. <br />3. <br />Plan for Disbursement (eg. Amount or %) <br />100% <br />By signing this form, I certify that the foregoing entities are eligible beneficiaries under N.C. <br />Gen. Statute 163-278.16B(a). A copy of this form should be maintained with the Committee <br />records. <br />Signature of Candi <br />Date: <br />CRO-3900 <br />Candidate Designation of Commiltee Funds <br />