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Statement of Organization - Candidate Committee Is this statement: <br />New Amended <br />Use this form to create a new or update an existing candidate committee. <br />This form must be accompanied by form CRO-3500. An amended form its rectuired for each new election year. <br />1. Committee Information <br />a. Name of Committee <br />_ <br />d. ID Number <br />Committee to Elect Phil Henry <br />b. Mailing Address (include Ci , State and Zip Code) <br />e. Date organized <br />515 Claramont Dr. SW <br />Concord, NC 28027 <br />12/12/2025 <br />c. Committee Website (optional) <br />f. Phone Number <br />317-443-0847 <br />2. Candidate Information <br />a. Full Name <br />c. Party Affiliation <br />Phillip Lee Henry <br />Democratic <br />b. Mailing Address (include City, State, and Zip Code) <br />f. Office Sought <br />515 Claramont Dr. SW <br />Concord, NC 28027 <br />County Commissioner <br />c. Phone Number <br />d. Email Address <br />g. Next Election Year <br />h. Jurisdiction <br />317-443-0847 <br />plhenry0115@yahoo.com <br />202$ <br />Cabarrus County <br />❑ Email copy of report notices <br />3. Treasurer Information <br />4. Assistant Treasurer Information <br />a. Full Name <br />a. Full Name <br />NIA ---- <br />+ <br />J r� Wiy5 r 1c, y+�[ �7 tJ c, <br />b. Address (include City, State, and Zip,Code) <br />b. Mailing Address (include City, State, and. Zip Code) ., _ IN <br />RMailing <br />T f fi V° r 5 'iT- 5 E <br />DEC <br />c. Phone Number <br />Address <br />c. Phone Number <br />d. Email AddressCAA__—BA <br />BOARD <br />Ld.mail <br />Send re ort notices by email Yes MjNo <br />❑ Email copy of report notices <br />5. Custodian of Books Information Kee er of Ree <br />5. Account Information (incl. CRO-3500) <br />a. Full Name <br />a. Financial Institution Full Name <br />NIA <br />Pinnacle <br />b. Mailing Address (include City, State, and Zip Code) <br />b. Purpose <br />Campaign Account <br />C. Phone ♦umber <br />d. Email Address <br />6. Account Code <br />r. Type <br />Checking <br />❑ Email copy of report notices <br />I certify that the Committee is in compliance with all applicable provisions of Article 22A of Chapter 153 of the <br />NC General Statutes and that no funds are commingled <br />with prohibited or other non -disclosed funds. 1 further <br />certify that this report is complete, true and correct. <br />VT Wif CIO y« k j <br />I �- <br />Printed Name ofTreasurcr Sign f App r urer Date <br />I certify that the information above is correct, and I, as the candidate, appoint said treasurer to personally fulfill <br />the duties and responsibilities imposed upon tie aappe' d t easurer and subje to the penalties in Article 22A o <br />Chapter lft3 of he NC General Statutes. <br />: I t c c yep� <br />� Z./, /'?, S- <br />Printed 14ame of Candidate <br />Signabre of Candidate Date <br />C'RU-210014 NC State Board of Elections November 2019 <br />CEfVED <br />F,tSON <br />19 2025 <br />US COUNTY <br />F EI.ECTiONS <br />