Political Consultant Form Requirements for Campaign Finance

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1 Statement of Organization Packet The Statement of Organization Packet is required for candidates in order to establish a committee with the appropriate Board of Elections. Required forms are the Statement of Organization (CRO-2100A), Certification of Treasurer (CRO-3100), and Certification of Bank Account Information (CRO-3500). Optional forms are Designation of Committee Funds (CRO-3900) and Certification of Threshold (CRO- 3600). These forms are required within 10 days of the committee s inception, along with the first campaign finance report, called an Organizational Report. Instructions on completing each form is located on the NC State Board of Elections website, under the Campaign Finance Tab, along with a sample of most forms. An Organizational Report is due covering the transactions of first few days of the committee, not to exceed 10 days. If the Statement of Organization states that the committee organized on 2/10/2014, then the Organizational Report should cover 2/10/14 to any day within that 10 day period. Coverage between 2/10/2014 and 2/20/2014 is the maximum. For completing the Organizational Report, the committee should sign up for Treasurer Training and Campaign Finance Software Training. Both can be done by ing the NC State Board of Elections at campaign.reporting@ncsbe.gov. The committee can download the software from the website.

2 STATE BOARD OF ELECTIONS 441 North Harrington Street Raleigh, NC GARY O. BARTLETT Executive Director TO: FROM : New Candidate Committees Campaign Finance Office Mailing Address: P.O. BOX RALEIGH, NC (919) CAMPAIGN REP. FAX (919) DATE: February 2012 RE: Organizational Report Organizational paperwork must be filed with the appropriate board of elections office within 10 days of whichever of these actions occurs first: making a public declaration of candidacy; or receiving or spending any money in support of that candidacy; or filing a notice of candidacy The Organizational Report consists of multiple forms. At a minimum, these include the Statement of Organization (form CRO-2100A), the Certification of Treasurer (form CRO-3100), the Certification of Financial Account Information (form CRO-3500), the Disclosure Report Cover (form CRO-1000) and the Detailed Summary (form CRO-1100). Please note that some banks will not set up an account for a committee until the committee is registered with the board of elections. If this is the case, the Board of Elections will register the committee in advance of receiving the CRO-3500; the committee must provide this form immediately after the account is established. Please refer to the Detailed Summary to determine what other forms might be required. The required form for each transaction is noted on the same line as the transaction description. If you have engaged in any of the activities described, please include the cited form. After the Organizational Report has been filed additional reports will be necessary. Refer to the 2012 Candidate Campaign Finance Guide (page 5) for the schedule of reports due. If you are a candidate eligible to file a Certification of Threshold, the financial disclosure part of the Organizational report (CRO forms 1000 and 1100) is not required. See the 2012 Candidate Campaign Finance Guide to determine Threshold eligibility. State Board of Elections campaign finance staff is available to advise new committees on the proper forms to use for campaign finance reporting. Candidates for statewide, legislative and judicial offices file reports at the State Board of Elections. Candidates for county and municipal offices file reports at the County Board of Elections.

3 Amendment Statement of Organization - Candidate Committee Yes No Use this form to create a new or update an existing candidate committee. This form must be accompanied by forms CRO-3100 and CRO-3500 (when amending, only re-submit if applicable). 1. Committee Information a. Full Name c. ID Number b. Mailing Address (include City, State and Zip Code) d. Date Organized e. Phone Number 2. Candidate Information a. Full Name e. Candidate ID Number Candidate's Primary Committee f. Party Affiliation b. Mailing Address (include City, State, and Zip Code) g. Office Sought (Indicate Non-partisan if applicable) c. Phone Number d. Address h. Next Election Year i. Jurisdiction copy of notices 3. Treasurer Information 4. Custodian of Books Information a. Full Name a. Full Name b. Mailing Address (include City, State, and Zip Code) b. Mailing Address (include City, State, and Zip Code) c. Phone Number d. Address c. Phone Number d. Address I prefer to receive notices by Yes No copy of notices 5. Assistant Treasurer Information Add 6. Account Information (incl. CRO-3500) a. Full Name Remove a. Financial Institution Full Name Add Remove b. Mailing Address (include City, State, and Zip Code) b. Purpose c. Phone Number d. Address c. Account Code d. Type copy of notices CERTIFICATION I certify that the Committee or Fund is in compliance with all applicable provisions of Article 22A, 22B & 22D-22M of Chapter 163 of the NC General Statutes and that no funds are commingled with prohibited or other non-disclosed funds. I further certify that this report is complete, true and correct. Printed Name of Signer Signature of Appointed Treasurer Date CRO-2100A NC State Board of Elections July 2011

4 !" #$ % & '()!'*(( +,-..$ /0.01$. 2-3/0.01.$45 Certification of Treasurer This Certification is used by Candidate Committees to appoint a treasurer to the committee. This form is required and must accompany the Candidate s Statement of Organization FILED BY: Candidate Name: Treasurer Name: Treasurer Address: (include city, state, & zip) Treasurer Phone: I certify that the above information is correct, and I, as candidate, appoint said treasurer to personally fulfill the duties and responsibilities imposed upon the appointed treasurer and subject to the penalties and sanctions in Subchapter VIII. Regulation of Election Campaigns of Chapter 163 of the North Carolina General Statutes. I understand that if the above Treasurer changes, it will be necessary to certify a new treasurer and amend the existing Statement of Organization within 10 days of the vacancy. I further understand that the above Treasurer is required to receive training by the State Board of Elections within three months of this appointment according to Article (k). Date Signed Signature of Candidate Note: This Certification is to be filed at the Election Board where the committee s campaign reports are filed. CRO-3100 Certification of Treasurer June 2007

5 North Carolina State Board of Elections 441 N Harrington Street Raleigh, NC Kimberly Westbrook-Strach Mailing Address Deputy Director Campaign Reporting PO Box Raleigh, NC (919) Fax: (919) Confidential Certification of Financial Account Information This Certification is used to report confidential bank account information for all financial accounts established by the committee and must accompany the Statement of Organization Form FILED BY: Committee Name: Treasurer Name: Treasurer Address: (include city, state, & zip) Treasurer Phone: I certify that the information provided below is true and accurate. I am providing all account information for the above named Committee. These account numbers include all bank accounts utilized, credit card accounts, money market or savings accounts, or any other financial account used for any purpose by the Committee. The information provided on this form is considered confidential and is not subject to public disclosure. The information provided is only used for the purposes of an audit or investigation or as required by a court of competent jurisdiction. Each treasurer (or candidate) must designate below an account code (any number or letter or combination of numbers and letters) by which to refer to the account number on reports. If an account number is used as the account code, confidentiality of the account number is presumed to have been waived. The treasurer shall maintain all moneys of the political committee in a bank account or bank accounts used exclusively by the political committee and shall not commingle those funds with any other moneys. Type of account Financial Institution Address Account Number Account Code By signing this statement, I authorize agents of the State Board of Elections to inspect all accounts provided. Date Signed For Candidate Committees Only Signature of Candidate or Treasurer In lieu of providing account information, I certify that this committee will not raise any money nor spend any money except that which is the candidate s personal funds. I furthermore understand that an audit or investigation could warrant the probe of any personal bank account that is being used for campaign expenditures. By signing this statement, I authorize agents of the State Board of Elections to inspect applicable accounts. Date Signed Signature of Candidate or Treasurer CRO-3500 Certification of Financial Account Information August 2012

6 !" #$ % & '()!'*(( +,-..$ /0.01$. 2-3/0.01.$45 Certification of Threshold This Certification is used to declare or withdraw a committee s intent to raise or spend $1,000 or less in the current election cycle. This Certification is only valid for political party committees and candidates for a county office, municipal office, local school board office, soil & water conservation district board of supervisors, or sanitary district board. FILED BY: Committee Name: Treasurer Name: Treasurer Address: (include city, state, & zip) Treasurer Phone: Check One: I certify that this committee intends to neither receive nor expend more than $1,000 during the current election cycle under the procedures set forth in G.S A. This certification will remain in effect until the end of the election cycle for this committee. If this committee exceeds $1,000 in contributions or expenditures during this election cycle, I understand that I must immediately notify the appropriate board of elections and file required campaign finance reports. THIS DECLARATION CAN ONLY BE MADE AT THE BEGINNING OF AN ELECTION CYCLE. I am withdrawing my Certification to remain at or under the $1,000 threshold. I will now be required to file the next scheduled report for all contributions and expenditures that have not been previously reported from the beginning of the current election cycle. I further agree to file all future reports required. Date Signed Signature Note: This Certification is to be filed at the Election Board where the committee s campaign reports are filed. CRO-3600 Certification of Threshold December 2009

7 North Carolina State Board of Elections 506 N Harrington Street Raleigh, NC Kimberly Westbrook-Strach Mailing Address Deputy Director Campaign Reporting PO Box Raleigh, NC (919) Fax: (919) Candidate Designation of Committee Funds This form is used by candidate committees only and allows the candidate to designate in the event of their death, how the committee s funds are to be disbursed using the nine allowable methods outlined in B(a). Candidate Name: Committee Name: Treasurer Name: If Candidate is own treasurer, designate an agent to carry out designations: Committee ID #: Level Registered: [State] [County] If county, specify: I,, hereby direct that in the event of my death or incapacity all (Name of Candidate) funds remaining in my Campaign Committee account(s) (after payment of permitted outstanding debts or reasonable expenses for winding up the Committee or closing office) be paid in the following manner as permitted by N.C. Gen. Stat B(a). Name of Entity Plan for Disbursement (eg. Amount or %) (Select from B(a)) By signing this form, I certify that the foregoing entities are eligible beneficiaries under N.C. Gen. Statute B(a). A copy of this form should be maintained with the Committee records. Signature of Candidate: Date: Note: This Designation is to be filed with the Election Board where the committee s campaign reports are filed. CRO-3900 Candidate Designation of Committee Funds December 2009

8 B. Use of contributions for certain purposes. (a) A candidate or candidate campaign committee may use contributions only for the following purposes: (1) Expenditures resulting from the campaign for public office by the candidate or candidate's campaign committee. (2) Expenditures resulting from holding public office. (3) Donations to an organization described in section 170(c) of the Internal Revenue Code of 1986 (26 U.S.C. 170(c)), provided that the candidate or the candidate's spouse, children, parents, brothers, or sisters are not employed by the organization. (4) Contributions to a national, State, or district or county committee of a political party or a caucus of the political party. (5) Contributions to another candidate or candidate's campaign committee. (6) To return all or a portion of a contribution to the contributor. (7) Payment of any penalties against the candidate or candidate's campaign committee for violation of this Article imposed by a board of elections or a court of competent jurisdiction. (8) Payment to the Escheat Fund established by Chapter 116B of the General Statutes. (9) Legal expense donation not in excess of four thousand dollars ($4,000) per calendar year to a legal expense fund established pursuant to Article 22M of Chapter 163 of the General Statutes. 170(c) of the Internal Revenue Code of 1986 (26 U.S.C. 170(c)) (c) Charitable contribution defined. For purposes of this section, the term "charitable contribution" means a contribution or gift to or for the use of-- (1) A State, a possession of the United States, or any political subdivision of any of the foregoing, or the United States or the District of Columbia, but only if the contribution or gift is made for exclusively public purposes. (2) A corporation, trust, or community chest, fund, or foundation (A) created or organized in the United States or in any possession thereof, or under the law of the United States, any State, the District of Columbia, or any possession of the United States; (B) organized and operated exclusively for religious, charitable, scientific, literary, or educational purposes, or to foster national or international amateur sports competition (but only if no part of its activities involve the provision of athletic facilities or equipment), or for the prevention of cruelty to children or animals; (C) no part of the net earnings of which inures to the benefit of any private shareholder or individual; and (D) which is not disqualified for tax exemption under section 501 (c) (3) by reason of attempting to influence legislation, and which does not participate in, or intervene in (including the publishing or distributing of statements), any political campaign on behalf of (or in opposition to) any candidate for public office. A contribution or gift by a corporation to a trust, chest, fund, or foundation shall be deductible by reason of this paragraph only if it is to be used within the United States or any of its possessions exclusively for purposes specified in subparagraph (B). Rules similar to the rules of section 501(j) shall apply for purposes of this paragraph.