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Form CPF M 102: Campaign Finance Report <br />Municipal Forma <br />l ug Office of Campaign and Political Fin C 691AA0q, .19 :• <br />Commonwealth <br />of Massachusetts � <br />File with: � (( lt � Ti4� 00 8 r�lection C mmission <br />I Fill in Reporting Period dates: Beginning Date: January 1, 2012 Ending ate: December 1, 012 <br />of Report: (Check one) <br />❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election X❑ year -end report ❑ dissolution <br />Dawn McKenna <br />Candidate Full Name (if applicable) <br />1 9 Hancock Street, Lexington, MA 02420 <br />Residential Address <br />Committee to Elect Dawn McKenna <br />Committee Name <br />16 Franklin Road, Lexington, MA 02420 <br />Committee Mailing Address <br />SUMMARY BALANCE INFORMATION: <br />Line 1: Ending Balance from previous report -3o 3 <br />�c o <br />Line 2: Total receipts this period (page 3, line 11) 0 .0 <br />Line 3: Subtotal (line 1 plus line 2) $, ® Y. 3 <br />Line 4: Total expenditures this period (page 5, line 14) ®. Dd <br />Line 5: Ending Balance (line 3 minus line 4) � ®s 3 a <br />Line 6: Total in -kind contributions this period (page 6) ®, a <br />Line 7: Total (all) outstanding liabilities (page 7) !3 , U <br />Line 8: Name of bank(s) used: Cambridge Savings Bank <br />Affidavit of Committee Treasurer: <br />I certify that I have examined this report including attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all campaign finance <br />activity, including all contributions, loans, receipts, expenditures, disbursements, in -kind contributions and liabilities for this reporting period and represents the campaign <br />finance activity of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G,L. c. 55. <br />Signed under the penalties of perjury: (Treasurer's signature) Date: 1 1 ^_ 1 <br />Affidavit of Candidate: (check 1 box only) <br />ndidate with Committee and no activity independent of the committee <br />B�I certify that I have examined this report including attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all campaign finance <br />activity, of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. I have not received any contributions, <br />incurred any liabilities nor made any expenditures on my behalf during this reporting period. <br />Candidate without Committee OR Candidate with independent activity filing separate report <br />❑ I certify that I have examined this report including attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all campaign <br />finance activity, including contributions, loans, receipts, expenditures, disbursements, in -kind contributions and liabilities for this reporting period and represents the <br />campaign finance activity of all persops,ac ing under the autho or behalf of this committee in accordance with the requirements of M.G.L. 0 55. <br />., <br />Date: D <br />Signed under the penalties of perjury: (Candidate's signature) <br />