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±' <br />.`� Form CPF Rl: Itemization of Reimbursements <br />Commonwealth Municipal Form <br />of Massachusetts <br />Office of Campaign and Political Finance <br />File with: <br />City or Town Clerk or Election Commission <br />1/4/2013 <br />Benghiat, Gilbert <br />Individual Being Reimbursed <br />Jessie Steigerwald for School Committee <br />Committee Name <br />$209.03 <br />Amount of Reimbursement <br />11/29/2012 <br />Date of Reimbursement <br />Signed under the penalties of perjury: <br />Y —,. <br />Candidate's /Treasurer's signature (in ink) <br />Date Vendor Name and Address <br />11/25/2012 Go Daddy <br />14455 N. Hayden Rd., Ste. 226 <br />Scottsdale, AZ 85260 <br />Date <br />Amount Purpose <br />$209.03 Website Expenses <br />