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Form CPF M 102-0: Campaign Finance Report <br />Municipal Form <br />Wet ofCampoign and Political Finance <br />Itt <br />City or Town of. E, V Candidate .�'! F L. A A'( wf A L k f <Of f ice <br />Please print or ripe all information, except signatures. <br />Fill in dates: Month Day Year Month Day,'Vea, <br />Reporting Period Beginning —Lii-1I I lab 1 lcf Ending 0 ,,) I Y <br />Type of Report: (Check One) <br />8th day preceding 8th day preceding election� (Town or following election 20th day of January <br />'r <br />preliminary/primary (Town or Special) (Year-End Report)' <br />Pursuant to M.G.L., Chapter 55: <br />1. 1 certify that I am a candidate for or hold Municipal Office. <br />2. 1 certify that I have not received any contributions, made any expenditures, or incurred any obligations during this <br />reporting period, and do not have a campaign fund in existence. <br />3. 1 certify that I do not have a political committee. <br />DATE <br />1. SIGNATURE <br />Signed under the penalties of perjury <br />11. RESIDENTIAL ADDRESS <br />(Street and Number) <br />111. OFFICE SOUGHT <br />M --t <br />11/97 <br />fYi <br />