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Commonwealth <br />of Massachusetts <br />Form CPF M 102: Campaign Finance Report <br />Municipal Form <br />Office of Campaign and Political Finance <br />File with: City or Town Clerk or Election Commission <br />Fill in Reporting Period dates: Beginning Date: <br />10/18/14 <br />Ending Date: <br />11/25/14 <br />Type of Report: (Check one) <br />❑ 8th day preceding preliminary ❑ 8th day preceding election ® 30 day after election ❑ year -end report ❑ dissolution <br />Robert Rotberg <br />Candidate Full Name (if applicable) <br />Selectman, Town of Lexington <br />Office Sought and District <br />14 Barberry Road, Lexington, MA 02421 <br />Telephone Number (optional): <br />Residential Address <br />Committee to Elect Robert Rotberg <br />Committee Name <br />Michael Bliss <br />Name of Committee Treasurer <br />113 Barberry Road, Lexington, MA 02421 <br />Committee Mailing Address <br />Telephone Number (optional): <br />SUMMARY BALANCE INFORMATION: <br />Line 1: Ending Balance from previous report <br />Line 2: Total receipts this period (page 3, line 11) <br />Line 3: Subtotal (line 1 plus line 2) <br />Line 4: Total expenditures this period (page 5, line 14) <br />Line 5: Ending Balance (line 3 minus line 4) <br />1295.56 <br />Line 6: Total in -kind contributions this period (page 6) <br />Line 7: Total (all) outstanding liabilities (page 7) <br />Line 8: Name of bank(s) used: <br />4705.00 <br />6000.56 <br />r <br />575t09 <br />c..„ I 246.47 <br />tr, <br />-f <br />31,88 <br />Citizens 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: ■`s. + S s- <br />(Treasurer's signature) <br />Date:f i;,J "3c /V`T <br />FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate: (cheek 1 box only) <br />Candidate with Committee and no activity independent of the committee <br />n/ 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 />1-7 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 persons acting under the authority or rhalf of this committee in accordance with the requirements of M.G.L. c 55. <br />Signed under the penalties of perjury: <br />[pp e f <br />(Candidates signature) Date:1 4 t ;a I( LI <br />