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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: loci 18, 2014 <br />Ending Date: 'Nov 25, 2014 <br />r <br />- <br />. <br />2,313.32 <br />Type of Report: (Check one <br />❑ 81h day preceding preliminary ❑ 8th day preceding election © 30 day after election • year -end report • dissolution <br />eC - <br />Suzie Barry <br />(Committee to Elect Suzie Barry <br />Committee Name <br />Candidate Full Name (if applicable) <br />Selectman 1 <br />'Kim Coburn <br />Office Sought and District <br />Name of Committee Treasurer <br />1159 Burlington Street, Lexington, MA 02420 I <br />2,425.67 <br />66 Liberty Avenue. Lexington, MA 02420 <br />Committee Mailing Address <br />Residential Address <br />Telephone Number (optional): <br />I (781) 862 -5853 <br />Telephone Number (optional): <br />(781) 863 -6285 <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 />r <br />- <br />. <br />2,313.32 <br />Mt0 <br />eC - <br />4,5da02 <br />2,987:9 <br />r4 <br />1,515.4 <br />Line 6: Total in -kind contributions this period (page 6) <br />Line 7: Total (all) outstanding liabilities (page 7) <br />0 <br />2,425.67 <br />Line 8: Name of bank(s) used: TD Bank <br />Affidavit of Committee Treasurer: <br />1 certify that have examined this report including attached schedules and it is, to the best ofmy 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 activi y of all persons acting under the authori or :.. helnl(ofthis committee in accordance with the requirements ofMO.L- c. 55. <br />(Treasurer's signature) Date:l f®3/rt/' %y <br />Signed uncle the penalties of perjury: <br />FOR CANDIDATE FILINGS ON <br />Y: <br />Affidavit of Candidate: (check 1 box only) <br />Candidate with Committee and no activity independent of the committee <br />❑ <br />1 certify that 1 have examined this report including attached schedules and it is, to the best ofmy knowledge and belief, a true and complete statement of all campaign finance <br />activity, of all persons acting under the authority or an behalf of this committee in accordance with the requirements of MALL. c. 51 1 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 />❑ <br />I certify that I have examined this report including attached schedules and it is, to the bast ofmy knowledge and belief, a true and comptae statement of all campaign <br />finance activity, including contributions, loans, reset penditures, dish lents, in -kind contributions and liabilities for this reporting period and represents the <br />campaign finance activity of all persons acting and the authority or on be of this committee in accordance with the requirements of M.G.L. c 55. <br />Signed under the penalties of perjury: <br />(Candidates signature) Date:I fn-77 <br />