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,A„Nak „nll <br />OfMwulcuc, <br />City or Town of: <br />Form CPF M 102 -0: Campaign Finance Report <br />Municipal Form <br />/ %,( ,ty/ /�/j /bmee orCampaign and Political Finance eel <br />L.? x(�1S' <br />Candidate <br />Please print or type all Information, except signatures. <br />/Ol4 D r 29 <br />1: 02 <br />t1 <br />Office <br />Fill in dates: Month Day Year <br />Reporting Period Beginning Ending <br />Month - Day Year <br />Type of Report: (Check One) <br />8th day preceding 0 8th day preceding election ❑ 30th day following election CI 20th day of January <br />preliminary/primary <br />(Town or Special) <br />(Year -End Report)' <br />Pursuant to M.G.L„ Chapter 55: <br />I. I certify that I am a candidate for or hold Municipal Office. <br />2. 1 certify that 1 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. I certify that I do not have a political committee. <br />DATE <br />1. SI ATURE <br />Signed under a penalties rju <br />11. RESIDENTIAL ADDRESS <br />(Street and Number) <br />III, OFFICE SOUGHT <br />Lfir Zto sT <br />11/97 <br />0 <br />