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Commonwealth <br />of Massachusetts <br />1: U1 111 'Lit_ i' 1Yi ivy.. campaign t' ivauw n pvi L <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 />[jut 1 204 <br />Ending Date: <br />31,2c1`1 <br />Type of Report: (Check one) <br />❑ 8th day preceding preliminary ® 8th day preceding election Q 30 day after election [year -end report ® dissolution <br />c -L-t✓t?- CI T 14Ata,� <br />Committee Name <br />Candidate Full Name (if pplicable) <br />Name of Committee Treasurer <br />1P rv\` NNO- -r <br />Co nnnittee Mailing Address <br />Office Sought and District <br />1 a �oR t �� -\v-ac v Le:.i...t w' c <br />Residential Address \b.3' <br />2.1 <br />Telephone Number (optional): 17 a 1 - aof • 15 Tio <br />1 C011 \t tti' o.+0 C Peta t eAl. e:i Cadealitt14 <br />Committee Name <br />Linda- a- TS • tali t t i a.t\eS <br />Name of Committee Treasurer <br />16 Ross /rilivc 01, OVA Oz-4P-it <br />Co nnnittee Mailing Address <br />Telephone Number (optional): ir-18t- catol -84'+8 <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 />IO1(' 71 <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 />largo, 71 <br />6 <br />10 76i `1q <br />C-3 <br />O <br />, `J\ 061-CA (c" ?\'\ \< <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: G>,. \' . tiJ o_y Q.i cTj .17..t s (Treasurer's signature) Date: <br />--2-;0t47 <br />FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate: (check 1 box only) <br />Candidate with Committee and no activity independent of the committee <br />❑ <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, 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 tiling separate report <br />in 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 on behalf of this committee in accordance with the requirements of M.G.L. c. 55. <br />Sinner) under thr nen nl fi ec of nerin rv: <br />!Candidate's sinnnhuel <br />Date: I ( ) c d t5 <br />