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Comiwiwullb <br />ofMnu4gall <br />Form CPF M 102-0: Campaign Finance Report <br />Municipal Form <br />bmee of Cempatge awl Political Finance <br />City or Town of; <br />Candidate L., bor0.h r p writ Office Mtoaera4 <br />Please print or type all information, except signatures. <br />Fill in dates: Mon Dar <br />Reporting Period Beginning ' pw/t <br />Year Month Day Year <br />A D /o/ Ending Pp C,. 3 / 2 015/ <br />Typo of Report: (Check Ono) <br />0 8th day preceding ❑ 8th day preceding election ❑ 30th day following election <br />preliminary /primary (Town or Special) <br />5 20th day of January <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. I certify that t 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 1 do not have a political committee, <br />DATE <br />I. SIGNATURE <br />Signed under the penalties of perjury <br />11. RESIDENTIAL ADDRESS <br />(Street and Number) <br />IA. OFFICE SOUGHT <br />/ /A(%s <br />maL9h_ <br />"97 /Pob,k o.t Roo <br />m,de Tor <br />r__, <br />c_r; <br />..,.. <br />___ <br />,_ <br />_ <br />n <br />. 11/97 <br />0 <br />