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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: <br />City or Town Clerk or Election Commission <br />:2 2/13/2015 <br />Reporting Period - Beginning: 1/1/2015 Ending: 2/13/2015 <br />Type of report: Pre- election <br />Thomas R. Diaz Tom Diaz for School Committee <br />Full Name of Candidate <br />Committee Name <br />School Committee Alice M. Pierce <br />Office Sought/ District <br />354 Waltham St <br />Lexington, MA 02421 <br />Name of Committee Treasurer <br />1010 Waltham St Apt 419 <br />Lexington, MA 02421 <br />Residential Address <br />Committee Address <br />SUMMARY BALANCE INFORMATION <br />Ending Balance from previous report: <br />Total receipts this period: <br />Subtotal: <br />Total expenditures this period: <br />Ending Balance: <br />Total inkind contributions this period: <br />Total outstanding liabilities: <br />Name of bank(s) used: TD Bank <br />$3,262.70 <br />$2,045.00 <br />$5,307.70 <br />$580.72 <br />$4,726.98 <br />$0.00 <br />$6,015.22 <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 <br />belief, a true and complete statement of all campaign finance activity including all contributions, loans, receipts, <br />expenditures, disbursements, inkind 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 <br />requirements of N.G.L. c. 55. <br />Signed under the penalties of perjury: <br />Treasurer's signature (in ink) <br />7 <br />Date <br />Aff' vit of Candidate (check 1 box only) : <br />Candidate with Committee and no activity independent of the committee <br />I certify that 1 have examined this report, and attached schedules and it is, to the best of my knowledge and belief, a <br />true and complete statement of all campaign finance activity, of all persons acting under the authority or on behalf of <br />this committee in accordance with the requirements of N.G.L. c. 55. I have not received any contributions, incurred <br />any liabilities nor made any expenditures on my behalf during this reporting period. <br />El Candidate without Committee OR candidate with independent activity filing separate report. <br />I certify that I have examined this report and attached schedules and it is, to the best of my knowledge and belief, <br />a true and complete statement of all campaign finance activity including contributions, loans, receipts, expenditures, <br />disbursements, inkind 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 <br />requirements of M.G.L. c. 55. <br />Signed under the penalties of perjury: <br />