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Cee e>e.eel0. <br />efMondauro <br />Form CPF M 102-0: Campaign Finance Report <br />Municipal Form <br />Office of Campaign end Political Finnee <br />City or Town of: me/ <br />candidate 6/A7/14 1/hnt'n <br />Please print or type all Information, except signatures, <br />Offic <br />Fill In dates: Mouth <br />Reporting Period Beginning <br />;Q l rq <br />Ending <br />Toe <br />Type of Report: (Check One) <br />8th day preceding 0 8th day preceding election 0 30th day following election 0 20th day of January <br />(Year -End Report)' <br />preliminary/primary <br />(Town or Special) <br />Pursuant to M.G.L„ Chapter 55: <br />1. I certify that I am a candidate for or hold Municipal Office. <br />2, I certify that I 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 />1. SIGNATURE <br />Signed under the penalties of perJury <br />./q /rsi - <br />11. RESIDENTIAL ADDRESS <br />(Street and Number) <br />x3$4`,/. (y4 <br />111. OFFICE SOUGHT <br />P /,inn +t m' <br />11/97 <br />