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Commonwealth <br />of Massachusetts <br />Form CPF R1: Itemization of Reimbursements <br />Municipal Form <br />Office of Campaign and Political Finance <br />File with: <br />City or Town Clerk or Election Commission <br />3/24/2015 <br />Diaz, Thomas <br />Individual Being Reimbursed <br />Tom Diaz for School Committee <br />Committee Name <br />$754.03 <br />Amount of Reimbursement <br />3/3/2015 <br />Date of Reimbursement <br />Signed under the penalties of perjury: <br />Candidate's /Treasurer's signature (in ink) Date <br />Date Vendor Name and Address Amount Purpose <br />2/27/2015 Facebook Inc. <br />1601 Willow Rd <br />Menlo Park, CA 94025 <br />2/22/2015 Staples <br />800 Lexington St <br />Waltham, MA 02451 <br />2/20/2015 Staples <br />800 Lexington St <br />Waltham, MA 02451 <br />2/16/2015 Staples <br />800 Lexington St <br />Waltham, MA 02451 <br />2/6/2015 Staples <br />800 Lexington St <br />Waltham, MA 02451 <br />$184.43 Ads <br />$186.97 Supplies <br />$194.41 Supplies <br />$104.54 Supplies <br />n, I e40(31 $83.68 Supplies <br />+ <br />95 ,C kld ;1Z'S � =t f <br />s SUL <br />