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Corxonuealth <br />of Massachusetts <br />Form CPF M 102: Campaign Finance Report <br />Office of Campaign and Political Finance <br />File with: Director <br />Office of Carpaign and Political Finance <br />One Ashburton Place Rm. 411 <br />Boston, MA 02108 <br />16170 979 -8300 <br />l( o is d�M k,�9 4329 <br />Reporting Period: Beginning: 1/1/2015 Ending: 12/31/2015 <br />Type of Report: 2015 Year -end report (tIUN) <br />Cohen, Norm <br />Frill Mace of Candidate <br />Municipal, Lexington <br />Office Sought/ District <br />33 Forest St. #309 <br />Lexington, MA 02421 <br />Residential Address <br />Cohen Committee <br />Cormittee Sane <br />Alice M. Pierce <br />Name of Cormittee Treasurer <br />1010 Waltham St Apt 419 <br />Lexington, MA 02421 <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 />$1,582.96 <br />$0.00 <br />$1,582.96 <br />$0.00 <br />$1,582.96 <br />Total inkind contributions this period: <br />Total outstanding liabilities: <br />Name of Bank Used: <br />$0.00 <br />$0.00 <br />TD Bank <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 />22 fe 1.42 , <br />JitLJL 2o (t <br />Treasurer's signature (in ink) <br />Date <br />Affidavit of Candidate (check 1 box only) : <br />Candidate with Committee and no activity independent of the committee <br />L11 certify that I 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 M.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 />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 N.G.L. c. 55. <br />Signed under the penalties of perjury: <br />; CM/11444.Y <br />Candidate's signature (in ink) <br />A2-1 c? <br />Date <br />