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CIONxwl,Itb <br />OMmulladm <br />Form CPF M 102 -0: Campaign Finance Report <br />Municipal Form <br />one of Campaign and Political Finance <br />City or Town of: 1-- e?CIY1Cl If r1 <br />Candidate 3G,Dti � , , Cr0CI`�( Office �SChOD <br />Qcnl rn119-e -t <br />Please print or type all information, except signatures. <br />Fill in dates: Month Day Year Month Day Year <br />Reporting Period Beginning rin I avl s Ending )J.tC 3 1 a or; <br />Type of Report: (Check One) <br />0 8th day preceding 0 8th day preceding election 0 30th day following election 20th day of January <br />preliminary/primary <br />(Town or Special) <br />(Year -End Report)' <br />Pursuant to M.G,L., Chapter 55: <br />vi; I certify that I am a candidate for o aid unicipal Office. <br />I certify that 1 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 />ty: I certify that 1 do not have a political committee. <br />DATE <br />1. SIGNATURE <br />Signed under the penalties of perjury <br />11, RESIDENTIAL ADDRESS <br />(Street and Number) <br />III, OFFICE SOUGHT <br />I/Is,fl to <br />liA(,un-hA-C 0016-. <br />5 Cu.rn'er Coin <br />$cltool enrr,rnl ee <br />11/97 <br />0 <br />