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Commonwealth of Massachusetts Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance Fill in Reporting Period dates: Beginning Date: 01/07/2016 File with: City or Towi$ ltrk or Eledtion Connnission Ending Date: IFeb 12, 2016 Type of Report: (Check one) ❑ 8th day preceding preliminary © 8th day preceding election ❑ 30 day after election ❑ year -end report ❑ dissolution Eileen Jay Candidate Full Name (if applicable) Lexington School Committee Board Member Office Sought and District 191 Waltham St., Lexington, MA 02421 Telephone Number (optional): Residential Address Eileen Jay for School Committee Committee Name Becky Barrentine Name of Committee Treasurer 100 Bedford St., lexington, MA 02420 Committee Mailing Address Telephone Number (optional): SUMMARY BALANCE INFORMATION: Line 1: Ending Balance from previous report Line 2: Total receipts this period (page 3, line 11) Line 3: Subtotal (line 1 plus line 2) Line 4: Total expenditures this period (page 5, line 14) Line 5: Ending Balance (line 3 minus line 4) 0 Line 6: Total in -kind contributions this period (page 6) Line 7: Total (all) outstanding liabilities (page 7) Line 8: Name of bank(s) used: 6,635 6,635 1,400 5,235 0 88 Citizen's Bank Affidavit of Committee Treasurer: I certify that I have examined this report including attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all campaign finance activity, including all contributions, loans, receipts, expenditures, disbursements, in -kind contributions and Liabilities for this reporting period and represents the campaign finance activity of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.O.L. c. 55. Signed under the penalties of perjury: "� (Treasurer's signature) Date: I Z// VA Le FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate: (check 1 box only) Candidate with Committee and no activity independent of the committee I certify That I have examined this report including attached schedules and it is, to the bat of my knowledge and belief, a true and complete statement of all campaign finance activity, of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.O.L. c. 55. I have not received any contributions, incurred any liabilities nor made any expenditures on my behalf (luring this reporting period. Candidate without Committee DB Candidate with independent activity filing separate report ❑f certify that 1 have examined this report including attached schedules and it is, to the bat of my knowledge and belief, a true and complete statement of all campaign finance activity, including contributions, loans, receipts, expenditures, disbursements, in -kind contributions and liabilities for this reporting period and represents the campaign finance activity of all persons acting under the aWgorily or on behalf of this l fommittee in accordance with the requirements of M.O.L. c 55. C 1 Signed under the penalties of perjury: , �C-- d46t (Candidate's signature) Date: I