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CimmowMill <br />of Mw atIRM <br />Form CPF M 102 -0: Campaign Finance Report <br />Municipal Form <br />brute of Campaign and Political Finance <br />City or Town of: J_ jc(r)C( o <br />Please print or type all Information, except signatures. <br />CJ mHI /J41 ronil, <br />Lty(ng CA <br />ffice --/-(1)/4-17/06-' <br />Fill in dates: Month Day Year <br />Reporting Period Beginning 0 I 01 2-0 (S' Ending ( Z 3 I <br />Month Day <br />Year <br />Lo ISf <br />Type of Report: (Check One) <br />o 8th day preceding 0 8th day preceding election ❑ 30th day following election <br />preliminary/primary (Town or Special) <br />Pursuant to M.G.L., Chapter 55: <br />1. I certify that 1 am a candidate for or hold Municipal Office, <br />2. 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 />3. I certify that I do not have a political committee. <br />DATE <br />I. SIGNATURE <br />Signed under the penalties of perjury <br />II. RESIDENTIAL ADDRESS <br />(Street and Number) <br />III. OFFICE SOUGHT <br />2-0/�( <br />O <br />f ,, <br />A_A !, el <br />(Arc ti v)40 �� h� <br />I K (ter C % <br />Lei ; > au t.H km <br />11/97 <br />0 <br />