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Commonwealth <br />of Massachusetts <br />Fonn CPF M 102 -0: Campaign Finance Report <br />Municipal Form <br />Office of Campaign and Political Finance <br />City or Town on <br />Reporting Period: Beginning: ng: CjCv ;,,, 2=0 ( <br />Please print or type all information, except signatures. <br />(MM /DD /YYYY) <br />nding: <br />l)e C <br />3t ��r5 <br />(MrVVDD /YYYY) <br />Type of Report: (Check One) <br />0 8th day preceding preliminary/primary ❑ 8th day preceding election <br />0 30th day following election (town or special) <br />RelOth day of January (Year -End report) <br />Pursuant to M.G.L. Chapter 55: <br />1. I certify that I am a candidate for or currently hold Municipal Office. <br />2.1 certify that I have not received any contributions, made any expenditures, <br />3. I cc if that I do not have a political committee . <br />or incurred any obligations during this reporting period, and do not have a campaign fund in existence. <br />SIGNATURE RESIDENTIAL ADDRESS <br />DATE PRINT NAME Signed under the .enalt/ies of perjury (Street and Number) OFFICE SOUGHT <br />� <br />J the o-k 1'�.ro,).),-, <br />/ - 19_.._ -- <br />4/7 /Cjhi:tsa•t. <br />%vuvi. 714ockftz e r <br />y <br />1 <br />1 <br />