2016-02-22-Anderen-OCPF - Laserfiche WebLink

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Commonwealth of Massachusetts Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance File with_rA.lity be o,F clerk �Fie tioii Ci'ontmission Fill in Reporting Period dates: Beginning Date: 'Jan 1, 2016 Ending Date: Feb 22, 2016 Type of Report: (Check one) 8th day preceding preliminary 8th clay preceding election ❑ 30 day after election ❑ year -end report ❑ dissolution 'Mark Andersen Campaign to Elect Mark Andersen Candidate hill Name (if applicable) Committee Name School Committee member 'Daniel P. Blake Name of Committee Treasurer Ounce Sought and District 12 Thoreau Rd, Lexington, MA 02420 12 Thoreau Rd, Lexington, MA 02420 Committee Mailing Address Residential Address Telephone Number (optional): Telephone Number (optional): SUMMARY BALANCE INFORMATION: Line l: Ending Balance from previous report Line 2: Total receipts this period (page 3, line 11) Line 3: Subtotal (line I plus Zinc 2) Line 4: Total expenditures this period (page 5, line 14) Line 5: Ending Balance (line 3 minus line 4) 0 100 100 100 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: 0 0 0 Citizens Bank Affidavit of Committee Treasurer: I certify that I have examined this report including attac tF1el,edules 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, ex( enditure.. disbursements, in -kind contributions and liabilities for this reporting period and represents the campaign linancc activity of all persons acting under the authority o nr to f if lm}it 1e in accordance with the requirements of M.QI,. c. 55. q (Treasurer's signature) Date: � , / /[7 Signed under the penalties of perj mv: FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate: (check 1 box only) Candidate with Committee and no activity independent of the committee I certify that 1 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 linancc activity, of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. I have not received any contributions, incurred any liabilities nor made any expenditures 00 my behalf during this reporting period. Candidate willmut Committee DR Candidate with independent activity filing separate report I certify That I have examined this report including attached schedules and it is, to the best of any knowledge and belief, a true and complete statement of all campaign ❑ linancc activity, including contributions, loans, receipts, expenditures, disbursements, in -kind contributions and liabilities for this reporting period •cod represents the campaign linancc activity of all persons acing under/he authority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. under/ he Signed under the penalties of perjury: (Candidate's signature)