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Y <br /> .t4 <br /> Form CPF R 1: Itemization of Reimbursements.. <br /> Office of Campaign and Political Finance <br /> Commonwealth <br /> of Massachusetts <br /> Office of Campaign and Political Finance <br /> One Ashburton Place,Room 411 <br /> Boston,MA 02108 <br /> (617)979-8300 <br /> Please itemize any reimbursements by detailing the date,payee,address,purpose and amount for each expenditure made by the person being <br /> reimbursed. The total amount reimbursed to the individual(which must be by committee check)should be the same as the amount shown on <br /> the reimbursement form. <br /> Date of Reimbursement: 3/30/2022 <br /> Name of Individual Being Reimbursed: I Janet Kern <br /> iet Clean Lexington <br /> CommitteeName: FQ u <br /> CPF ID Number(if applicable): F77 Telephone Number(optional): <br /> ITEMIZE EXPENDITURES IN EXCESS OF$50 <br /> Date Paid Vendor Name Vendor Address Purpose of Expenditure Amount <br /> 3/29/2022 Conigliaro Industries 701 Waverly St. lawn sign recycling $65.00 <br /> Framingham, MA 01701 <br /> rrl-Ml "` <br /> C);t. <br /> C-) <br /> O <br /> � 1 <br /> 1� <br /> (Include items listed on Page 2) Line 1: Expenditures in excess of$50(itemized above): 65 <br /> Line 2: Expenditures$50 or under(not itemized): <br /> Line 3: TOTAL AMOUNT REIMBURSED: 65 <br /> Signed under the penalties of perjury: <br /> Date: <br /> Signature of Candidate I r asurer <br /> Please prepare a separate report for each reimbursement check issued by the committee. <br />