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Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political FinanceCommonwealth of Massachusetts f �p r AM 9: 05' File with; City pr Town Clerk or Election Commission Fill in Reporting Peripi :CL c R KBeginning Date: Eroding Date: CZ�31 :QZZ XINGTQ Type of Report: (Check one) ❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election %year-end report ❑ dissolution Candidate Full Name(if applicable) Committee Name 'Se Cfi BOaaSam e-64!el Office Sought and District Name of Committee Treasurer IQ ; hta.^cl ve, c x>, I v� ��z� 5 s c. I I" oziz l Residential Address Committee Mailing Address rr Telephone Number(optional): �" y �bL ��" Telephone Number(optional): ' —4 b SUMMARY BALANCE INFORMATION: Line 1: Ending Balance from previous report GG 0-TCX Line 2: Total receipts this period(page 3, line 11) 0 Line 3: Subtotal(line 1 plus line 2) 6&0 -i D Line 4: Total expenditures this period(page 5,line 14) 0. 0D Line 5: Ending Balance(line 3 minus line 4) (p ej�► Line 6: Total in-kind contributions this period(page 6) 0 Line 7: Total(all)outstanding liabilities(page 7) Line S: Name of bank(s)used:I uWj,(j ; mx —771 - 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 rity oro behalf i camF� gi#tee in accordance with the requirements of M.G.L.c.55. �v'v,1//�� Date: 0110312A)'),$ Signed under the penalties of perjury: (Treasuref'S Signature) FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate:(check 1 bog 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 best 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.G.L.c.55. I have not received any contributions, incurred any liabilities nor made any expenditures on my behalf during this reporting period. Candidate without Committee DR Candidate with independent activity filing separate report EiI certify that I have examined this report including attached schedules and it is,to the best of my knowledge and belie$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 ac� g under the authors on behalf of this committee in accordance with the requirements of M.G.L.c.55_ Signed udder the penalties of per3ury_ ' (Candidate's signature) Date: q' O3 �Ua3�