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Commonwealth <br />of Massachusetts <br />Form CPF M 102: Campaign Finance Report <br />Municipal Form <br />Office of Campaign and Political Finance <br />File with: City or ToxrrCleric or Election Commission <br />Fill in Reporting Period dates: Beginning Date: <br />IFebruary 13, 2016 <br />Ending Date: <br />IMarch 222016 <br />Type of Report: (Check one) <br />❑ <br />811, day preceding preliminary ❑ 8th day preceding election © 30 day after election ❑ year-end report ❑ dissolution <br />Isuzie Barry <br />(Committee to Elect Suzie Barry <br />Committee Name <br />Candidate Full Name (if applicable) <br />'Selectman <br />'Kim Coburn <br />Office Sought and District <br />Name of Committee Treasurer <br />1159 Burlington Street, Lexington, MA 02420 <br />166 Liberty Avenue, Lexington, MA 02420 <br />Committee Mailing Address <br />Residential Address <br />Telephone Number (optional): 1 (781) 862 -5853 <br />Telephone Number (optional): (781) 863 -6285 <br />SUMMARY BALANCE INFORMATION: <br />Line 1: Ending Balance from previous report <br />Line 2: Total receipts this period (page 3, line 11) <br />Line 3: Subtotal (line I plus line 2) <br />Line 4: Total expenditures this period (page 5, line 14) <br />Line 5: Ending Balance (line 3 minus line 4) <br />549.02 <br />275 <br />824.02 <br />Line 6: Total in -kind contributions this period (page 6) <br />Line 7: Total (all) outstanding liabilities (page 7) <br />Line 8: Name of bank(s) used: <br />4.23 <br />819.79 <br />0 <br />112.72 <br />TD Bank <br />Affidavit of Committee Treasurer: <br />I certify that I have examined this report including attached schedules and it is, to are best of my knowledge and belief, a true and complete statement of all campaign finance <br />activity, including all contributions, loans, receipts, expenditures, disbursements, in -kind contributions and liabilities for this reporting period and represents the campaign <br />finance activity of all persons acting under the allayed ra - of this co m ee in accordance with the requirements ofhMG.L. e. 55. <br />Signed under the penalties of perjury: (Treasurets signature) Date: <br />I VIA <br />FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate: (check 1 bon only) <br />Candidate with Committee and no activity independent of the committee <br />I certify that I have examined this report including attached schedules and it is to the best of ray knowledge and belief, a true and complete statement of all campaign finance <br />in activity, of all persons acting under the authority or on behalf of this committee in accordance with the requirements ofM.0 L_ c. 55. 1 have not received any contributions, <br />incurred any liabilities nor made any expenditures on my behalf during this reporting period. <br />Candidate without Committee OR Candidate with independent utility filing separate report <br />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 <br />❑ finance activity, including contributions, loans, receipts, expenditures, disbursements, in -kind contributions and liabilities for this reporting period and represents the <br />campaign finance activity of all persons actin gy rrthe authority or on behayof Jiis corn a in accordance with the requirements of M.G.L. e. 55. <br />Date: 4// l/b <br />Signed under the penalties of perjury: L= '�VCx / V(iVf�r'"Yr'= ndidalis signature) <br />