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Form CPF M 102: Campaign Finance Report /III -I <br />Municipal Form, <br />Office of Campaign and Political Flume <br />Pile with; <br />City or Town Clerk or Elation Coumdalon <br />Please print or type all information, except signatures. <br />Fill in dates: syra5 <br />Reporting Period Beginning A I , <br />20Yr6 Ending vecemberpa 31 21716 <br />Type of report: (Check one) <br />08th day preceding preliminary 081h day preceding election °30 day alter election ®year-end report °dissolution <br />,Joe Pato <br />Full Name of Candidate (If applicable) <br />Selectman <br />Office Sought and Dhlrict <br />900 Mass. Ave., Lexington, MA 02420 <br />. Residential Address <br />Tel. No. (optional) <br />Committee to Elect Joe Pato Selectman <br />Committee Name <br />Kerry Brandin <br />Name of Committee Treasurer <br />16 Franklin Rd, Lexington, MA 02420 • <br />Committee Mailing Address <br />Tel. No. (optional) <br />SUMMARY BALANCE INFORMATION: <br />Line 1: Ending balance from previous report $ 200.00 <br />Line 2: Total receipts this period (page 2, line 11) $ 0.00 <br />Line 3: Subtotal pine 1 plus tins 2) $ 200.00 <br />Line 4: Total expenditures this period (page 3, line 14) $ 0.00 <br />Line 5: Ending balance (line 3 mints lino a) $ 209.17 <br />Line 6: Total in -kind contributions this period (page 4) $ 14.99 <br />Line 7: Total (all) outstanding liabilities (page 4) $ a 17 <br />Line 8: Name of bank(s) used Cambridge Savings Bank <br />Affidavit of Committee Te asurea <br />I artily that I have exandned Ode report including attached schedules and it is, to the bat of my knowledge and belief, a true end complete sWemem of all ampatgt <br />finance activity, including all comnbudan, loon, receipts, axpeediturea, di.Wnaneree, unkind contributions and Iubllilla for this reporting period and represents the <br />campaign finance activity of all perdu actingunda the authority or bdsifof lNa committee in accordance with the requ'remcnu of M.QL a. SS. <br />Signed under the penalties of perjury' <br />Treasurer's aiputua* On ink) <br />Date <br />FOR CANAMIj4TE FILINGS ONLY: (CANDIDATE MUST SIGN BELOW) <br />Affidavit orCandidater (check 1 box only) <br />0 Candidate with Comnilltee and no tedMty independent orthe manatee* <br />I certify that I We examined this repot including steadied schedules and it is, to the bat any knowledge and belief, a true and complete statement oral! campaign <br />rinence activity, ofal pan acting mks. the authorttyor on bdulfof Uric carmine, in accordancewith the requirements of M.O.L o. SS. I have not received any <br />ooarituUom, Intoned any liabilities nor nude any expo dllwa onmy behalf during Ude reporting period <br />O Ca didatewithout Commnke O�Candidate with Independent activity filing separate report <br />I witty out i have examined this report Including alnutad schedules and it k to the bat of my knowledge and belle4 a we and complete statement of all an ,sign <br />fiance activity, including contributions, loam, receipts, expndibuµ disbursements, btkind conuibuQom and liabilities for thin reponing period and represents the <br />campaign finance activity of all pesau acting under the authority or on Walter Ihu ootmniice in accordance with the aqubemenu of M.O.L a SS, <br />Signed under the penalties of perjury; r <br />if <br />Data <br />