2016-12-31-Cohen-OCPF - Laserfiche WebLink

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Commonwealth of Massachusetts Form CPF M 102: Campaign Finance Rep'ott') Municipal Form Office of Campaign and Political Finance File wish: City or Town Clerk or Election Commission Fill in Reporting Period dates: Beginning Date: 1 —(— 20(6 Ending Date: Iz 3t- 2, it Type of Report: (Check one) ❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election year -end report ❑ dissolution C 0I,, e eft I i(/d 4t-- Candidate Full Name (if applicable) 1 delec Ott_ k0 —, i--zJ cµyfuw Office Sought and District ( 3 3 6 vc s 1" 51- 1f 3 0 q Lee ve- gfri,. 6 3 el 2 r' Residential Address Telephone Number (optional): C,. ft C-GL C a rµ ,.L< :('t'e — Committee Name 1 Al L C_. )—t.. ?r e v( 'e— Name of Committee Treasurer ( roll/ l.J it 1 ftL$ t,tL r r it it (q 11A; tki 2r' a 2-((Li Committee Mailing Address Telephone Number (optional): 7 21—C 11-' 6V ft ( SUMMARY BALANCE INFORMATION: Line 1: Ending Balance from previous report • 'Line 2: Total receipts this period (page 3, line 11) Line 3: Subtotal (line 1 plus linen) Line 4: Total expenditures this period (page 5, line 14) Line 5: Ending Balance (line 3 minus line 4) 17112. q ' 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: 1. 58-2. t 0 D O l o 73a AA-At 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 authority or on behalf of this conunittee in accordance with the requirements of M.G.L. c. 55. Signed under the penalties of perjury: .8,41, CA— ( -L_' ' (Treasurer's signature) Date: I _7 - r'1 FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate: (check 1 box 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 tare 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 ndr made any expenditures on my behalf during this reporting period. Candidate without Committee OR 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 my knowledge and belief, 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 acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L. c 55. Signed under the penalties of perjury: (Candidate's signature) Date:I 1 I ci ) 11