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Comm: wealth <br />of Massachusetts <br />Form CPF M 102 -0: Campaign Finance Report <br />Municipal Form <br />Office of Campaign and Political Finance <br />City or Town of: Lexington <br />Please print or type all information, except signatures. <br />Reporting Period: Beginning: 01/01/2016 <br />(MM/DD/YYYY) <br />Ending: 12/31/2016 <br />(MM/DD/YYYY) <br />Type of Report: (Check One) <br />D 8th day preceding preliminary/primary ❑ 8th day preceding election ❑ 30th day following election (town or special) <br />20th day of January (Year -End report) <br />Pursuant to M.G.L. Chapter 55: <br />1. I certify that I am a candidate for or currently hold Municipal Office. <br />2. I certify that I have not received any contributions, made any expenditures, or incurred any obligations <br />3. I certify that I do not have a political committee. <br />during this reporting period, and do not have a campaign fund in existence. <br />DATE <br />PRINT NAME <br />SIGNATURE <br />Signed under the penalties of perjury <br />RESIDENTIAL ADDRESS <br />(Street and Number) <br />OFFICE SOUGHT <br />01/04/2017 <br />Charles Hornig <br />75 Reed Street <br />Planning Board <br />