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Commonwealth of Massachusetts Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance I, Fill in Reporting Period dates: Beginning Date: (Nov 30, 2016 File with: City or Town Clerk or Election Commission Ending Date: Jan 20, 2017 Type of Repoli: (Check one) 0 8th day preceding preliminary ❑ 8th day preceding election (] 30 day after election D year -end report D dissolution KATHRYN R. COLBURN Candidate Full Name (if applicable) SCHOOL COMMITTEE Office Sought and District 49 Forest Street, Lexington, MA 02421 Residential Address Telephone Number (optional): I (617) 872 -9428 !SCHOOL COMMITTEE Committee Name (CERISE JALELIAN Name of Committee Treasurer 7 Lois Lane, Lexington, MA 02420 Committee Mailing Address Telephone Number (optional): (617) 733 -6278 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 line 2) Line 4: Total expenditures this period (page 5, line 14) Line 5: Ending Balance (line 3 minus line 4) 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: Affidavit of Committee 'I reasuren 0 7,418 7,418 0 7,418 199.8 0 BROOKLINE BANK I certify that 1 have examined this report including atta hed 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, pendimres, disbursemers in -kind contributions and liabilities for this reporting period and represents the campaign finance activity of all persons acting under the a ority or on behalf of this! =tee in accordance with the • quirements of M.G.L. c. 55. Signed under the penalties of perjury: FOR CANDJDATE FILINGS ONLY: Affidavit of (Treasurer's signature) Date: ndidale• (check 1 box only) Jan 19, 2017 Candidate with Committee and no activity Independent o- he . nrmittee 1 certify that 1 have examined this report including attached schc ules and it is, to the best of my knowledgc 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 4R Candidate with independent activity filing separate report ❑ I cenify that 1 have examined this report including attached schedules and it is, to the best of my knowledge and belief, a toe 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 yodei the authority or 0 behalf of this committee in accordance with the requirements of M.G.L. c 55. i Signed under the penalties of perjury: a ' — (Candidate's signature) Date: Jan 19, 2017