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Commonwealth of Massachusetts Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance r11 30 File with: City o Town Clerk. or Election Commission Fill in Reporting Period dates: Beginning Date: March 23, 2016 Ending Date: aci taibeit 31)203.ft Type of Report: (Check one) ❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election E year -end report ❑ dissolution Suzie Barry Committee to Elect Suzie Barry Candidate Full Name (if applicable) Committee Name Selectman Kim Coburn Office Sought and District Name of Committee Treasurer 159 Burlington Street, Lexington, MA 02420 66 Liberty Avenue, Lexington, MA 02420 Residential Address Committee Mailing Address Telephone Number (optional): (781) 862 -5853 Telephone Number (optional): (781) 863 -6285 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 perjod (page 5, line 14) Line 5: Ending Balance (line 3 minus line 4) 819.79 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: 0 819.79 112.72 707.07 0 0 TD Bank Affidavit of Committee Treasurer: I certify that I have examined this report including attached schedules and it is, to the hest 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 auth• ity - r behalf o this committee in accordance with the requirements of M,QL. c. 55. Signed under the penalties of perjury: 'it4. 4d (Treasurer's signature) Date: 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 Only knowledge 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 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 and •' authority or on behalf this c nmittee in accordance with the requirements of M.G.L. c 55. Signed under the penalties of perjury: � � }eit - f �,/ �(Candidate's signature) Date: I � 11q I