2017-12-31-Kelley-Dissolution - Laserfiche WebLink

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?'p�cs ((, 20 t rl J Municipal Form_ - Office of Campaign and Political Finance b Commonwealth I ' of Massachusetts L EX i 3 File with: City or Town Clerk or Election Commission Fill in Reporting Period dates: Beginning Date: �p` ( 1 7 Ending Date: I I . -3k uj Type of Report: (Check one) ❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election ❑ year-end report Vdissolution �K C � Candidate Full Name (i pplicable) Office Sought and District R ST S e-� Residential A dress Telephone Number (optional): I ')sI I�rltn� �t Committee Name �1 R7 t7 F>• t 6 \ il- Name of Committee Treasurer 5&'Rulsew i YI o� 4�0 Comn6ee Mailing Achiress Telephone Number (optional): I Jol—g(p(, gq g SUMMARY BALANCE 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) 0 Line 7: Total (all) outstanding liabilities (page 7) Q Line S: Name of bank(s) used: dfidavit of Committee Treasurer: certify drat I have examined this report including attached schedules and it is, to the best of my knowledge and belief, a [rue and complete statement of all campaign finance etivity, 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 committee in accordance with the requirements of M.G.L. c. 55. igned under the penalties of perjury: l Q-. Kl(A. � , - W k -n it Q 1l 4 (Treasurer's signature) Date: 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 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. t 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 ceri& 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 fmmce activity, including contributio , ans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the .=paign finance activity of all perso a C g der t uthority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. Ou!•-