2017-12-31-Hai-OCPF - Laserfiche WebLink

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Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance Commonwealth �f Moecarhucntte File with: Citv or Town Clerk or Election Commission Fill in Reporting Period dates: Beginning Date: 11/08/2017 Ending Date: 12/31/2017 Type of Report: (Check one) ❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election ® year-end report ❑ dissolution Jill I. Hai Candidate Full Name (if applicable) Selectman Lexington, MA Office Sought and District 6 Highland Avenue, Lexington, MA 02421 Residential Address Telephone Number (optional): (781) 862-3776 SUMMARY BALANCE Line 1: Ending Balance from previous report gill Hai for Selectman I Committee Name Jodi R. Galin Name of Committee Treasurer PO Box 248, Lexington, MA 02420 Committee Mailing Address Telephone Number (optional): 1 (781) 910-4681 Line 2: Total receipts this period (page 3, line 11) I:joe 3: Subtotal (line 1 plus line 2) Lilpe 4: Total expenditures this period (page 5, line 14) Line 5 ding Balance (line 3 minus line 4) �® o 2,430 2,430 260.89 2,169.11 Line &-Idtal in-kind contributions this period (page 6) I 82I Line 7: Total (all) outstanding liabilities (page 7) � 0 Line 8: Name of bank(s) used: citizens Bank IfBdavit of Committee Treasurer: 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 ctivity, including all contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for his reporting period and represents the campaign finance activity of all persons acting under the only or onjbchat this room ltee in accordance with the requirements of M.G.L. e. 55. signed under the penalties of perjury: �/ 1 - //% (Treasurer's signature) Date: 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 Ractivity, of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. 1 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 E]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 al I campaign finance activity, including contributions, loaV, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign finance activity of all persons aefifg under the authority wit+4 utirof this committee in accordance with the requirements of M.G.L. c. 55. under the penalties of perjury: signature) Date: