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LDForm CPF M 102: Campaign Finance Report <br />Municipal Form � r 1 -g r It {Z� 54_ <br />Office orcampadgn and Political n 1swe I-" <br />Pile with: <br />City or Town Clerk or Election Commfafm <br />Please print or type all information, except signatures. <br />Fin r agPeU °I�ecemberons 31 2Tle17 <br />ReporingpertadHeginning_J"�I11ary 1 2017 Ending <br />Type of report: (Check one) <br />08th day preceding preliminary 08th day preceding election 030 day after election ®year-end report ❑dissolution <br />Joe Pato <br />Full Name of Candidate (If applicable) <br />Selectman <br />Office Sought and District <br />900 Mass. Ave., Lexington, MA 02420 <br />Residential Address <br />TOL No. (optional) <br />Committee to Elect Joe Pato Selectman <br />Committee Name <br />Kerry Brandin <br />Name of Committee Treasurer <br />16 Franklin Rd, Lexington, MA 02420 <br />Committee Mailing Address <br />Tel. No. (optional) <br />SUMMARY BALANCE INFORMATION: <br />Line 1: Ending balance from previous report <br />$ 209.17 <br />Line 2: Total receipts this period (page 2, line )1) <br />$ 0.00 <br />Line 3: Subtotal eine t plus line 2) <br />$ 209.17 <br />Line 4: Total expenditures this period (page 3, line Its) <br />$ 9.17 <br />Line 5: Ending balance (tine 3 minus line a) <br />$ 200.00 <br />-------------------- -------------- <br />Line 6: Total in-kind contributions this period (page a) <br />$ 0.00 <br />Line 7: Total (all) outstanding liabilities (page a) <br />$ 14 as <br />Line 8: Name of bank(s) used Cambridge Savings Bank <br />Amdavit of ConaltinTreaaurarr <br />I certify dw I have exa shad ads report including enadted sch dules and it 4 to the bed of my knowledge and belief, a true and eo rPic4 rlatemmt of all ampeign <br />Cowles activity, including all conuibutlom, loam, rw6p4, expe"num, diaburvacuu, btddnd contributions and liabilities for this reporting period and repro enp dw <br />eampsign then O, usivity of all perms acing under the authority son behalf of rids owunium In soconimoo with the requiranents ofM.O.L, o. $5. <br />LAS signed wader the Penalties of per)uryr <br />.--i <br />1/212018 <br />FOR CANDWATE FILINGS ONLY: (CANDIDATE MUST SIGN BELOW) <br />Affidavit orCandlda4s (cltttk l box osdy) <br />❑ Candldaa with Committee amt no*cavity hwepadent ofdte eommmaa <br />I oenify dot I lave oundeed this report including alladW seladuta and it it, to the bat of my knowledge aid belie& a toe and complete statement Oren cufiWp <br />finuaa activity, of all persons acing under do Authaniry or on behalf of gds oomadees in accordance with the roquiranems of M.O.I. c. 55. 1 have not received any <br />contributions, incurred any liabilities nor mado my *VmaWm on my behalf during this roportingpodad. <br />❑ Cmndldatewithout Commllke OR Csndidx4 with dndependenl "Oly nllns separate report <br />1 certify that I have examined this report Including atacdad tdadules and 4 4 In da beet of my knowledge and beII4 awe and complete eatmant of All ampsign <br />finance activity, alluding cadributione. tam, mceip4 experdlnw, didasmang irokind eordributi" and liabilities for this reposing period and represents the <br />cmnpaignfuanc*xxxlyylwty of,#x-•.�-R�.-,�,�—� aping under the sudarity oro bduVof this cormnince in accordance with aw requirements ofM.QL. e. 35. <br />L�/I ,t '\- t glguedunderMeperWaesofper)ury; <br />