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Form CPF M 102: Campaign Finance Report
<br />Municipal Form
<br />uV Offcti of gampaign and Political Finance
<br />Commonwealth t(I10 1 ' 1 ::'t �."' 1 . a
<br />of MaccarhucPttc fi tt. ,++(,
<br />Type of Report: (Check one)
<br />❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election year-end report ❑ dissolution
<br />Suzie Barry
<br />Candidate Full Name (i r applicable)
<br />Selectman
<br />Office Sought and District
<br />159 Burlington St, Lexington, MA 02420
<br />Residential Address
<br />Telephone Number (optional) (781) 862-5853
<br />Line 1: Ending Balance from previous report
<br />Line 2: Total receipts this period (page 3, line 11)
<br />Line 3: Subtotal (line I plus line 2)
<br />lCommittee to Elect Suzie Barry
<br />Committee Name
<br />Kim Coburn
<br />Name of Committee Treasurer
<br />66 Liberty Ave, Lexington MA 02420
<br />Committee Mailing Address
<br />'telephone Number (optional). 1 (781) 863-6285
<br />INFORMATION:
<br />Line 4: Total expenditures this period (page 5, line 14)
<br />Line 5: Ending Balance (line 3 minus line 4)
<br />707.07
<br />"I
<br />707.07707. 7
<br />_I
<br />707.07
<br />Line 6: Total in-kind contributions this period (page 6)
<br />Line 7: Total (all) outstanding liabilities (page 7) 0
<br />Line 8: Name of bank(s) used: TD Bank
<br />Affidavit of Committee Treasurer:
<br />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 ofall campaign finance
<br />activity, including all contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign
<br />finance activity of all persons acting under the author ty or on half of II is coi 5nni ice in accordance with the requirements of M.G.L. c. 55.
<br />Signed under the penalties of perjury: L(IYIQ"— (Treasurers signature) Date: /
<br />FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate (chect, I box only)
<br />Candidate will, Committee and no activity independent of tine committee
<br />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
<br />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,
<br />incurred any liabilities nor made any expenditures on my behalf during this reporting period.
<br />Candidate without Committee OR Candidate with independent activity filing separate report
<br />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
<br />❑ finance activity, including contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the
<br />campaign finance activity of all persons acting tun a authority or on he a f ofdnis co
<br />Ti cc in accordance with the requirements of M.G.L. c. 55.
<br />Signed under the penalties of perjury: (Candidate's signature) Date: j
<br />File with:
<br />City or Tovm Clerk or Election Commission
<br />Fill in Reporting Period dates:
<br />Begi bai8:'
<br />oanuary 1, 2017
<br />Ending Date:
<br />December 31, 2017
<br />Type of Report: (Check one)
<br />❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election year-end report ❑ dissolution
<br />Suzie Barry
<br />Candidate Full Name (i r applicable)
<br />Selectman
<br />Office Sought and District
<br />159 Burlington St, Lexington, MA 02420
<br />Residential Address
<br />Telephone Number (optional) (781) 862-5853
<br />Line 1: Ending Balance from previous report
<br />Line 2: Total receipts this period (page 3, line 11)
<br />Line 3: Subtotal (line I plus line 2)
<br />lCommittee to Elect Suzie Barry
<br />Committee Name
<br />Kim Coburn
<br />Name of Committee Treasurer
<br />66 Liberty Ave, Lexington MA 02420
<br />Committee Mailing Address
<br />'telephone Number (optional). 1 (781) 863-6285
<br />INFORMATION:
<br />Line 4: Total expenditures this period (page 5, line 14)
<br />Line 5: Ending Balance (line 3 minus line 4)
<br />707.07
<br />"I
<br />707.07707. 7
<br />_I
<br />707.07
<br />Line 6: Total in-kind contributions this period (page 6)
<br />Line 7: Total (all) outstanding liabilities (page 7) 0
<br />Line 8: Name of bank(s) used: TD Bank
<br />Affidavit of Committee Treasurer:
<br />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 ofall campaign finance
<br />activity, including all contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign
<br />finance activity of all persons acting under the author ty or on half of II is coi 5nni ice in accordance with the requirements of M.G.L. c. 55.
<br />Signed under the penalties of perjury: L(IYIQ"— (Treasurers signature) Date: /
<br />FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate (chect, I box only)
<br />Candidate will, Committee and no activity independent of tine committee
<br />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
<br />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,
<br />incurred any liabilities nor made any expenditures on my behalf during this reporting period.
<br />Candidate without Committee OR Candidate with independent activity filing separate report
<br />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
<br />❑ finance activity, including contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the
<br />campaign finance activity of all persons acting tun a authority or on he a f ofdnis co
<br />Ti cc in accordance with the requirements of M.G.L. c. 55.
<br />Signed under the penalties of perjury: (Candidate's signature) Date: j
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