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44 <br />Form CPF M 102-0: Campaign Finance Report <br />Municipal Form <br />Comm wealth Office of Campaign and Political Finance <br />of Ma Chusetts <br />City or Town of <br />Reoortine Period: <br />Ending: <br />Please prier or type a[i information, excepf signator s. <br />Type of Report: (Check One) <br />'F� 8th day preceding preliminary/primary ❑ 8th day preceding election ❑ 30th day following election (town or special) 20th day of January (Year -End report) <br />Pursuant to M.G.L. Chapter 55: <br />1. I certify that I am a candidate for or currently hold Municipal Office. <br />2. I certify that I have not received any contributions, made any expenditures, or incurred any obligations during this reporting period, and do not have a campaign fund in existence. <br />3. I certify that I do not have a political committee. <br />SIGNATURE RESIDENTIAL ADDRESS <br />DATE PRINT NAME Signed under the penalties (Street and Number) SOUGHT/ <br />soofperjury <br />/OOFFICE <br />LZoyS:i� u�L dl, <br />—1 <br />F-- <br />m, —T- <br />