2019-01-08-Sandeen-OCPF - Laserfiche WebLink

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Form CPF M101: STATEMENT OF ORGANIZATION CANDIDATE'S COMMITTEE MUNICIPAL FORM Commonwealth Office of Campaign and Political Finance of Massachusetts JfiIg i File with: City/Town Clerk or Election Commission NOTICE IS HEREBY GIVEN in accordance with the provisions of General Laws, Chapter 55,as ame�i „'dhe organization of a candidate's committee as follows: CANDIDATE: Full Name. Mark Douglas Sandeen Residential Address: 10 Brent Road City/State 1 Zip: Lexington MA 02420 E-Mail Address: mark@marksandeen.com Phone 9: 781-863-8784 Party Affiliation: (If applicable) OFFICE SOUGHT/PURPOSE: Title: Selectmen District: Town of Lexington COMMITTEE: Name of Committee: Committee to Elect Mark Sandeen (The name of the committee must include the candidate's last name) Committee Mailing Address: 10 Brent Road City/State/Zip: Lexington MA 02420 Phone#: 781-863-8784 OFFICERS: Chairman: Todd Burger Treasurer*: Jeanne Krieger Residential Address: 386 Lincoln Street Residential Address: 44 Webster Road City 1 State I Zip: Lexington MA 02421 City I State I Zip: Lexington MA 02421 Phone#: 781-820-2521 Phonefl: 781-862-7730 Email: kriegerjk44@gmail.com *A public employee may not serve as treasurer of ally pohtical committee see reverse. Other Officer/Title: Other Officerfritle: Residential Address: Residential.Address: City/State I Zip: City/State/zip; Phone{l: Phone#: (Complete and attach a Form CPF M A 101,if necessary,with other officers and finance committee,if any.) I hereby consent to the filing of this committee. 1 understand that a candidate shall not give consent to the organization of more than one committee on his/her behalf. I am aware that candidates are required to keep detailed accounts and records of all campaign finance activity for a period of six years from the date of the relevant election. SIGNED UNDER THE PENALTIES OF PERJURY: Date: Candidate's signature I hereby accept die office of Treasurer of the above-named committee.I affirm that I am not a public employee as defined by M.G.L.c.55,S. 13.1 understand that: 1)1 am subject to certain duties and liabilities under M.G.L.c,55, including the timely filing of campaign finance reports and keeping detailed accounts and records of all campaign finance activity for a period of sixyears from the date of the relevant election;2)if after my acceptance of this office I become an appointed public employee,I must resign this position and notify OCPF of my resignation;and 3)a candidate may not serve as treasurer of the political committee organized on his/her behalf, SIGNED UNDER THE PENALTIES OF PERJURY: y J l�t/t.E•. Date: Treasurer's signature I hereby accept the office of Chairman of the above-named co itee, SIGNED UNDER THE PENALTIES OF PERJURY: Date: Chairman's signature / �