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tiorm. CPF M 102: Campaign Finance Report <br /> 2 9 , 1 18: Municipal Form <br /> Office of Campaign and Political Finance <br /> T ti <br /> Commonwealth L E n l N,(. <br /> of Massachusetts <br /> File with: City or Town Clerk or Election Commission <br /> Pill in Reporting Period dates: Beginning Date: January 7, 2019 Ending Date: January 9, 2019 <br /> Type of Report: (Check one) <br /> ❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election ❑ year-end report ❑X dissolution <br /> Scott Burson _'o s' i�t /t"'�' U /%d ✓ �J <br /> Candidate Full Name(if applicable) Committee Name a <br /> Selectman Nancy Sofen <br /> Office sought and District Name of Committee Treasurer <br /> 5 Willard Circle, Lexington, MA 02421 5 Willard Circle, Lexington, NEA 02420 <br /> Residential Address Committee Mailing Address <br /> E-mail: scottburson02421@gmafl.com E-mail: nsofen@gmall.com <br /> Phone#(optional): 781-863-8367 Phone#(optional): 781-861-8532 <br /> SUMMARY BALANCE INFORMATION: <br /> Line 1: Ending Balance from previous report 0.00 <br /> Line 2: Total receipts this period(page 3,line 11) 0.00 <br /> Line 3: Subtotal(line 1 plus line 2) 0.00 <br /> Line 4: Total expenditures this period(page 5, line 14) 0.00 <br /> Line 5: Ending Balance(line 3 minus line 4) 0.001 <br /> Line 6: Total in-kind contributions this period(page 6) 1 0.00 <br /> Line 7: Total(all)outstanding liabilities(page 7) 0.00 <br /> Line 8: Name of bank(s)used: none <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 of all campaign finance <br /> activity,including all contributions,loans,receipts,expenditures,disbursements,in-kind contributions and liabilities for this reportingperiod and represents the campaign <br /> finance activity of all persons acting under the authority or on behalf of thihiJs commit a in accordance with the requirements of M.G.L.c.55. <br /> Signed under the penalties of perjury: r' { ' (Treasurer's signature) Date: January 10, 2019 <br /> FOR CANDIDATE FILINGS ONLY: AffidavKof Candidate:(ch 1 box only) <br /> Candidate with Committee and no activity independent of the 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 /> X 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. 1 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,ex%�4z7— ;�=(Caiididatc's <br /> nditres disbursements,in-kind contributions and liabilities for this reporting period and rep eWrits the <br /> campaign finance activity of all persons acting under the an behance with the requirements of M.G.L,c. / <br /> / Date:Signed under the penalties of perjury: ! signature) <br />