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2018-12-31-Jay-OCPF
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2018-12-31-Jay-OCPF
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r <br /> _ IL A <br /> Municipal Form <br /> 0 ke of Campaign and Political Fitrance <br /> Commonwealtht .q 22 "` 1 <br /> of Massaehusctts `� " � t �) <br /> Dile with: City or Town Clerk or Election Commission <br /> Fill in Reporting Period dates: LE ;' 't a `x IU c�t c c+r trading Date: <br /> Type of Report: (Check. one) <br /> ❑ Sth day preceding preliminary ❑ Sth day preceding election ❑ 30 day aper election year-end report ❑ dissolution <br /> (✓ l_ �?.1r"�r =i Z= i! Pe r xr <br /> Candidate Ful]'Nonte(if applicable) Committee NameL- <br /> r, <br /> Office Sought and Di5lriel Mame of Committee Treasurer <br /> - c - r � ltG � <br /> I ,t 1 -1 f-3 i�3 r t t__ _ i:_7. t;/r f r 1' �; �> ;'j �,_ = <br /> Residential Address Committee Mailing Address <br /> I'cicphonc lumber(optional): fetcphone Number(optional): <br /> SUIVIMARY BALANCE INFORMATION: <br /> Line I: Ending Balance from previous report J �� <br /> Line 2: Total receipts this period (page 3, line 1 1) <br /> Line 3: Subtotal (line 1 plus line 2) 2-0 <br /> Line 4: Total expenditures this period (page 5, line 14) <br /> Lane 5: Ending Balance(line 3 minus line 4) <br /> Line 6: Total ire-kind contributions this period(page 6) <br /> Line 7: Total (all) outstanding liabilities (page 7) <br /> Line 8: Name of bank(s) used: ('. ; Z F'-/')=3 fj A-,mss <br /> Affidavi(of Connmittee Treasru•er: <br /> I certify Haat I have e.xamined this report tnckad'€ng atlached sche(itiles and it is,to the best of my katowledge and belief,a true and complete statement of all campaign finance <br /> activity,including all contributions,loans,receipts,expenditin es,disbit senents,in-kind contributions and Liabilities for this repotting period and represents the campaign <br /> finance activity of all persons acting tulder the autliority or on behnit-of this committee in accordance with the requirements of M_G.L,c.55_ <br /> z <br /> Signed under the penalties of perjury: -,— -- -�� ' {'I reasttrer s signature) D71te: ZQ J <br /> FOR CANDIDATE FILINGS ONLY, affidavit of Candidate:(check t box only) <br /> Candidate with Comndttec and no activity indepeudcut of the committee <br /> I certify that 1 have examined this report including attached schedules and it is,to the hest of my knowledge and belief,a true and complete statement of all campaign finance <br /> activity,of all persons acting tutdcr the authority or on behalf of this committee in accordance with the regsritetnenis of M.G.L.c.55, 1 have not received any contributions, <br /> incltrrcd any liabilities nor made any cxpendintres oil airy behalf during this reporting peaiod. <br /> Candidate without Committee OR Candidate with independent activity filing separate report <br /> ❑ I certify that I have examined thus report including attached schedrtles and it is,to the best of my knowledge and belief,a true and complete statement of alI campaign <br /> final€ce activity,including contributions,loans,receipts,expenditures,disbirrsemen€s,in-kind contributions and liabilities for this reporting period and represents the <br /> c<9mpaign finance activity of all persons acting tinder the authority or on behalf of this committee in accordance with the regisirentcots of M.G.L.c.55. <br />
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