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Form CPF M 102: Campaign Finance Report <br /> Municipal Form <br /> Office of Campaign and Political Finance <br /> Commonwealth <br /> ofMassachusettiM APR —2 A H, 9: 44 <br /> bile with: CitV or Town Clerk or Election Commission <br /> Fill in Reportirlg^Pgr.i_pd da a.: Beginning Date: 1 2 ! Ending Date: 2 <br /> 1 i -r <br /> Type of Report: (Check one) <br /> ❑ 8th day preceding preliminary ❑ 8th day preceding election DQ 30 day after election ❑ year-end report ❑ dissolution <br /> Ltt <br /> Candidate Full[dame(if applicable) Committee Name <br /> Town nw o ' 6 migtg1�Pv- , 7>Veb n(-i <br /> 004ice Sought and District Name of Committee Treasurer <br /> i Ciel�Yt' S � a <br /> ii Residential Address Committee Mailing Address <br /> E-mail: ho llrj ,el,bAo I'ti'6k"A 6 E-mail: <br /> Phone N(optional): Phone#(optional): <br /> SUMMARY BALANCE INFORMATION: <br /> Line 1: Ending Balance from previous report <br /> Line 2: Total receipts this period(page 3, line 11) �� , <br /> Line 3: Subtotal(line 1 phis line 2) <br /> Line 4: Total expenditures this period (page 5, line 14) <br /> Line 5: Ending Balance(line 3 minus line 4) t7 <br /> Line 6: Total in-kind contributions this period(page 6) <br /> Line 7: Total(all) outstanding liabilities(page 7) <br /> Line 8: Name of bank(s) used: �'�y ,� i ,a de (— <br /> Affidavit or 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 authority or on behalf of this committee in accordance with the requirements of M.G.L.c.55. <br /> Signed under the penalties of perjury: (Treasurer's signature) Date: <br /> FOR CANDIDATE FILINGS ONLY: Affidavit urCandidate:(check I box only) <br /> Candidate with Committee and no activity independent or the committee <br /> ❑ t certify that t 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 /> 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 /> I <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 under the authority ur�nhhalfof this committee in accordance with the requirements of M.G.L.c.55. <br /> Date: <br /> Signed under the penalties or perjury: l (Candidate's signature) <br />