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Form CPF M 102: Campaign Finance Report <br /> Municipal Form <br /> Office of Campaign and Political Finance <br /> Commonwealth <br /> of Massachusetts File with: City or Town Clerk or Election Commission <br /> Fill in Reporting Period dates: Beginning Date: Ending Date- FO2/715:/:19:� <br /> Type of Report: (Check one) <br /> 8th day preceding preliminary RX 8th day preceding election 0 30 day after election R year-end report R dissolution <br /> Eileen Jay 1 iee7nJay for School Committee Campaign 7 F <br /> Candidate Full Name(ifapplicable) Committee Name <br /> School Committee jBecky Barrentine <br /> Office Sought and District Name ofCominittee'rreasurer <br /> 191 Waltham Street, Lexington, MA 02421 100 Bedford Street, Lexington, MA 02420 <br /> Residential Address Committee Mailing Address <br /> Telephone Number(optional):L Telephone Number(optional): <br /> SUMMARY BALANCE INFORMATION: <br /> Line 1: Ending Balance from previous report 1255.1; <br /> Line 2: Total receipts this period(page 3, line 11) <br /> Line 3: Subtotal(line I plus line 2) 1255 <br /> Line 4: Total expenditures this period(page 5, line 14) 5 <br /> Line 5: Ending Balance(line 3 minus line 4) 1250 <br /> Line 6: Total in-kind contributions this period(page 6) 01 <br /> ! <br /> Line 7: Total (all)outstanding liabilities(page 7) 0 <br /> Line 8: Name of bank(s)used: citizens <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 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) Da <br /> VOKC Affidavit of Candidate:(check Lbox 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 /> activity,of all persons acting under the authority or on behalf ofthis committee in accordance with the requirements ofM.GL 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 riling 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,Imns,receipts,expenditures,disbursements,in-kind contributions and liabilities for this reporting period and reprcsLids the <br /> campaign finance activity of all persons acting oil t�:Tpflu ri 0 o' behalf of this committee in accordance with the requirements o(W.G.L.c.55. <br /> Signed under the penalties of perjury: (Candidate's signature) Date: of <br /> AA_ <br />