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Form CPF M 102: Campaign Finance Report <br /> Municipal Form <br /> _ <br /> Office of Campaign and Political Finance '�� IV E <br /> Commonwealth ? d( °1 <br /> oPMassackmseliS 2u 3A., t C] t (l <br /> File with City or"Town Cleric or'Ele§iJn Commission <br /> Fill In Reporting Period dates: Beginning Date: March 23, 2019 Ending Date: dc 'rribdrl3i. 19 <br /> Type of Report: (Check one) <br /> ❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election year-end report ❑ dissolution <br /> Suzie Barry Committee to Elect Suzie Barry <br /> Candidate Full Name(ifapplicable) Conuniltee Name <br /> Selectman Kim Coburn <br /> Office Sought and District Name of Committee Treasurer <br /> 159 Burlington St, Lexington, MA 02420 66 Liberty Ave, Lexington, MA 02420 <br /> Residential Address Committee Mailing Address <br /> Telephone Number(optional): (781) 862-5853 Telephone Number(optional): (781) 863-6285 <br /> SUMMARY BALANCE INFORMATION: <br /> Line 1: Ending Balance from previous report 2,656.64 <br /> Line 2: Total receipts this period(page 3, line 11) o <br /> Line 3: Subtotal (line 1 plus line 2) 2,656.64 <br /> Line 4: Total expenditures this period (page 5, line 14) 49 <br /> Line 5: Ending Balance(line 3 minus line 4) 2,607.64 <br /> Line 6: Total in-kind contributions this period(page 6) o <br /> Lime 7: Total(all) outstanding liabilities(page 7) 0 <br /> Line 8: Nance of bank(s)used: TD Bank <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 author b t f thi .cpmt ittee in accordance with the requirements of M.G.L.c.55. <br /> Signed Linder the penalties of perjury: G (Treasurers signature) Date: ]an 14,_2 <br /> FOR CANDIDATE PILINGS ONLY: Affidavit ofCandidate.(check I bog 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 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 Ott 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,expenditures,disbursements,in-kind contributions and liabilities for this reporting period and represents the <br /> campaign finance activity of all persons act' er the authority or on behof oflhis com itee in accordance with the requirements of M.G.L,c.55. <br /> Signed under the penalties of perjury: �Cafldidate's signature) Date: J <br /> _... f <br />