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1 <br /> f <br /> Form C PF M 10 ® Campaign ]Finance Report <br /> a - Municipal Form <br /> Office of Campaign and Political Finance <br /> Commonwealth <br /> of Massachusetts <br /> Pile with: City or Town Clerk or Election Commission <br /> Fill in Reporting Period dates: Beginning Date: 03/23/2019 Ending Date: Dec 31, 2019 <br /> Type of Report: (Check one) <br /> ❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after electionX❑ year-end report ❑ dissolution <br /> Eileen]ay Eileen Jay for School Committee <br /> Candidate Full Name(ifapplicable) Committee Name <br /> School Committee Becky Barrerltine <br /> Office Sought and District Name of Comm ittee Treasurer <br /> 191 Waltham St., Lexington, MA 02421 100 Bedford St., Lexington, MA 02420 <br /> Residential Address Committee Mailing Address <br /> Telephone Number(optional): Telephone Number(optional); <br /> SUMMARY BALANCE INFORMATION: <br /> Liti►e I: lading.Balance from previous report <br /> Line 2: Total receipts this period(page 3, line 1 1) <br /> Line 3: Subtotal (line I plus line 2) r _ <br /> i t'o <br /> Line 4: Total expenditures this period(page 5, line 14) <br /> Line 5: Ending Balance(line 3 minus line 4) Cie 1,17 <br /> Line 6: Total in-kind contributions this period (page 6) >' t <br /> Line 7: Total (all)outstanding liabilities(page 7) <br /> Line S: Name of bank(s)used: Citizens Bank, Paypal <br /> Affidavit of Committee"treasurer: <br /> 1 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 oral]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 underthe i or on behalf of this committee in accordance with the requirements of M.G.L.c.55. <br /> Signed under the penalties of per jury: _- (Treasurer's signature) Date: / f <br /> FOR CANDIDATE FILINGS ONLY: Affidavit of Candidnte:(check I box only) <br /> Candidate with Committee and no activity independent of the committee <br /> I certify that I have examined lhis report including attached schedules and it is,to the best of my knowledge and belief,a true and complete statement oral]campaign finance <br /> activity,of all persons acting under[lie 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 beha€f during this reporting period. <br /> Candidate without Committee Olt Candidate svith 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 ofall 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 acting under the aut ori or on behalf of this committee in accordance with the requirements of M.G.L.c.55. <br /> Signed under the penalties of perjury: (Candidate's signature) Date: i <br />