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E Form CPF M 102: Campaign Finance Report EC1 :D t:_ y Municipal Form Office of Campaign and Political Finance r-, 2J N1 5: 52 Commonwealth of Massachusetts U4 (, 'N pile with; Ci or Town Clerk or Election Commission ! ll 606f' F i El:in Reportli 1��fe� Beginning Date: ( - tr'1 Ending Date: Type of Report: (Check one) 8th day preceding preliminary ❑ 8th day preceding election 30 day after election Q'year-end report ❑ dissolution Candidate pull Name(ifapplicable) Committee Name r f �^ Office Sought and District Name of Committee Treasurer Residential Address Committee Mailing Address Telephone Number(optional): tf1 ( ' j U i- Telephone Number(optional): SUMMARY BALANCE INFORMATION: Line 1: Ending Balance from previous repoit ;" s 5 Line 2: Total receipts this period(page 3, line 11) Line 3: Subtotal(line 1 plus line 2) Line 4: Total expenditures this period(page 5, line 14) Line 5: Ending Balance(line 3 minus line 4) - `" Line 6: Total in-kind contributions this period (page 6) w Line 7: Total (all)outstanding liabilities(page 7) Line 8: Name of bank(s)used: Affidavit or Committee Treasurer: I corlify that I have examined this report includuig attached schedules and it is,to the best of my knowledge and belief,a true and complete statement of al€campaign finance activity,including all contributions,loans,receipts,expenditures,disbursements,in-kind contributions and liabilities for this reporting period and represents the campaign finance activity of alt persons acting tinder the at�l}ority7l behalf of this committee in accordance with the requirements of M.G.L.c.55. Signed under the penalties of pei jary: �.- � — (Treasurer's signature) Date: t i ' FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate:(check t box only) Candidate with Committee and no activity independent of fhe committee E] I certify that 1 have examined this report including attached schedules and it is,to the best of my knowledge and belief,a true and complete statement of alt campaign 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. I have not received any contributions, incurred any liabilities nor made any expenditures on my behalf during this reporting period. f Candidate without Committee OR Candidate with independent activity riling separate report r¢ 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 JJ finance activity,including contributions,loans,receipts,expenditures,disbursements,in-kind contributions and liabilities for this reporting period and represents the campaign finance activity of all persons acting under the authority aro half ofthis committee in accordance with the requirements of M-G.L.c.55. Signed under the penalties of perjury: (Candidate's signa(ure) Date: