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f Commonwealth of Massachusetts Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance File with: City or Town Clerk or Election Commission Reporting Period - Beginning: 1/1/2012 Type of report: Year -end Norman Cohen Full Name of Candidate Selectman /Lexington Office Sought/ District 3 c r y „ y„ #1 30 � Lexingt MA 02421 Residential Address Norm Cohen for Selectman Committee Name Alice M Pierce Name of Committee Treasurer 17 Volunteer Way Lexington, MA 02420 Committee Address SUMMARY BALANCE INFORMATION Ending Balance from previous report: Total receipts this period: Subtotal: Total expenditures this period: Endinq Balance: Total inkind contributions this period: Total outstanding liabilities: Name of bank(s) used: TD Bsnk $574.48 $0.00 $574.48 $0.00 $574.48 $0.00 $0.00 Affidavit of Committee Treasurer: 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 activity including all contributions, loans, receipts, expenditures, disbursements, inkind contributions and liabilities for this reporting period and represents the 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. Signed under the penalties of perjury: T si (in ink) Date Affidavit of Candidate (check 1 box only) . Candidate with Committee and no activity independent of the committee I certify that I have examined this report, and attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all 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. ❑ Candidate without Committee OR candidate with independent activity filing separate report. I certify that I have examined this report and attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all campaign finance activity including contributions, loans, receipts, expenditures, disbursements, inkind contributions and liabilities for this reporting period and represents the 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. Signed under the penalties of perjury: x C' T C'o !�l/ 2013 Ending: 12/31/2012 Type of report: Year -end Norman Cohen Full Name of Candidate Selectman /Lexington Office Sought/ District 3 c r y „ y„ #1 30 � Lexingt MA 02421 Residential Address Norm Cohen for Selectman Committee Name Alice M Pierce Name of Committee Treasurer 17 Volunteer Way Lexington, MA 02420 Committee Address SUMMARY BALANCE INFORMATION Ending Balance from previous report: Total receipts this period: Subtotal: Total expenditures this period: Endinq Balance: Total inkind contributions this period: Total outstanding liabilities: Name of bank(s) used: TD Bsnk $574.48 $0.00 $574.48 $0.00 $574.48 $0.00 $0.00 Affidavit of Committee Treasurer: 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 activity including all contributions, loans, receipts, expenditures, disbursements, inkind contributions and liabilities for this reporting period and represents the 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. Signed under the penalties of perjury: T si (in ink) Date Affidavit of Candidate (check 1 box only) . Candidate with Committee and no activity independent of the committee I certify that I have examined this report, and attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all 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. ❑ Candidate without Committee OR candidate with independent activity filing separate report. I certify that I have examined this report and attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all campaign finance activity including contributions, loans, receipts, expenditures, disbursements, inkind contributions and liabilities for this reporting period and represents the 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. Signed under the penalties of perjury: