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i ` x <br />Form CPF° M 102: Campaigns Finance Report <br />Commonwealth <br />of Massachusetts Office of Campaign and Political F'in�r�c , ,..... <br />Pile with: 1/5/2013 <br />City or Town Clerk or Election Commission U� 'f is 1 A M 9. 4 f <br />Reporting Period: Beginning: 1/1/2012 Ending: 12/31/2012 LEXI H <br />Type of Report: Year -end <br />Michelle Ciccolo <br />Full Name of Candidate <br />Planning Board /Lexingto <br />office Sought/ District <br />50 Shade Street <br />Lexington, MA 02421 <br />Residential Address <br />Committ to Elect Michelle Ciccolo <br />Committee Name <br />Margar C -Kl <br />Name of Committee Treasurer <br />94 Winter Street <br />Lexington, M 02420 <br />Committee Address <br />Ending balance from previous report: <br />Total receipts this period: <br />Subtotal: <br />Total expenditures this period: <br />Ending Balance: <br />Total inkind contributions this period: <br />Total outstanding liabilities: <br />Name of Bank used: TD Bank <br />$295.38 <br />$0.00 <br />$295.38 <br />$0.00 <br />$295.38 <br />$0.00 <br />$0.00 <br />Affidavit of Committee Treasurers <br />I certify that I have examined this report, including attached schedules and it is, to the best of my knowledge and <br />belief, a true and complete statement of all campaign finance activity including all contributions, loans, receipts, <br />expenditures, disbursements, inkind 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 <br />requirements of M.G.L. c. 55. <br />Signed under the penalties of perjury: <br />Treasurer's signature (in ink) Date <br />Affidavit of Candidate (check 1 box only) s <br />rKJfi /Candidate with Committee and no activity independent of the committee <br />I certify that I have examined this report, and attached schedules and it is, to the best of my knowledge and belief, a <br />true and complete statement of all campaign finance activity, of all persons acting under the authority or on behalf of <br />this committee in accordance with the requirements of M.G.L. c. 55. I have not received any contributions, incurred <br />any liabilities nor made any expenditures on my behalf during this reporting period. <br />Candidate without Committee OR candidate with independent activity filing separate report. <br />I certify that I have examined this report and attached schedules and it is, to the best of my knowledge and belief, <br />a true and complete statement of all campaign finance activity including contributions, loans, receipts, expenditures, <br />disbursements, inkind 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 <br />requirem nts f M.G. 55. <br />Signed der' he pe I es o erjury: J <br />r <br />C ndid e's signature (in ink) / ate <br />