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Form CPF M 102 -0: Campaign Finance Report <br />Municipal Form <br />O(rice of Campaign and Political Finance <br />Cormonwnllh <br />o! Mwabuutu ' <br />City or Town of: (, >' X K� Candidate ���= t d `'t' Z 0f (X) Office l L"W (QCs <br />Please print or type all information, except signatures, <br />'ill in dates: Month <br />Day Year <br />Month <br />Day <br />Year <br />teporting Period Beginning i <br />I ' i <br />Ending 1 <br />i <br />Type of Report: (Check One) <br />8th day preceding El 8th day preceding election 30th day following election 20th day of January <br />preliminary/primary (Town or Special) (Year -End Report)' <br />Pursuant to M.G,L., Chapter 55: <br />1. I certify that I am a candidate for or hold Municipal Office, <br />2. 1 certify that 1 have not received any contributions, made any expenditures, or incurred any obligations during this <br />reporting period, and do not have a campaign fund in existence. <br />3. I certify that I do not have a political committee. <br />DATE <br />1, SIGNATURE <br />S n under the penalties of perjury <br />11. RESIDENTIAL ADDRESS <br />(Street and Number) <br />III. OFFICE SOUGHT <br />1 it <br />13 <br />3 3 Wa�v T+?G r <br />�V >J1"3 1PCA <br />E <br />C.- <br />11/97 <br />M <br />