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d Form CPQ' M 142: Campaign Finance Report Municipal Form Y_. I . Office of Campaign and Political Finance Commonwealth 13 , ifi i H . 04 of Massachusms Fi[ewith: C' n er r lection Commission Fill in Repor mg Period dates: egirtning nate: January 1, 2021 Ending bate: L -! 1 Type of Report: (Check one) 0 8th day preceding preliminary ❑ 8t>tf day preceding election ❑ 30 day after election ❑X year-end report ❑ dissolution I 5uzle Barry � Committee to Elect Suzie Barry Candidate Cull Name(if apph`tiable) Committee name Select:Board Member I Kim Coburn Office Sought and District Name of Committee Treasurer 159 Burlington St, Lexington, MA 02420 66 Liberty Ave, Lex€ngon, MA 02420 Residential Address Committee Mailing Address E-mail: suziebarrylex@gmi,ill.com mil: t:hecoburns@aol.com Phone (optional): (781) 867-51353 Phone (optional). (781) 863-6285 SUMMARY BALANCE INFORMATION: Line 1: Ending Balance from previous report 2607.64 Line 2: Total receipts this period(page 3,lige I I) 726 Line 3: Subtotal(line 1 plus litre 2) 3333.64 Line 4: Total expenditures this period(page 5, line 14) 16.41 Line 5: Ending Balance(line 3 minus line 4) 3317.29 Line 6: Total in-kind con ibut:ions this period(page 6) Line 7-. Total(all)outstar ding liabilities(page 7) 49 Line 8: Name ofbank(s) sed: Bank t Affidavit of Committee Treasurer: I certify that I have examined this report including attael ted schedules and it is,to the best of my knowledge and belief,a true and complete statement ofull campaign finance activity,Including all contributions,loans,receipts,exp nditures,disbursements,in-kind contributions and liabilities for this reporting period and represents the campaign finance activity of all persons acting under tic authority or on behalf this committee in accordance with the requirements of M.Q.L.U.55. Signed under the penalties of perjury: (`t'reasurer's signature) bate: January 17,2022 ( p OR CAATE GS ONLY: Aff davit of Candidate:(check 1 box only) Candidate,with Committee I certify that I have examined this report including ttached schedules and it is,to the best of my knowledge and belief,a true and complete statement of ail campaign finance activity,of all persons acting under the authority or on behalfof this committee in Accordance with the requirements of M.G.L.c.55. 1 have not received any contributions, incurred any liabilities nor mads any expenditures i in my behalfduring(his reporting period that are not othenvisc disclosed in this report. Candidate without Committee I certify that l have examined this report including ttached schedules and it is,to the best of my knowledge and belief,a true and complete statement of all oampaign finance activity,including contributions,loans,re ipts,expenditures,disbursements,in-land contributions and liabilities for this reporting period and represents the campaign finance netivity of ull persons acting and r thorily or an be f of!tris c dilate in accordance with the requirements ofM.G.I..e.55. Bate: ) Signed under Ilia penalties of perjury: (Candidate's signature)