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RECEIVED <br /> Form CPF 10'9: 2022 02 Feb,9:23 am <br /> Statement of M nkipal Candidate <br /> Not Raising or Expending Campaign Funds TOWN CLERK <br /> office of Campaign stand Political Finance LEXINGTON M A <br /> ai?»S�aau�uscCb� <br /> Fj�e vnith: LocA 1:trctkt d Official(Ciry or Town Quik-) <br /> Candiate's Name: <br /> Office scm�i_ 4.✓fie� �_����� -f�" <br /> f x ; d ,] <br /> Re=sidential Add � <br /> city I statr d dip. <br /> E-Mail tl cir ss, t" f ;F vs 4 '.y r cs�. Num�r I ��6- <br /> Phone <br /> -T _ <br /> I lz=by certify the i have not opened a campaign b *account fox casnpaigr*t funis because I do not intend to accept <br /> c t$ribu6ahs at in-kind cntttrt-butions,make cxpendimres,Including expenditures of my own funds,or ittc m liabilid <br /> for arty cmmpnign-reWedparpose,nor do I currently have any outstanding latabilitic for per campaign-related activity. <br /> I whmit the following as my campaign repoA for all bank rgotting pm ia&in this calendar yen as prQvided for in Chapter 55 <br /> of the Masachasctts General laws. <br /> 1. Ending balance f m previous,art ZERO <br /> Z. Total rmcipts fsr reporting period 7_I;RO <br /> 3. Subtotal ZERO <br /> 4a Total Expmufitums for reporting period 7F_R0 <br /> S, Ending,bplancr ZERO <br /> rlfier ding this statcmcnt,it I decide to raiser accept,or expend funds,or incur l#abilities,for a campaign-related <br /> purpose,I wi immediate y notify my loW eledion official in writing,and wail file peri ndic c=paign finance rcparts <br /> according to the stawtory tiling scbedute. <br /> Until such nulicc is on file with the loml clection off eial,i card fy shat ihc above Zero report v tiU be in efiCct for s --h <br /> rLVnin&period,in the cakodar year in wkkh it is Med,Tcquircd by Chapter 55 of'tho Mas; huscm Gesarral Laws. <br /> This form is kid throuo Dree31 of the year in which it was signed. <br /> SIGNED UNDER TRE PRNI ALTIES OF PERJURY. <br /> E <br /> i <br />