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Form CPF M 102: Campaign Finance Report <br /> ` EOMunicipal Form <br /> 2022 FED 24 FIl''f '. 5 4 Office of Campaign and Political Finance <br /> Commonwealth <br /> of Massachusetts TOWN OLE K <br /> EXINGIGN H.4. Filewith: Cit or Town Clerk or Election Commission <br /> Fill in Reporting Period dates: Beginning Date: / - Ending Date: <br /> Type of Report: (Check one) <br /> ❑ <br /> 8th day preceding preliminary ❑ 8t1i day preceding election ❑ 30 day after election ❑ year-end report ❑ tfissoltltion <br /> Candidate Fall Name(ifapplicable) Committee Name <br /> Office Sought and District Name of Cornmittee Treasurer <br /> 27urot <br /> Reside ial A ess Committee Mailing Address <br /> E-mail: Email: f afV tr 'Ct.o ',C& tY�' <br /> Phone#(optional): y t'hone#(optional): <br /> SUMMARY BALANCE INFORMATION: <br /> Line 1: Ending Balance from previous report <br /> t <br /> Line 2: Total receipts this period (page 3, line 11) "6 <br /> Line 3: Subtotal (line 1 plus line 2) <br /> Line 4: Total expenditures this period(page 5, lime 14) <br /> Line 5: Ending Balance (line 3 minus line 4) <br /> Line 6: Total in-kind contributions this period (page 6) d <br /> Line 7; Total (all)outstanding liabilities (page 7) <br /> Line 8: Name of bartk(s) used: e �� <br /> Affidavit of Committee Treasurer: <br /> 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 oral]campaign finance <br /> activity,including all contributions,loans,receipts,expenditures,disbursements,in-kind contributions and liabilities for this reporting period and represents the campaign <br /> finance activity of all persons acting under the authofl or on behalf of this committee in accordance with the requirements of M.G.L,c.55. <br /> Signed under the penalties of perjury: >� ' ,i--- (Treasurer's signature) Date: p7� <br /> FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate:(check I box only) <br /> Candidate with Committee <br /> ❑ 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 oral]campaign finance <br /> activity,of all persons acting under the authority or on bcl;alf of this committee in accordance with the requirements of M,G.L.c.55. 1 have not received any contributions, <br /> incurred any liabilities nor made any expenditures on my behalyduring this reporting period that are not otherwise disclosed in this report. <br /> Candidate without Committee <br /> ]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 <br /> finance activity,inciuding contributions,loans,receipts,expenditures,disbursements,in-kind contributions and liabilities for this reporting period and represents the <br /> campaign finance activity oral]persons acting Under the authority or on behalf of this candidate in accordance with the requirements of M.G.L.c.55. <br /> Signed under the penalties of perjury; Date: <br /> (Candidate's signature) <br />