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i <br /> Form CM109: <br /> Statement of Municipal Candidate <br /> Not raising or Expending Campaign Funds <br /> Commonwealth <br /> of Massachusetts Office of Campaign and Political Finance <br /> File with: Local Election Official iter or Town Clerk) <br /> Candidate lane: <br /> Charles Hornig <br /> Office Sought: <br /> Planning <br /> Residential Ad&ess: 18 Bacon Street <br /> City Stats exp.. LexingtonMA 02421 <br /> _I1axlAddress: <br /> hornig.lex@charleshornig.org <br /> - Phone Number-, 7818621112 <br /> I hereby certify that I have not opened a campaign bank account for campaign funds because I do not intend to accept <br /> contributions or in-kind contributions,make expenditures,including expenditures of my own funds, or incur liabilities <br /> for any campaign-related purpose, nor do I currently have any outstanding liabilities for prior campaign-related activity. <br /> I submit the following as my campaign report for all bank reporting;periods in this calendar year as provided for in Chapter 55 <br /> of the Massachusetts General Laws: <br /> r-"., <br /> 1. Ending balance from previous report ZERO <br /> 2. Total receipts for reporting period ZERO -� <br /> . Subtotal ZEROt. <br /> ` <br /> IF . ..� <br /> 4. Total Expenditures for reporting eri <br /> 5. Ending balance ZERO ; rFG' <br /> �;�.7 <br /> t. <br /> M <br /> F <br /> After filing this statement, if I decide to raise, accept, or expend finds,or incur liabilities,for a camp ain-related <br /> purpose,I will immediately notify nay local election official in writing, and will file periodic campaign fmance reports <br /> according to the statutory filing schedule. <br /> Until such notice is on file with the local electron official,I certify that the above Zero report will be in effect for each <br /> reporting period,in the calendar year in which it is filed,required by Chapter 55 of the Massachusetts General Lags. <br /> This form is valid through December 31 of the year in which it was signed. <br /> SIGNED UNDER THE PENALTIES OF PERJURY: <br /> Candidate's signature. Date:1 January 2024 <br /> MI 09 12121 <br />