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Commonwealth <br />of Massachusetts <br />Form CPF M 102: Campaign Finance Report <br />Municipal Form <br />Office of Campaign and Political Finance <br />File with: City or Town Clerk or Election Commission <br />Fill in Reporting Period dates: Beginning Date: <br />Nov 30, 2016 <br />Ending Date: <br />Feb 1i;1201Z <br />Type of Report: (Check one) <br />❑ 8th day preceding preliminary <br />8th day preceding election ❑ 30 day after election ❑ year -end report ❑ dissolution <br />KATHRYN R. COLBURN <br />Candidate Full Name (if applicable) <br />SCHOOL COMMITTEE <br />Office Sought and District <br />49 Forest Street, Lexington, MA 02421 <br />Residential Address <br />Telephone Number (optional): (617) <br />872 <br />-9428 <br />SCHOOL COMMITTEE <br />Committee Name <br />CERISE JALELIAN <br />Name of Committee Treasurer <br />7 Lols Lane, Lexington, MA 02420 <br />Committee Mailing Address <br />Telephone Number (optional): <br />(617) 733 -6278 <br />SUMMARY BALANCE INFORMATION: <br />Line l: Ending Balance from previous report <br />Line 2: Total receipts this period (page 3, line 11) <br />Line 3: Subtotal (line 1 plus line 2) <br />Line 4: Total expenditures this period (page 5, line 14) <br />Line 5• Ending Balance (line 3 minus line 4) <br />0 <br />Line 6: Total in -kind contributions this period (page 6) <br />Line 7: Total (all) outstanding liabilities (page 7) <br />Line 8: Name of bank(s) used: <br />11,972 <br />11,972 <br />6,923.86 <br />5,048.14 <br />243.8 <br />0 <br />BROOKLINE BANK <br />Affidavit of Committee Treasurer: <br />I certify that I have examined this report including attached schedules 4 d is, to the best of my knowledge and belief, a true and complete statement of all campaign finance <br />activity, including all contributions, loans, receipts, expenditures, disbuksetr ents, in -kind contributions and liabilities for this reporting period and represents the campaign <br />finance activity of all persons acting under theudihority or on behalf of Fits committee in accordance with the requirements of M.G.L. c. 55. <br />&is <br />Signed under the penalties of perjury: : (Treasurer's signature) Date: <br />Feb 21, 2017 <br />FOR CANDIDATE FILINGS ONLY: Affidavit of Lagdldate: (check 1 box only) <br />Candidate with Committee and no activity independent of the 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 of all campaign finance <br />activity, of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. I have not received any contributions, <br />incurred any liabilities nor made any expenditures on my behalf during this reporting period. <br />Candidate without Committee 014 Candidate with independent activity filing separate report <br />rsh 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 of all campaign <br />IL-1 finance activity, including contributions, loans, receipts, expenditures, disbursements, in -kind contributions and liabilities for this reporting period and represents the <br />campaign finance activity of all persons acting und-'the authority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. <br />Signed under the penalties of perjury: / (Candidate's signature) Date: <br />Feb 21, 2017 <br />