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Form CPF M 102 -0: Campaign Finance Report <br />Municipal Form <br />Office of Campaign and Political Finance <br />Comm3if eal <br />of Massachusetts <br />City or Town of: e-/Z/ 'D-7/0.4 <br />Reporting Period: Beginning: ////20/7 <br />(MM/DD/YYY Y) <br />Please print or type all information. except signatures. <br />Ending: <br />Type of Report: (Check One) <br />lEitth day preceding preliminary/primary ❑ 8th day preceding election ❑ 30th day following election (town or special) ❑ 20th day of January (Year -End report) <br />Pursuant to M.G.L. Chapter 55: <br />1. I certify that I am a candidate for or currently hold Municipal Office. <br />2. I certify that I have not received any contributions, made any expenditures, or incurred any obligations during this reporting period, and do not have a campaign fund in existence. <br />3. I certify that I do not have a political committee. <br />SIGNATURE RESIDENTIAL ADDRESS <br />DATE PRINT NAME Signed under the penalties of perjury (Street and Number) OFFICE SOUGHT <br />3/61A0/7 <br />i CAce ?eft y <br />7u ioe <br />44,2 / ries-f, <br />o a/Aier.:7E <br />