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ILI-IN <br /> Form CFF M109: <br /> Statement of Municipal Candle i <br /> Not Raising o Expending Ca _Fi�,i 3; .4 <br /> Commonwealth _} <br /> r= <br /> .0frice of Campaign and Political` inan <br /> of Masachusctt - ,.., <br /> File with: Local Election Oficial(City or Town Clerks <br /> i <br /> Cadlte lase. <br /> Office Sought: C 6 a�. l <br /> Residential Address: 14 L A oe c 8 ,n LA wO�. <br /> City State exp; . <br /> ., <br /> E-Mail Address: n4 .E'4PNrj0L P v ON Phone Number: <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,mane 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 /> 1. Ending balance from previous report ZERO <br /> 2. Total receipts for reporting period ZERO <br /> . Subtotal ZERO <br /> . Total Expenditures for reporting period ZERO <br /> . Ending balance ZERO <br /> After filing this statement,if I decide to raise,accept,or expend funds,or incur liabilities,for a campaign-related <br /> purpose,I will immediately notify my local election official in writing, and will file periodic campaign finance reports <br /> according to the statutory filing schedule. <br /> Until such notice is on bile with the local election 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 Laws. <br /> This form is valid through December 31 of the year in which it was signed, <br /> SIGNET]LTNDER TTIE PENALTIES OF PERJURY: <br /> Candidate's signature; Date E 6 +.0 0J, <br /> 1 09 12121 <br />