2018-02-26-Hai-OCPF - Laserfiche WebLink

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a�l Form CPF M 102: Campaign Finance Report Municipal Form uV Office of Campaign and Political Finance Commonwealth of Maecachnsetts File with: City or Town Clerk or Election Commission Fill in Reporting Period dates: Beginning Date: of/0l/2ols Ending Date: 02/19/2018 Type of Report: (Check one) — rt —+ ❑ 8th day preceding preliminary 8th day preceding election ❑ 30 day after election ❑ year-end report [ dissolution Jill I. Hai Candidate Full Name (if applicable) Selectman Lexington, MA Office Sought and District 6 Highland Avenue, Lexington, MA 02421 Residential Address Telephone Number (optional): (781) 862-3776 Jill Hai for Selectman CommitteeName Jodi R. Galin •• Nameof Committee Treasurer U-, P.O. Box 248, Lexington, MA 02420 Committee Mailing Address Telephone Number (optional): (781) 910-4681 SUMMARY BALANCE INFORMATION: Line 1: Ending Balance from previous report Line 2: Total receipts this period (page 3, line 11) Line 3: Subtotal (line 1 plus line 2) Line 4: Total expenditures this period (page 5, line 14) 2,169.11 100 2,269.11 380.83 Line 5: Ending Balance (line 3 minus line 4) 1 1,888.281 Line 6: Total in-kind contributions this period (page 6) Line 7: Total (all) outstanding liabilities (page 7) Line 8: Name of bank(s) used: citizens sank Affidavit of Committee Treasurer: I certify that I have examined this report including attached schedules and itis, to the best of my knowledge and belief, a true and complete statement of all campaign finance activity, including all contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign finance 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. \ d Signed order the penalties of perjury: LLL4� �( A �V- �t7 (Treasurers signature) Date: �� I ei t FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate: (check 1 box only) Candidate with Committee and no activity independent of the committee ®I certify that 1 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 activity, of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L.. a 55. I have not received any contributions, incurred any liabilities nor made any expenditures on my behalf during this reporting period. Candidate without Committee OR Candidate with independent activity filing separate report ❑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 activity, including contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign finance 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. ! r (Candidate's signature) Date: Signed under the penalties of perjuryr I q I t