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Form CPF M 102: Campaign Finance Report Municipal Form uV Office of Campaign and Political Finance Commonwealth of Maccan,osettc File with' City -T-- Clerk or Election Commission Fill in Reporting Period dates: Beginning Date: 1; $ 11 Ending Date: I j Vto 1 v Type of Report: (Check one) [Q(8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election ❑ year-end report ❑ dissolution Candidate Full Name (if applicable) Office Sought and (District 1 UC�n.I Fr Ri� �lri b� n t1\A Residential Address L -p L'-( V I Telephone Number (optional): Op 0 V 3 60.L Committee Name - e' Name of Committee Treasurer Committee Mailing Addicss.. -- Telephone Number (optional):— r r" SUMMARY BALANCE INFORMA 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) Line 5: Ending Balance (line 3 minus line 4) 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: C' 6,v •t, (o - 1 l me 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 ictivity, 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 au roriTy prpn behalf of this committee in accordance with the requirements of M.G.L. c. 55. " iigned wider the penalties of perjury: r (TreasurerDate: s signature) IO ( V Affidavit of Candidate: (check I box only) Candidate with Committee and no activity independent of the committee 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, of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. 1 have not received any contributions, incurred any liabilities nor made any expenditures on my behalf during this reporting period. Candidate without Committees 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 acrd 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 tinder the authority or on behalf of this committee in accordance with the requirements of M.G.L, c. 55. Signed under the penalties of perjury: �� (Candidate's signature) Date: I V�Z7/