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Form CPF M 102: Campaign Finance Report <br />Municipal Form <br />uV Office of Campaign and Political Finance <br />Commonwealth <br />of Massachusetts <br />File with: City or Town Clerk or Election Commission <br />Fill in Reptifting Period' dabs:' `i Beginning Date: 02/20/2018 Ending Date: 03/25/2018 <br />Type of Repofit. (Check one) <br />❑ 8th day preceding preliminary ❑ 8th day preceding election 30 day after election ❑ year-end report ❑ dissolution <br />Jill I. Hai <br />Candidate Full Name (if applicable) <br />Selectman <br />Office Sought and District <br />6 Highland Avenue, Lexington, MA 02421 <br />Residential Address <br />Telephone Number (optional): (781) 862-3776 <br />Lill Hai for Selectman <br />Committee Name <br />Jodi R. Galin <br />Name of Committee Treasurer <br />P.O. Box 248, Lexington, MA 02420 <br />Committee Mailing Address <br />Telephone Number (optional): (781) 910-4681 <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 />�— 1,8s8.2s <br />VI <br />1,888.28 <br />1,022.44 <br />Line 5: Ending Balance (line 3 minus line 4) ` 865.841 <br />Line 6: Total in-kind contributions this period (page 6) 1 <br />Line 7: Total (all) outstanding liabilities (page 7) 0 <br />Line 8: Name of bank(s) used: citizens Bank <br />certify that I have examined this report including attached schedules and it is, to the best of my knowledge and belief, a tine and complete statement of all campaign finance <br />ctivity, including all contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign <br />finance activity of all persons acting under the authority or on behalf f thi coin ittee in accordance with the requirements of M.G.L. c. 55. <br />ligned under the penalties of perjury:-�w�'VV r i� (Treasurer's signature) Date:--F-—w <br />of Candidate: (check I 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 tine 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 OR Candidate with independent activity riling separate report <br />I certify that I have examined this report including attached schedules and it is, to the best of my knowledge and belief, a tine mrd complete statement of all campaign <br />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 ogling under the authority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. <br />under the penalties of perjury: <br />signature) Date:16.1 19 S 2 <br />