Laserfiche WebLink
Form CPF M 102: Campaign Finance Report <br />Municipal Form <br />Office of Campaign and Political Finance <br />Commonwealth <br />of Massachusetts <br />File with, City or Town Clerk or Flection Commission <br />Fill in Reporting Period dates: Beginning Date: ( e Po j Ending Date: jj� 6 4 uj ('s - <br />Type of Report: (Check one) <br />❑ 8th day preceding preliminary ❑ 8th day preceding election Kn-So day after election ❑ year-end report ❑ dissolution <br />Candidate Full Name (if applicable) <br />S(kt t C>M01tl1­1`EE K M6eL [ (0&—VA�flP((o <br />Office Sought and District <br />6 P�2z� i N -NC' WX1i`J(;rF0ry MA <br />Residential Address��y)) <br />E-mail: <br />Phone N (optional): <br />Line 1: 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 />(RJA&WTUf 70yl eL7 DrMI A K Wy1\,Ai <br />Committee Name <br />1t�N�=� J(7eSAy�N1�S <br />Name of Committee Treasurer <br />6 tPoc�NC" ,,=kltjb—ct)N, MA 02120e tee Mailing Address <br />E-mail: <br />Phone U (optional): <br />�GOr Gr <br />Olr W <br />$'1560'62 <br />Line 4: Total expenditures this period (page 5, line 14) 1 in, Ub <br />Line 5: Ending Balance (line 3 minus line 4)14 b d V 2 <br />Line 6: Total in-kind contributions this period (page 6) <br />Line 7: Total (all) outstanding liabilities (page 7) <br />Line 8: Name of bank(s) used: t D . <br />affidavit of Committee Treasurer: <br />certify that i have examined this report including attached schedules and it is, to the hest of my knowledge and belief, a true and complete statement ofall campaign Finance <br />cavity, including all contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign <br />Fiance activity of all persons acting under the authority or on behalf of this committee in accordance with (lie requirements of M.G.L. c. 55. <br />tinder the penalties of perjury: <br />Affidavit of Candidate: (check 1 box only) <br />signal=) Date: �Z�G�/XIIg <br />lCandidate with Committee and no activity independent of the committee <br />Fj certify that 1 have examined this tepon including attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all campaign finance <br />Lactivity, of all persons acting tinder the authority or on behalf of this committee in accordance with the requirements ofM.G.L, c. 55. 1 have not received any conMbutions, <br />incurred any liabilities nor made any expenditures on my behalf during this reporting period. <br />Candidate without Committee OR Candidate with independent activity filing 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 true and 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 at I persons acting 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 er'm^^t9'� Date: <br />P p J 7: (Candidate's signature) <br />