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Z� <br />rte_ <br />Form CFF N 102: Campaign Finance Report <br />. <br />0 —A' <br />-�.- Municipal Form <br />r Ofnce of Campaign and Political Flnanca t y J 9 ,r . <br />Commoawvirfi <br />of Nitn�ua.,rr 2011 JAN 1 R A j4 g r , <br />rile •.: <br />City or Toum Cleric or Election Comn-ission TOW .'� ' <br />Please print or type all information, except signatures. L E X IN G i M AA g <br />Fill in dates: Montt, pate Year conch Date Year <br />Reporting Period Bt3giririing April 1 2010 Ending December 31 2010 <br />Type or report: (Check one) <br />u 8th day prece&ng p reliminary ❑8th day precedi ele c t ion ❑3 day afte elec Myear-end rep Eissofution <br />Iane Jeon <br />Full Name of Candidate (if applicable) <br />Board of Selectmen <br />Clffiee Sought and District <br />7 Litchfield Rd. Lexington 02420 <br />Residential .Address <br />TeL No. (optional) <br />Committee to Elect Iane Jeon <br />Committee Name <br />Alan V. Seferian <br />Name of Committee Treasurer <br />10 Aueustus Rd. Lexington, MA <br />Committee Mailing Address <br />ST, MIN ARY BALANCE INFORMATION: <br />Line l.: Endin balance from previous report <br />Tine 2: Total receipts this period (page 2, line 1 1) <br />Line 3 : Subtotal (line 1 pleas line 2) <br />Line 4: Total expenditures this period (pace 3, line 11 <br />Line 5: End ing balance (line 3 minus Iine 4) <br />Tel. No. (optional) <br />111.61 <br />0.00 <br />111.61 <br />111.61 <br />0.00 <br />- <br />Line 6: Total ixz -kind contributions this period (page 4) S 0.00 <br />Lime 7: Total (all) outstanding liabilities (page 4) SI 0.00 <br />Line 8: Name o f barzk used I Citizens Bank (account closed) <br />I AMdavit of Commlttee Treasurer: <br />i ;ecru ; drat i have examined this report including attached schedules and it is, to the best of my knowledge and Wlief, a true and complete statement of all campai!w <br />fug. ^et ari4iry including all contributions, loans, receipts, txpendilures, disbum- meats, in -kind contributio:s and liabilities for this reporting period artd represcns the <br />campat zp futan,ce activ• of ail persons acting under the authority or on behalf of this committee in accordance with the requirements c. 55. <br />` Signed under the penalties of perjury: <br />Tr" surtr's signature (in ink) <br />Bata <br />FOR CANDMATE FILINGS ON LY: (CANDID MUST SIGN BELOW) <br />Affidavit of Candidatat (check 1 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 bat of my knowledge and belief, a true and complete statement ofall campaign <br />finance activity, of ail persons acting under the authority or on behalf of this comrninee in accordance with Lhc requirements of M.G.L a $5. I have not rectivcd any <br />conuibuliora, incurred any liabilities nor made any expenditures on my behalf during this rcpooing peric�l. <br />U Candidate without Conunittee OR Candidate with Independenf activity fil1ng separate report <br />i certify that I have examined this report including attached schedules and it is, to the best of my knowledge and beiiaf, a true and complete statement of all campaign <br />finance activity, including contributions, loans, receipts, expmditures, disbursements, in•kird contributions and liabilities for this reporting period and represents the <br />,:=paip f:rraticc activity of all persons acting under the authority or on behalf of this committee in accordance with the requirements of N1.G.L e, 55. <br />Sighed under the penalties of perjury-: <br />1 Candidate si ?mature (in ink) Date <br />i <br />