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Form CPF M 102: Campaign Finance; pq <br />Commonwealth Municipal Form <br />of Massachusetts U !ry C <br />Office of Campaign and Political A in I V 0 AM tU , J 9 <br />T 0 1 61 r'q (,I FRK <br />LE X1tVGtdh j1A <br />File with: 2/10/2011 <br />City or Town Clerk or Election Commission <br />Reporting Period - Beginning: 1/1/2011 Ending: 2/11/2011 <br />Type of report: Pre - election <br />Norman Cohen Norm Cohen for Selectman <br />Full Name of Candidate Committee Name <br />Selectman /Lexington Alice M Pierce <br />Office Sought/ District Name of Committee Treasurer <br />3 Captain Parker Arms #24 17 Volunteer Way <br />Lexington, MA 02421 Lexington, MA 02420 <br />Residential Address Committee Address <br />SUMMARY BALANCE INFORMATION <br />Ending Balance from previous report: <br />Total receipts this period: <br />Subtotal: <br />Total expenditures this period: <br />Ending Balance: <br />$569.48 <br />$0.00 <br />$569.48 <br />$0.00 <br />$569.48 <br />Total inkind contributions this period: <br />Total outstanding liabilities: <br />Name of bank(s) used: TD Bsnk <br />$0.00 <br />$0.00 <br />Affidavit of Committee Treasurer: <br />I certify that I have examined this report, including attached schedules and it is, to the best of my knowledge and <br />belief, a true and complete statement of all campaign finance activity including all contributions, loans, receipts, <br />expenditures, disbursements, inkind contributions and liabilities for this reporting period and represents the campaign <br />finance activity of all persons acting under the authority or on behalf of this committee in accordance with the <br />requirements of M.G.L. c. 55. <br />Signed under the penalties of perjury: <br />'2111 l � <br />Treasurer's signature (in in Date <br />Affidavit of Candidate (check 1 box only) <br />® Candidate with Committee and no activity independent of the committee <br />I certify that I have examined this report, and attached schedules and it is, to the best of my knowledge and belief, a <br />true and complete statement of all campaign finance activity, of all persons acting under the authority or on behalf of <br />this committee in accordance with the requirements of M.G.L. c. 55. I have not received any contributions, incurred <br />any liabilities nor made any expenditures on my behalf during this reporting period. <br />El Candidate without Committee OR candidate with independent activity filing separate report. <br />I certify that I have examined this report and attached schedules and it is, to the best of my knowledge and belief, <br />a true and complete statement of all campaign finance activity including contributions, loans, receipts, expenditures, <br />disbursements, inkind contributions and liabilities for this reporting period and represents the campaign <br />finance activity of all persons acting under the authority or on behalf of this committee in accordance with the <br />requirements of M.G.L. c. 55. <br />Signed under the penalties of perjury: <br />