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x .1;1 <br />Form CPF M 102: Campaign Finance Report <br />Commonwealth Municipal Form <br />of Massachusetts <br />Office of Campaign and Political Finance <br />File with: <br />City or Town Clerk or Election Commission <br />$0.00 <br />Reporting Period - Beginning: 1/1/2011 Ending: 2/11/2011 <br />Type of report: Pre - election <br />Michelle Ciccolo Committee to Elect Michelle Ciccolo <br />Full Name of Candidate Committee Name <br />Pl Board /Lexington Margaret Counts -Klebe <br />Office Sought/ District Name of Committee Treasurer <br />50 Shade Street 94 Winter Street <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 />Total inkind contributions this period: <br />Total outstanding liabilities: <br />Name of bank(s) used: TD Bank <br />2/15/2011 <br />$5,631.33 <br />$5,631.33 <br />$1,813.48 <br />$3,817.85 <br />$21*. 55 <br />$1,00@0 rrI <br />co <br />Affidavit of Committee Treasurer:o �- <br />I certify that I have examined this report, including attached schedules and it is, to the best knoo led nd <br />belief, a true and complete statement of all campaign finance activity including all contributio ,'`]0arf reqqa4,p ts, <br />expenditures, disbursements, inkind contributions and liabilities for this reporting period and represent's the- e°ampaign <br />finance activity of all persons acting under the authority or on behalf of this committee in accordance b th the <br />requirements of M.G.L. c. 55. <br />Signed under the penalties of perjury: <br />i U1/�fC 6 W 4- _ _ ' � <br />s signature (in ink) <br />0-/ /,- 0-0 t f <br />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 />❑ Candidate without Committee OR candidate with independent activity filing separate geport. <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 />e <br />