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IT 4 <br />Commonwealth <br />of Massachusetts <br />Form CPF M 102: Campaign Finance <br />Municipal Form <br />Office of Campaign and Political Finance <br />File with: <br />City or Town Clerk or Election Commission <br />Report <br />? <br />t v <br />t °' <br />-r7 <br />n <br />3:!/1 <br />11 <br />Y$` <br />N <br />Reporting Period - Beginning: 2/12/2011 Ending: 3/28/2011 <br />Type of report: 30 day after election <br />Michelle Ciccolo Committee to Elect Michelle Ciccolo <br />Full Name of Candidate Committee Name <br />Planning 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 j <br />Ending Balance from previous report: $3,842.85 <br />Total receipts this period: $1,236.95 <br />Subtotal: $5,079.80 <br />Total expenditures this period: $4,784.42 <br />Ending Balance: $295.38 <br />Total inkind contributions this period: $30.00 <br />Total outstanding liabilities: $0.00 <br />Name of bank(s) used: TD Bank <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 />r <br />Treasure 's signature (in ink) Da te <br />Af fitdavIt 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 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 beha -Af of this committee in accordance with the <br />requirements of M.G.L. c. 55. <br />Signed under the penalties of perjury: <br />